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CONTRACTOR'S AFFIDAVIT REGARDING EROSION <br />CONTROL AND TREATMENT OF DEWATERING WATER <br />AND STORMWATER FROM THE CONSTRUCTION SITE <br />TO BE MADE A PART OF THE STORMWATER POLLUTION PREVENTION PLAN) <br />This sworn statement is submitted for Indian River County Project No. 1024 for <br />INDIAN RIVER BLVD. AND 17T" ST. INTERSECTION IMPROVEMENTS <br />STATE OF _ <br />COUNTY OF <br />Personally before me the undersigned authority, appeared <br />administered, stated as follows: <br />1. This sworn statement is submitted by the CONTRACTOR, <br />2 <br />whose business address is <br />applicable) its Federal Identification No.(FEIN) is <br />FEIN, include the Social Security Number of the individual <br />My name is <br />entity named above is <br />who upon oath duly <br />and (if <br />If entity has no <br />signing this sworn statement: <br />and my relationship to the <br />3. I understand and agree that in addition to the Stormwater Management System Permit <br />issued by Indian River County, CONTRACTOR is responsible for complying with the <br />terms and conditions of the following as applicable to the site: <br />a. State of Florida Generic Permit for Stormwater Discharge From Large and Small <br />Construction Activities (for projects one acre or larger), <br />b. Stormwater Pollution Prevention Plan (regardless of project size), <br />c. St. Johns River Water Management District permit(s) (regardless of project size), <br />d. Florida Department of Environmental Protection permit(s) (regardless of project <br />size), <br />e. All other permits required for this project not specifically listed herein, and <br />f. All Codes and Ordinances of Indian River County. <br />4. I understand that "pollution" as defined by Florida Statutes Chapter 403.031(7) means: ".. . <br />the presence in the outdoor atmosphere or waters of the state of any substances, <br />contaminants, noise, or manmade or human -induced impairment of air or waters or <br />alteration of the chemical, physical, biological, or radiological integrity of air or water in <br />quantities or at levels which are or may be potentially harmful or injurious to human health <br />or welfare, animal or plant life, or property or which unreasonably interfere with the <br />enjoyment of life or property, including outdoor recreation unless authorized by applicable <br />law." <br />5. I understand that in addition to the definition set fort <br />h in Item 5 above, "pollution" is also <br />defined by paragraph 1.6 of Section 02225 of the Technical Specifications for this <br />Project. <br />01025-11 Technical Specifications <br />F:\Public Works\ENGINEERING DIVISION PROJECTS\1024-17thStreet and IR Blvd Intersection\Admim\Contract <br />DocumentslTechnical Specifications.doc <br />