04 Attachment B Worker Protection Form.docx
DOCX document 33 KB Posted
- Attached to
- UBIQUITI Equip for DGS_CMS (REBID)
- Solicitation number
- 6100066423
- Issued by
- Berks County, Pennsylvania
About this file
This is a Worker Protection and Investment Certification Form required by the Commonwealth of Pennsylvania's Department of General Services on behalf of Commonwealth Media Services for the procurement of Ubiquiti Network Equipment. The form mandates that all contractors and grantees certify compliance with Pennsylvania's Unemployment Compensation Law, Workers' Compensation Law, and applicable state labor and workforce safety laws, including provisions related to workplace misclassification, child labor, minimum wage, prevailing wage, equal pay, and employment records inspection. The certification must be executed by an authorized official of the contractor or grantee and submitted as part of the bid package. The Invitation for Bids is being reissued with IT Terms and Conditions, and questions regarding the solicitation must be submitted to ra-gsfarmprocunit@pa.gov by 1 p.m. on August 4, 2026, with the solicitation number 6100066423 included in the subject line.
Pennsylvania law establishes significant penalties for false certifications, including immediate contract termination and three-year ineligibility to bid on future Commonwealth contracts under 62 Pa. C.S. Section 531 (Debarment or Suspension). Additionally, providers are subject to criminal penalties under 18 Pa. C.S. Section 4904 (Unsworn Falsification to Authorities) for providing false information. Contractors and grantees must immediately report any changes in their compliance status to the Purchasing Agency. No substitutions of equipment are permitted in this rebid solicitation, and an item has been removed from the original specifications as obsolete.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 05 Attachment C - Required Documents.doc | DOC document | |
| 03 Attachment A_Rec Limitations Act Requirements.doc | DOC document | |
| 02 CMS Ubiquiti Equipment Specifications.docx | DOCX document | |
| IT_Terms_and_Conditions 4.1.26.docx | DOCX document | |
| locating and responding to a solicitation.pdf |
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Text version
WORKER PROTECTION AND INVESTMENT CERTIFICATION FORM
A. Pursuant to Executive Order 2021-06, Worker Protection and Investment (October 21, 2021), the Commonwealth is responsible for ensuring that every worker in Pennsylvania has a safe and healthy work environment and the protections afforded them through labor laws. To that end, contractors and grantees of the Commonwealth must certify that they are in compliance with Pennsylvania’s Unemployment Compensation Law, Workers’ Compensation Law, and all applicable Pennsylvania state labor and workforce safety laws including, but not limited to:
1. Construction Workplace Misclassification Act
2. Employment of Minors Child Labor Act
3. Minimum Wage Act
4. Prevailing Wage Act
5. Equal Pay Law
6. Employer to Pay Employment Medical Examination Fee Act
7. Seasonal Farm Labor Act
8. Wage Payment and Collection Law
9. Industrial Homework Law
10. Construction Industry Employee Verification Act
11. Act 102: Prohibition on Excessive Overtime in Healthcare
12. Apprenticeship and Training Act
13. Inspection of Employment Records Law
B. Pennsylvania law establishes penalties for providing false certifications, including contract termination; and three-year ineligibility to bid on contracts under 62 Pa. C.S. § 531 (Debarment or suspension).
CERTIFICATION
I, the official named below, certify I am duly authorized to execute this certification on behalf of the contractor/grantee identified below, and certify that the contractor/grantee identified below is compliant with applicable Pennsylvania state labor and workplace safety laws, including, but not limited to, those listed in Paragraph A, above. I understand that I must report any change in the contractor/grantee’s compliance status to the Purchasing Agency immediately. I further confirm and understand that this Certification is subject to the provisions and penalties of 18 Pa. C.S. § 4904 (Unsworn falsification to authorities).
| Signature |
| Date |
Name (Printed)
Title of Certifying Official (Printed)
Contractor/Grantee Name (Printed)
BOP-2201
Published: 02/04/2022 image1.png
File details come from the government source that posted it. Updated .