2-Public Works Verification Form.pdf
PDF 125 KB Posted
- Solicitation number
- US.257981
- Issued by
- Delaware County, Masontown Borough, Pennsylvania
About this file
This is a Public Works Verification Form related to Delaware County, Pennsylvania's solicitation for the Delaware County Courthouse Façade Stabilization – Phase 1 project (eDPW-120926). The project encompasses structural stabilization and restoration of the courthouse's exterior marble work, including raking and repointing of joints around lower dentils and cornice sections, installation of fiberglass pins to unstable architectural elements, dutchman repairs with blind pins to spalled areas, marble patch repairs, crack repairs, and consolidation treatments to various facade components as detailed in the project drawings. A mandatory Pre-Bid Conference is scheduled for Tuesday, October 27, 2026, at 11:00 AM on-site at 201 West Front Street, Media, Pennsylvania 19063. Invitation to Bid responses must be submitted virtually through PennBid (penbid.bonfirehub.com) by December 9, 2026, at 11:00 a.m., at which time responses will be opened and publicly read aloud. Respondents are prohibited from modifying, withdrawing, or canceling proposals for sixty days following the response deadline.
The file does not explicitly disclose pricing terms, set-asides, incumbent contractors, or specific funding amounts and sources. Additional details regarding contract duration, renewal options, and other financial or administrative requirements would be found in the complete Invitation to Bid document available through the PennBid platform.
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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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| Doing Business As: |
| Street Address 1: |
| Street Address 2: |
| City: |
| State: |
| Zip Code: |
| Contractor: Off |
| Subcontractor: Off |
| Contracting Public Body: |
| ContractProject Number: |
| Project Description: |
| Project Location: |
| Printed Name: |
| Phone Number: |
| Email: |
| Today's Date: |
| Name of Authorized Representative: |
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