04. BOP-2201 WORKER PROTECTION AND INVESTMENT CERTIFICATION FORM.pdf

The document is a Worker Protection and Investment Certification Form issued by the Commonwealth of Pennsylvania pursuant to 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 such as the Construction Workplace Misclassification Act, Employment of Minors Child Labor Act, Minimum Wage Act, and Prevailing Wage Act.

The certification form establishes legal requirements for contractors, including a mandate to comply with all applicable Pennsylvania state labor and workplace safety laws. The document outlines potential penalties for providing false certifications, including contract termination and a three-year ineligibility to bid on contracts under 62 Pa. C.S. § 531. The form requires an authorized official to sign and confirm the contractor's or grantee's compliance, with an understanding that any changes in compliance status must be immediately reported to the purchasing agency, and that providing false information is subject to the provisions and penalties of 18 Pa. C.S. § 4904 (Unsworn falsification to authorities).