04 Worker Protection-Investment Cert Form.pdf
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- Attached to
- Emergency Care Services
- Solicitation number
- 4400030450
- Issued by
- Pennsylvania
About this file
The document is a Worker Protection and Investment Certification Form from the Commonwealth of Pennsylvania. The form requires contractors and grantees of the Commonwealth to certify that they are in compliance with various Pennsylvania state labor and workplace safety laws, including the Unemployment Compensation Law, Workers' Compensation Law, and other applicable state laws. The certification must be signed by an authorized official of the contractor or grantee, and false certifications can result in contract termination and three-year ineligibility to bid on Commonwealth contracts.
The related state and local contract opportunity is for Emergency Care Services, which qualifies responsible and responsive contractors to provide turnkey congregate sheltering services and large-scale feeding operations in response to an emergency or Governor-declared disaster. Suppliers must register as a PA Supplier and create a user profile within the JAGGAER portal to complete the qualification requirements. Qualifications will only be accepted electronically through JAGGAER, and technical support is available.
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WORKER PROTECTION AND INVESTMENT CERTIFICATION FORM
A. Pursuant to Executive Order 2021-06, Worker Protection and Investment (October 21, 2021), the Commonwealth is responsible for ensuring that every worker in Pennsylvania has a safe and healthy work environment and the protections afforded them through labor laws. To that end, contractors and grantees of the Commonwealth must certify that they are in compliance with Pennsylvania’s Unemployment Compensation Law, Workers’ Compensation Law, and all applicable Pennsylvania state labor and workforce safety laws including, but not limited to:
1. Construction Workplace Misclassification Act
2. Employment of Minors Child Labor Act
3. Minimum Wage Act
4. Prevailing Wage Act
5. Equal Pay Law
6. Employer to Pay Employment Medical Examination Fee Act
7. Seasonal Farm Labor Act
8. Wage Payment and Collection Law
9. Industrial Homework Law
10. Construction Industry Employee Verification Act
11. Act 102: Prohibition on Excessive Overtime in Healthcare
12. Apprenticeship and Training Act
13. Inspection of Employment Records Law
B. Pennsylvania law establishes penalties for providing false certifications, including contract termination; and three-year ineligibility to bid on contracts under 62 Pa. C.S. § 531 (Debarment or suspension).
CERTIFICATION
I, the official named below, certify I am duly authorized to execute this certification on behalf of the contractor/grantee identified below, and certify that the contractor/grantee identified below is compliant with applicable Pennsylvania state labor and workplace safety laws, including, but not limited to, those listed in Paragraph A, above. I understand that I must report any change in the contractor/grantee’s compliance status to the Purchasing Agency immediately. I further confirm and understand that this Certification is subject to the provisions and penalties of 18 Pa. C.S. § 4904 (Unsworn falsification to authorities).
Signature Date
Name (Printed)
Title of Certifying Official (Printed)
Contractor/Grantee Name (Printed)
BOP-2201
Published: 02/04/2022
| WORKER PROTECTION AND INVESTMENT CERTIFICATION FORM |
| CERTIFICATION |
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