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.� <br />(TO BE MADE A PART OF THE STORMWATER POLLUTION PREVENTION PLAN) <br />STATE OF _ <br />COUNTY OF <br />Personally before me the undersigned officer, authorized by the laws of saidstate <br />tate to <br />administer oaths, comes <br />says: That he or she is the CONTRACTOR with whom Indian River County, Florida, a political <br />subdivision of said state, did on the day of <br />20 , enter into a contract for the performance of certain work, more particularly described <br />as follows: <br />POWERLINE ROAD FROM C.R. 510 NORTH TO SEBASTIAN CITY LIMITS <br />UNDER PENALTY OF PERJURY, affiant further says that he or she understands and <br />shall comply with, the terms and conditions of the following: <br />1. The State of Florida Generic Permit for Stormwater Discharge From Large and <br />Small Construction Activities, <br />2, The Stormwater Pollution Prevention Plan, <br />3, Section 02225 of the Specifications - Erosion Control and Treatment of <br />Dewatering Water and Stormwater From the Construction Site, <br />4, The St. Johns River Water Management District permit, and <br />5. All Codes and Ordinances of Indian River County. <br />(Corporate Seal) <br />(Contractor) <br />By: <br />Subscribed and sworn to before me this day of 120 <br />Notary Public <br />My Commission expires: <br />+ + END OF SECTION + + <br />01025-11 Technical Specifications <br />FAEngineering\Capital Projects\0217-Powerline Road\Bid Documents\Technical Specifications.doc <br />