06. BOP-2201 Worker Protection Form.pdf

PDF 75 KB Posted

Attached to
11-3-23 REBID 23F-D15-1Fert
Solicitation number
6100059843
Issued by
Susquehanna County, Pennsylvania

About this file

The document is a Worker Protection and Investment Certification Form related to a state and local contract opportunity in Pennsylvania. The form requires contractors and grantees to certify compliance with various Pennsylvania state labor and workplace safety laws, including the Construction Workplace Misclassification Act, Minimum Wage Act, and Prevailing Wage Act, among others. Failure to provide accurate certification can result in contract termination and ineligibility to bid on future contracts.

The related state and local contract opportunity is for the provision of uniform ground application of fertilizer to approximately 376 acres of State Forest land in Pennsylvania, across eight blocks, by the Department of Conservation and Natural Resources (DCNR), Bureau of Forestry, Susquehannock State Forest. The project is a rebid of a previous contract, and the work is to be performed at various locations in Potter County, Pennsylvania.

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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 .