10-Public Works Employment Verification Form.pdf
PDF 125 KB Posted
- Attached to
- 2026 Road Paving Program
- Solicitation number
- Not on record
- Issued by
- Chester County, Pennsylvania
About this file
Public Works Employment Verification Form and 2026 Road Paving Program Summary
This is a Public Works Employment Verification Form issued by the Commonwealth of Pennsylvania in conjunction with West Whiteland Township's 2026 Road Paving Program. The form is required for contractors and subcontractors bidding on the township's road paving project, which involves milling and paving of approximately 19,500 square yards across six roads, including line painting and an add-alternate for four ADA-compliant ramps. Sealed bids for this project must be submitted online via PennBid by Tuesday, June 18, 2026, at 1:00 p.m., with bids to be publicly opened and posted on the same platform. The project is located in West Whiteland Township at 101 Commerce Drive, Exton, PA 19341, and work must be completed by September 30, 2026, or liquidated damages of $885.00 per calendar day will apply for unfinished work.
All contractors and subcontractors must complete and submit the Employment Verification Form to the contracting public body prior to contract award, attesting compliance with Pennsylvania's Public Works Employment Verification Act through enrollment in the federal E-Verify Program. Contractors must verify that all employees are authorized to work in the United States and commit to utilizing E-Verify for each new hire within five business days of the employee's start date throughout the contract duration. Prevailing wage requirements are in effect for this project, with wage rates available in the bidding documents. The municipality reserves the right to reject any or all proposals submitted.
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Text version
Street Address 2
City State Zip Code
Doing Business As:
(if different from Legal Name)
Commonwealth of Pennsylvania Public Works Employment Verification Form
Complete and return the form to the contracting Public Body prior to the award of the contract.
Company Legal Name: ___________________________________________________________
Mailing Address: ______________________________________________________
Check one: Contractor Subcontractor
Contracting Public Body: _________________________________________________________
Contract/Project Number: ________________________________________________________
Project Description: _____________________________________________________________
Project Location: _______________________________________________________________
Date Enrolled in E-Verify (MM/DD/YYYY): ___________________________________________ As a contractor/subcontractor for the above referenced public works contract, I hereby affirm that as of today’s 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 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 Date of Signature
Printed Name: _________________________________________________________________
Phone Number: ______________________ Email: ____________________________________
Street Address 1
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| Contractor: Off |
| Subcontractor: Off |
| Contracting Public Body: |
| ContractProject Number: |
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| Printed Name: |
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| Today's Date: |
| Name of Authorized Representative: |
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