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. The form requires contractors and grantees to certify compliance with Pennsylvania's worker protection laws, including the Construction Workplace Misclassification Act, Employment of Minors Child Labor Act, Minimum Wage Act, Prevailing Wage Act, Equal Pay Law, and various other labor-related statutes. Pennsylvania law establishes penalties for providing false certifications, including contract termination and three-year ineligibility for future contracts under 62 Pa. C.S. § 531.

The certification process requires the official named below to confirm compliance with all applicable Pennsylvania state labor and workplace safety laws, with penalties of up to 18 Pa. C.S. § 4904 for submitting false information to authorities. The form includes signature fields for the certifying official, their printed name, title, and contractor/grantee name, along with a date field. This certification is subject to the Purchasing Agency's provisions and penalties, and contractors must report any changes in their compliance status to maintain their certification throughout the contract term.