00462, Public Works Employment Verification Form. 2026.pdf
PDF 131 KB Posted
- Attached to
- Wetmore Run Well Development
- Solicitation number
- Not on record
- Issued by
- Potter County, Pennsylvania
About this file
This is a Public Works Employment Verification Form for the Wetmore Run Well Development project administered by the Galeton Borough Authority in Pennsylvania. The project involves construction work to bring two pre-drilled and cased water wells online, install interconnecting piping to existing treatment facilities, provide new electrical power service entrances and emergency generators, upgrade existing treatment facilities, and tie into the municipal potable water distribution system. Bids are requested for three prime contracts: 2026-W1 (General/Mechanical), 2026-W2 (Waterline Replacement), and 2026-W3 (Electrical/Controls/Instrumentation). The bid submission deadline is 2:00 PM local time on Tuesday, July 28, 2026, with public bid opening and reading scheduled for 2:05 PM on the same date at 24 West Main Street, Galeton, PA 16922. A non-mandatory pre-bid conference is scheduled for Tuesday, July 7, 2026 at 2:00 PM at the same location. Bidding documents are available for examination at no cost electronically via www.PennBid.net or at the issuing office (Century Engineering, a Kleinfelder Company) Monday through Thursday from 8:00 AM to 5:00 PM or Friday from 8:00 AM to Noon. Documents may be obtained electronically at no cost or purchased for $250 (non-refundable) including USPS regular mail delivery.
The employment verification form serves as a compliance document requiring contractors to verify that workers employed on this public works project meet Pennsylvania's prevailing wage and employment standards. As a public works project funded by the municipal authority, all bidders and their subcontractors must complete and submit this form to demonstrate compliance with applicable labor requirements prior to contract award.
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Text version
Galeton Borough Authority Wetmore Run Well Development
2026-W1, 2026-W2 & 2026-W3
CEI File No. 25001215.056B 00462 - 1 PUBLIC WORKS EMPLOYMENT VERIFICATION
Commonwealth of Pennsylvania
Public Works Employment Verification Form Complete and return the form to the contracting Public Body prior to the award of the contract.
Company Legal Name:
Doing Business As:
(if different from Legal Name) Mailing Address:
Street Address 1
Street Address 2
City State Zip Code
Check one: Contractor Subcontractor
Contracting Public Body:
Contract/Project Number:
Project Description:
Project Location:
Date Enrolled in E-Verify (MM/DD/YYYY):
As a contractor/subcontractor for the above referenced public works contract, I hereby affirm that as of today’s date, , our company is in compliance with the Public Works Employment Verification Act (‘the Act’) through utilization of the federal E-Verify Program (EVP) operated by the United States Department of Homeland Security. To the best of my/our knowledge, all employees hired are authorized to work in the United States.
It is also agreed to that all public works contractors/subcontractors will utilize the federal EVP to verify the employment eligibility of each new hire within five (5) business days of the employee start date throughout the duration of the public works contract. Documentation confirming the use of the federal EVP upon each new hire shall be maintained in the event of an investigation or audit.
I, , authorized representative of the company above, attest that the information contained in this verification form is true and correct and understand that the submission of false or misleading information in connection with the above verification shall be subject to sanctions provided by law.
Authorized Representative Signature Date of Signature Printed Name:
Phone Number: Email:
File details come from the government source that posted it. Updated .