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, specifically related to Executive Order 2021-06 from October 21, 2021. The form requires contractors and grantees to certify compliance with Pennsylvania's labor and workforce safety laws, including 13 specific statutes ranging from the Construction Workplace Misclassification Act to the Apprenticeship and Training Act. The certification mandates that contractors affirm they are in full compliance with these laws and understand the potential penalties for false certifications, which can include contract termination and a three-year ineligibility to bid on contracts under Pennsylvania law.

The document outlines strict requirements for contractors, emphasizing the Commonwealth's commitment to ensuring safe and healthy work environments. By signing this form, the contractor/grantee acknowledges their responsibility to immediately report any changes in compliance status to the purchasing agency and understands they are subject to provisions of 18 Pa. C.S. § 4904 regarding unsworn falsification to authorities. The form provides blank spaces for signature, printed name, title, and contractor/grantee name, and was published on 02/04/2022 with a standardized form number BOP-2201.