What counts as PFAS for reporting?

PFAS refers to a broad family of fluorinated compounds; list specific analytes tested (for example, PFOA, PFOS) rather than using the umbrella term only. Laboratories and regulators typically require named compounds to assess compliance.

How should lab results be presented?

Present numeric concentrations with units, detection limits, method names, lab accreditation, and chain-of-custody attachments so third parties can interpret and verify results.

Are electronic signatures valid?

Yes. Electronic signatures that demonstrate intent, consent, attribution, and retention meet ESIGN (15 U.S.C. ch. 96) and UETA standards in most U.S. jurisdictions when properly implemented.

Who must sign the statement?

An authorized representative with authority to bind the organization should sign. Document the signer’s title and basis of authority in the statement for legal clarity.

Do PFAS statements require notarization?

Not usually required unless a contract or state rule explicitly demands notarization or a sworn affidavit; remote online notarization (RON) may be acceptable where state law permits.

How do I correct an error after submission?

Issue a corrected statement that references the original, clearly marks revisions, attaches corrected lab reports, and is signed by an authorized party to maintain an auditable record.

Electronic Signature
Templates
Miscellaneous
Environmental PFAS Statement

Environmental PFAS Statement

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

Environmental PFAS Statement and Agreement

Client Name: Contractor Name:

Client Address Contractor Address

Whereas

WHEREAS, Client requires materials, products, or services that are free from regulated per- and polyfluoroalkyl substances (PFAS) to the extent required by applicable environmental standards and the parties' contractual obligations; and

WHEREAS, Contractor has represented that it has procured, tested, and will supply materials and provide services described in this Agreement consistent with PFAS declarations and testing protocols set forth herein; and

WHEREAS, the parties wish to document Contractor's PFAS-related representations, certifications, testing and notification obligations, and the commercial terms applicable to the supply and any required remediation or corrective actions.

Scope of Work

Describe services, materials, and PFAS-related deliverables

PFAS Statement and Certifications

Contractor certifies the following statements are true and accurate as of the date of execution:

No PFAS present above detection limits in supplied materials or products as tested in accordance with the testing protocol specified below.

PFAS detected in supplied materials or products. If checked, describe concentrations and locations:

Testing Performed

Testing performed prior to delivery Date of most recent test:

Laboratory and Method

Test reports and chain-of-custody records attached to this Statement

Sample Identifiers

Remediation, Notification and Indemnity

If PFAS in supplied materials or resulting from Contractor's performance are identified post-delivery at concentrations above applicable regulatory or contractual limits, Contractor shall, at Contractor's sole cost and expense: (a) notify Client in writing within three (3) business days of discovery; (b) coordinate and implement corrective action and remediation acceptable to Client and necessary to achieve compliance; and (c) indemnify, defend and hold Client harmless from and against all claims, liabilities, losses, costs, and expenses (including reasonable attorney fees) arising from such PFAS.

Contractor remedy description (if remediation anticipated)

Payment Terms

Total Contract Amount Payment Schedule Late Payment Fee

Term and Termination

This Agreement commences on and will continue until unless earlier terminated in accordance with this Section.

Either party may terminate this Agreement for material breach that is not cured within days' written notice. Contractor's unresolved failure to disclose PFAS or to perform required remediation shall constitute material breach permitting immediate termination by Client.

Confidentiality

Each party shall maintain as confidential any non-public technical data, testing results, reports, and business information provided by the other party that is designated as confidential or that a reasonable person would understand to be confidential. Confidential information shall not be disclosed except to employees, contractors, or regulators with a need to know or as required by law; provided that the disclosing party shall provide prompt written notice of compelled disclosure to allow the other party to seek protective relief.

Governing Law

This Agreement will be governed by and construed in accordance with the laws of the state indicated below. The parties submit to the exclusive jurisdiction of the state and federal courts located in that state for dispute resolution.

Governing State

Entire Agreement

This Agreement, including any attached PFAS test reports and schedules, constitutes the entire agreement between the parties with respect to its subject matter and supersedes all prior negotiations, representations, and agreements. Any amendment must be in writing and signed by authorized representatives of both parties.

Certifications and Acknowledgments

By signing below, each signatory certifies under penalty of civil liability that the information provided in this Environmental PFAS Statement is true and correct to the best of their knowledge, that the party has authority to make the certifications herein, and that the party will comply with the testing, notification, remediation, and indemnity obligations set forth above.

CLIENT

Printed Name:

By:

Date:

Title:

CONTRACTOR

Printed Name:

By:

Date:

Title:

What an Environmental PFAS Statement Is

An Environmental PFAS Statement is a formal disclosure or attestation that describes the presence, concentration, and testing methods for per- and polyfluoroalkyl substances (PFAS) associated with a product, material, property, or process. It typically lists tested compounds, analytical results with detection limits, laboratory accreditation, chain-of-custody information, and any remedial actions or restrictions. Organizations use the statement for procurement diligence, regulatory reporting, transaction due diligence, contractor compliance, and internal risk management as PFAS regulatory requirements continue to evolve across federal and state agencies.

Why a Clear PFAS Statement Matters

A concise Environmental PFAS Statement reduces ambiguity about chemical risk, supports regulatory and contract compliance, and documents testing and controls for stakeholders and regulators.

Who Prepares and Relies on PFAS Statements

Multiple stakeholders prepare or request PFAS statements to manage liability and meet regulatory or contractual requirements.

Manufacturers and suppliers providing material composition disclosures and compliance data to customers and regulators.
Real estate sellers, buyers, and environmental consultants during property transactions and site assessments.
Procurement, construction, and project managers who require material compliance for specifications and warranties.

Depending on the transaction, signatories may include an authorized company official, certified laboratory representative, or environmental consultant with delegated authority.

Core Sections Found in a Professional PFAS Statement

A practical statement is organized, traceable, and includes test data plus claims and limits to support clear interpretation by third parties.

Declaration

Who is attesting and their authority, including corporate name and title of the signatory for legal accountability.

Scope

Products, materials, locations, or processes covered, with sample identifiers and relevant dates for clarity.

Test Results

Quantitative results with units, detection limits, and flags for non-detects so readers can assess compliance numerically.

Analytical Methods

Laboratory method names (e.g., EPA methods), instrument type, and any deviations from standard protocols.

Chain of Custody

Sample handling, collection dates, courier or chain-of-custody documentation ensuring data integrity.

Limitations & Actions

Interpretive notes, risk mitigations, storage/disposal instructions, and any remediation commitments or restrictions.

Step-by-Step: Prepare and Sign a PFAS Statement

Follow a consistent sequence to collect evidence, document results, and complete the statement accurately.

01

Assemble Records: Gather sample IDs, lab reports, chain-of-custody, and applicable specifications.
02

Order Laboratory Tests: Select accredited labs and specify methods and detection limits.
03

Populate Statement: Complete required fields with exact values and attach supporting reports.
04

Sign and Distribute: Obtain authorized signature, retain copies, and send to stakeholders or regulators.

Configuring an Online PFAS Statement Workflow

Design the digital workflow to capture evidence, require attachments, and enforce signer authentication for defensibility.

Field	Configuration
Authorization	Require signer role validation and documented authority for attestations.
Authentication	Use email + OTP or stronger methods for higher assurance.
Attachments	Make laboratory reports and COC required uploads before signature.
Archive	Store signed PDFs with audit trail and tamper-evidence.

Where a Completed Statement Typically Goes

A signed statement moves through a predictable set of recipients depending on purpose and contractual or regulatory obligations.

Regulatory Submission: Sent to state or federal environmental authority where required.
Supplier Records: Retained by suppliers for compliance and future audits.
Transaction Closing: Included in due diligence packages for property or product sales.
Public Disclosure: Published when required by law or stakeholder agreements.

Technical Requirements for Digital Preparation and Signing

Choose tools that preserve attachments, enforce authentication, and maintain an immutable audit trail.

File Formats: Accept PDF/A and Word DOCX for archival and readability.
Integrations: Link to cloud storage and LMS for record retention.
Authentication: Support email OTP, SMS, and optional KBA for higher assurance.

Ensure the platform supports ESIGN/UETA legal requirements, stores audit logs, and offers encryption in transit and at rest for evidentiary weight.

Essential Security and Audit Items to Include

Signature Date: Timestamp of execution

Signer Identity: Name and title

Chain of Custody: Sample handling records

Lab Accreditation: Accrediting body listed

Method & MDL: Analytical method noted

Audit Trail: Action log preserved

Common Errors to Avoid When Preparing the Statement

Omitting the analytical method or detection limit, which prevents interpretation of non-detects and can invalidate comparisons.
Failing to attach an accredited lab report and chain-of-custody, leaving results unsupported and contestable.
Using vague product or location descriptions instead of specific identifiers like batch numbers or parcel IDs.
Allowing an unauthorized staff member to sign without documented delegation or corporate authority, risking unenforceability.

Key Risks and Potential Consequences

Regulatory Fines: Monetary penalties and enforcement actions

Contract Liability: Breach claims or warranty disputes

Remediation Costs: Cleanup and disposal expenses

Civil Litigation: Potential class or third-party suits

Operational Impact: Supply chain and product delays

Reputational Harm: Loss of trust among customers

Timing and Typical Deadlines

Deadlines vary by context; include laboratory turnaround, request-response windows, and any regulatory reporting dates in the project plan.

Response on Request:

Provide statement upon customer or regulator request promptly; no universal statute sets a standard interval.

Lab Turnaround:

Typically 2–6 weeks depending on compound list and method.

Retention Start Date:

Begin retention from report issuance or signature date, whichever is later.

Contractual Deadlines:

Align statement date with closing or delivery milestones in agreements.

Regulatory Reporting:

Meet any state-specific reporting dates when statutes require disclosure.

Frequently Asked Questions About PFAS Statements

Answers address scope, evidentiary standards, signing authority, eSignature validity, and correction procedures for common scenarios.

Need help? Contact support

What counts as PFAS for reporting?
PFAS refers to a broad family of fluorinated compounds; list specific analytes tested (for example, PFOA, PFOS) rather than using the umbrella term only. Laboratories and regulators typically require named compounds to assess compliance.
How should lab results be presented?
Present numeric concentrations with units, detection limits, method names, lab accreditation, and chain-of-custody attachments so third parties can interpret and verify results.
Are electronic signatures valid?
Yes. Electronic signatures that demonstrate intent, consent, attribution, and retention meet ESIGN (15 U.S.C. ch. 96) and UETA standards in most U.S. jurisdictions when properly implemented.
Who must sign the statement?
An authorized representative with authority to bind the organization should sign. Document the signer’s title and basis of authority in the statement for legal clarity.
Do PFAS statements require notarization?
Not usually required unless a contract or state rule explicitly demands notarization or a sworn affidavit; remote online notarization (RON) may be acceptable where state law permits.
How do I correct an error after submission?
Issue a corrected statement that references the original, clearly marks revisions, attaches corrected lab reports, and is signed by an authorized party to maintain an auditable record.

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