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 ranging from the Construction Workplace Misclassification Act to the Apprenticeship and Training Act.

The certification requires an authorized official to confirm that their organization is compliant with all listed Pennsylvania state labor and workplace safety laws. The document establishes legal consequences for providing false certifications, including potential contract termination and a three-year ineligibility to bid on contracts under 62 Pa. C.S. § 531. The form includes blank fields for signature, name, title, and contractor/grantee name, and was published on 02/04/2022, with a document code of BOP-2201.