1-A-1 Public Works Employment Verification Form (Upload with Bid).pdf
PDF 67 KB Posted
- Attached to
- Valley Road Storm Sewer
- Solicitation number
- Not on record
- Issued by
- Lancaster County, Milroy CDP, Pennsylvania
About this file
This is a Public Works Employment Verification Form required by the Commonwealth of Pennsylvania for contractors and subcontractors bidding on the Valley Road Storm Sewer project in Millersville Borough. The form certifies compliance with the Public Works Employment Verification Act through participation in the federal E-Verify Program (EVP) operated by the United States Department of Homeland Security. All contractors and subcontractors must verify employment eligibility of employees hired after January 1, 2013, and maintain documentation of E-Verify usage for all new hires within five business days of their start date throughout the duration of the contract. The sealed bid submission deadline is February 27, 2026, at 10:00 A.M. via the PennBid Program, with a mandatory prebid conference scheduled for February 17, 2026, at 10:00 A.M. at Millersville Borough Building. The project consists of 65 square yards of pavement restoration, installation of 4 inlets, 88 linear feet of storm sewer, 1 endwall, and associated items.
Each bid submission must include a certified check or bid bond equal to 10% of the total bid amount, a non-collusion affidavit, and a completed employment verification form. A performance bond in the amount of 100% of the contract price will be required upon award. The project is subject to prevailing minimum wage determinations established by the Pennsylvania Department of Labor and Industry. Millersville Borough reserves the right to reject any or all bids and waive informalities in the bidding process. Bids may be held for review and investigation of bidder qualifications for up to 60 days from the opening date prior to contract award.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
COMMONWEALTH OF PENNSYLVANIA
PUBLIC WORKS EMPLOYMENT VERIFICATION FORM
Date _______________________
Business or Organization Name (Employer)_________________________________________________
Address _____________________________________________________________________________
City _____________________________________ State_____________ Zip Code ________________
Contractor Subcontractor (check one)
Contracting Public Body _______________________________________________________________
Contract/Project No ___________________________________________________________________
Project Description ____________________________________________________________________
Project Location ______________________________________________________________________
As a contractor/subcontractor for the above referenced public works contract, I hereby affirm that as of the above date, our company is in compliance with the Public Works Employment Verification Act
(‘the Act’) through utilization of the federal E Verify Program (EVP) operated by the United States
Department of Homeland Security. To the best of my/our knowledge, all employees hired post
January 1, 2013 are authorized to work in the United States.
It is also agreed to that all public works contractors/subcontractors will utilize the federal EVP to verify the employment eligibility of each new hire within five (5) business days of the employee start date throughout the duration of the public works contract. Documentation confirming the use of the federal EVP upon each new hire shall be maintained in the event of an investigation or audit.
I, _________________________, authorized representative of the company above, attest that the information contained in this verification form is true and correct and understand that the submission of false or misleading information in connection with the above verification shall be subject to sanctions provided by law.
Authorized Representative Signature
C-410A
| Date: |
| Business or Organization Name - Employer: |
| Address: |
| City: |
| State: |
| Zip Code: |
| Check Box1: Off |
| Check Box2: Off |
| Contracting Public Body: |
| ContractProject No: |
| Project Description: |
| Project Location: |
| Name: |
| Signature: |
File details come from the government source that posted it. Updated .