04. BOP-2201 WORKER PROTECTION AND INVESTMENT CERTIFICATION FORM.pdf

This is a Worker Protection and Investment Certification Form issued by the Commonwealth of Pennsylvania under Executive Order 2021-06, dated October 21, 2021. The document outlines the state's responsibility to ensure worker safety and compliance with various labor laws. The form requires contractors and grantees to certify compliance with 13 specific labor and workplace safety regulations, including the Construction Workplace Misclassification Act, Employment of Minors Child Labor Act, Minimum Wage Act, Prevailing Wage Act, and others.

The form highlights that Pennsylvania law establishes penalties for providing false certifications, including potential contract termination and a three-year ineligibility to bid on contracts under 62 Pa. C.S. § 531. The certification requires an authorized official to confirm the contractor/grantee's compliance with applicable state labor and workplace safety laws, with an understanding that any changes in compliance status must be reported immediately. The document includes blank fields for signature, name, title, and contractor/grantee information, and was published on 02/04/2022.