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 the contractor or grantee to confirm they are compliant with all applicable 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 is designed to be signed by an authorized official who will attest to the contractor/grantee's compliance and understand the obligation to immediately report any changes in compliance status to the purchasing agency. The form was published on 02/04/2022 and includes blank fields for signature, name, title, and contractor/grantee information.