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, dated October 21, 2021. The form requires contractors and grantees to certify compliance with Pennsylvania's state 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 certification requires an authorized official to confirm that their organization is compliant with all listed Pennsylvania state labor and workplace safety laws. The document outlines potential penalties for non-compliance, including contract termination and a three-year ineligibility to bid on contracts under 62 Pa. C.S. § 531. The form provides spaces for signature, printed name, title, and contractor/grantee name, and was published on 02/04/2022 with a form number of BOP-2201. The certification also includes an understanding that any changes in compliance status must be immediately reported to the purchasing agency, with potential legal consequences for unsworn falsification to authorities.