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This certification is hereby signed in reference to the above named project Company Address Telephone Number Type of Construction Service Provided Printed Name Title Signature Date Form 25D-105 Rev.05/11. State of Alaska Department of Transportation Public Facilities Statewide Design Engineering Services SWPPP SUBCONTRACTOR CERTIFICATION Project Name Project Location Operator s As a subcontractor you are required to comply with the Construction General Permit CGP and the conditions of the Stormwater Pollution Prevention Plan SWPPP for any work that you perform on-site. Any person or group who violates any condition of the SWPPP may be subject to substantial penalties or loss of contract. You are encouraged to advise each of your employees working on this project of the requirements of the SWPPP. A copy of the SWPPP is available for your review at the office trailer. Each subcontractor engaged in activities at the construction site that could impact stormwater must be identified and sign the following certification statement I certify under the penalty of law that I have read and understand the terms and conditions of the SWPPP for the above designated project and agree to follow the BMPs and practices described in the SWPPP. State of Alaska Department of Transportation Public Facilities Statewide Design Engineering Services SWPPP SUBCONTRACTOR CERTIFICATION Project Name Project Location Operator s As a subcontractor you are required to comply with the Construction General Permit CGP and the conditions of the Stormwater Pollution Prevention Plan SWPPP for any work that you perform on-site. Any person or group who violates any condition of the SWPPP may be subject to substantial penalties or loss of contract. Any person or group who violates any condition of the SWPPP may be subject to substantial penalties or loss of contract. You are encouraged to advise each of your employees working on this project of the requirements of the SWPPP. You are encouraged to advise each of your employees working on this project of the requirements of the SWPPP. A copy of the SWPPP is available for your review at the office trailer. Each subcontractor engaged in activities at the construction site that could impact stormwater must be identified and sign the following certification statement I certify under the penalty of law that I have read and understand the terms and conditions of the SWPPP for the above designated project and agree to follow the BMPs and practices described in the SWPPP. State of Alaska Department of Transportation Public Facilities Statewide Design Engineering Services SWPPP SUBCONTRACTOR CERTIFICATION Project Name Project Location Operator s As a subcontractor you are required to comply with the Construction General Permit CGP and the conditions of the Stormwater Pollution Prevention Plan SWPPP for any work that you perform on-site. Any person or group who violates any condition of the SWPPP may be subject to substantial penalties or loss of contract. You are encouraged to advise each of your employees working on this project of the requirements of the SWPPP..

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