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

This is a Worker Protection and Investment Certification Form issued by the Commonwealth of Pennsylvania pursuant to Executive Order 2021-06, Worker Protection and Investment (October 21, 2021). The form establishes certification requirements for ensuring that every worker in Pennsylvania has safe and healthy work environments and that protections are afforded through labor laws, with contractors and grantees of the Commonwealth required to certify compliance with Pennsylvania's Unemployment Compensation Law, Workers' Compensation Law, and all applicable Pennsylvania state labor and workforce safety laws. The certification applies to thirteen specific acts including Construction Workplace Misclassification Act, Employment of Minors Child Labor Act, Minimum Wage Act, Prevailing Wage Act, Equal Pay Law, Employer to Pay Employment Medical Examination Fee Act, Seasonal Farm Labor Act, Wage Payment and Collection Law, Industrial Homework Law, Construction Industry Employee Verification Act, Act 102: Prohibition on Excessive Overtime in Healthcare, Apprenticeship and Training Act, and Inspection of Employment Records Law.

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). The certification requires the official named below to certify under penalty of perjury that they are duly authorized to execute this certification on behalf of the contractor/grantee identified below, and that the contractor/grantee is compliant with applicable Pennsylvania state labor and workplace safety laws, including but not limited to those listed in Paragraph A above, with the understanding that this Certification is subject to the provisions and penalties of 18 Pa. C.S. § 4904 (Unsworn falsification to authorities). The form includes signature fields for Date, Name (Printed), Title of Certifying Official (Printed), and Contractor/Grantee Name (Printed), and was published on 02/04/2022 as document BOP-2201.