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

This 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 labor and workforce safety laws, including 13 specific statutes such as the Construction Workplace Misclassification Act, Employment of Minors Child Labor Act, Minimum Wage Act, and Prevailing Wage Act.

The certification form mandates that contractors confirm they are compliant 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, certifying compliance and understanding that any changes in compliance status must be reported immediately to the purchasing agency, with potential subject to provisions and penalties under 18 Pa. C.S. § 4904 for unsworn falsification to authorities.