2-Appendix B - Public Works Employment Verification.pdf
PDF 63 KB Posted
- Attached to
- Cherryville Road Sidewalk Extension 999111905
- Solicitation number
- Not on record
- Issued by
- Northampton County, Northern Cambria Borough, Pennsylvania
About this file
This is a Public Works Employment Verification Form issued by the Commonwealth of Pennsylvania for use by contractors and subcontractors on public works projects. The form applies to the Cherryville Road Sidewalk Extension project (Contract No. 999111905) being managed by Allen Township in Northampton, Pennsylvania. Sealed bids for this sidewalk extension project are being accepted online through the PennBid program until 10:00 A.M. local time on Tuesday, November 3, 2026, with bids opened the same day. Questions regarding the project may be submitted through PennBid until 10:00 A.M. on Tuesday, October 27, 2026. No prebid meeting will be held for this project. The successful bidder must provide Performance and Payment Bonds equal to 100% of the contract amount and a Maintenance Bond equal to 10% of the contract amount. All bids must include a bid bond or certified check of at least 10% of the bid amount.
As a condition of contract award, all contractors and subcontractors must complete this employment verification form, affirming compliance with Pennsylvania's Public Works Employment Verification Act through enrollment in the federal E-Verify Program (EVP) operated by the U.S. Department of Homeland Security. Contractors must verify that all employees hired after January 1, 2013 are authorized to work in the United States and must utilize E-Verify within five business days of each new hire's start date throughout the duration of the contract. Documentation of E-Verify usage must be maintained for potential investigation or audit. Work on this project will be compensated in accordance with the Pennsylvania Prevailing Wage Act (Act No. 442). Bid quantities are not guaranteed and may vary by plus or minus an unspecified percentage.
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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 {dzōŎƻƴǘNJŀŎǘƻNJ όŎƘŜŎƪ ƻƴŜύ
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
| Date: |
| Address: |
| City: |
| State: |
| Zip Code: |
| Contracting Public Body: |
| ContractProject No: |
| Project Description: |
| Project Location: |
| Name: |
| Business or Organization Name - Employer: |
| Signature: |
| Check Box1: Off |
| Check Box2: Off |
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