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 under 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 form establishes legal requirements for contractors, including a mandatory certification that they are compliant with all applicable Pennsylvania state labor and workplace safety laws. The document warns that providing false certifications can result in significant penalties, including contract termination and a three-year ineligibility to bid on contracts under 62 Pa. C.S. § 531 (Debarment or suspension). The certification must be signed by an authorized official who understands the obligation to report any changes in compliance status and acknowledges potential legal consequences under 18 Pa. C.S. § 4904 for unsworn falsification to authorities.