15-Public Works EMployment Verification.pdf
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- Solicitation number
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- Fayette County, Pennsylvania
About this file
This is a Public Works Employment Verification Form issued by the Commonwealth of Pennsylvania, designed to ensure employment eligibility compliance for public works contractors and subcontractors. The form requires businesses to affirm they are utilizing the federal E-Verify Program (EVP) operated by the U.S. Department of Homeland Security, verifying that all employees hired after January 1, 2013 are authorized to work in the United States.
The document mandates that contractors and subcontractors must verify the employment eligibility of each new hire within five business days of their start date throughout the duration of the public works contract. Companies must maintain documentation confirming the use of the federal EVP in case of an investigation or audit. The form requires an authorized representative to attest to the truthfulness of the information provided, with the understanding that submitting false or misleading information may result in legal sanctions.
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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
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