04 BOP-2201 EO 2021-06 Worker Protection Form BOP FINAL.pdf

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Attached to
Tree Trimmer AWD Boom Saw State and local contract opportunity
Solicitation number
6100063756
Issued by
Dauphin County, Harveys Lake Borough, Pennsylvania

About this file

This document is a Worker Protection and Investment Certification Form issued by the Commonwealth of Pennsylvania under Executive Order 2021-06, dated October 21, 2021. The form requires contractors and grantees to certify compliance with Pennsylvania's state labor and workforce safety laws, including 13 specific acts ranging from the Construction Workplace Misclassification Act to the Inspection of Employment Records Law.

The certification requires an authorized official to confirm the organization's compliance with these labor laws, with potential penalties for false certification including contract termination and a three-year ban from bidding on Commonwealth contracts. The form must be signed and includes fields for the certifying official's signature, name, title, and the contractor/grantee's name. The document was published on 02/04/2022 and is identified with the form number BOP-2201, reflecting the Commonwealth's commitment to ensuring safe and legally compliant work environments for Pennsylvania workers.

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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

WORKER PROTECTION AND INVESTMENT CERTIFICATION FORM
CERTIFICATION

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