06. BOP-2201 Worker Protection and Investment Form.pdf

PDF 75 KB Posted

Attached to
DSA FD16 Right Asaph Road
Solicitation number
6100060519
Issued by
Warren County, Pennsylvania

About this file

The provided document is a Worker Protection and Investment Certification Form issued by the Commonwealth of Pennsylvania. This form requires contractors and grantees of the Commonwealth to certify their compliance with various Pennsylvania state labor and workplace safety laws, including but not limited to the Construction Workplace Misclassification Act, Minimum Wage Act, Prevailing Wage Act, and Apprenticeship and Training Act. The certification affirms that the contractor or grantee is duly authorized to execute the form and is compliant with the applicable laws. Failure to provide accurate certification can result in contract termination and a three-year ineligibility to bid on Commonwealth contracts.

The related state and local contract opportunity is for the Commonwealth of Pennsylvania's Department of Conservation and Natural Resources (DCNR), Tioga Forest District, to acquire services to deliver, paver-place, and compact approximately 4,350 tons of limestone Driving Surface Aggregate (DSA) to Right Asaph Road. The project details, location, and any other requirements are not provided in the given materials.

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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

File details come from the government source that posted it. Updated .