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

This is a Worker Protection and Investment Certification Form for state and local contracting in Pennsylvania, pursuant to Executive Order 2021-06, Worker Protection and Investment (October 21, 2021). The form certifies compliance with Pennsylvania's worker protection laws, including safety laws and various employment-related acts such as the Construction Workplace Misclassification Act, Employment of Minors Child Labor Act, Minimum Wage Act, Prevailing Wage Act, Equal Pay Law, and others. Contractors must establish penalties for providing false certifications, including contract termination, and the certification is subject to provisions and penalties of 18 Pa. C.S. § 531 (Debarment or suspension).

The certification process requires contractors to confirm compliance with Pennsylvania state labor and workplace safety laws, including but not limited to thirteen specific acts ranging from workplace misclassification to industrial homework regulations. The form includes spaces for signature, date, printed name, title of certifying official, and contractor/grantee name, indicating it must be completed by an authorized representative. Any sworn falsification to authorities is subject to penalties under 18 Pa. C.S. § 4904, and the document was published on 02/04/2022 with form number BOP-2201.