23-Public Works Employment Verification Form.pdf
PDF 125 KB Posted
- Attached to
- 2026 Traffic Signal Upgrades
- Solicitation number
- US.258736
- Issued by
- Chester County, Pennsylvania
About this file
This is a Commonwealth of Pennsylvania Public Works Employment Verification Form required for contractors and subcontractors on public works projects. The form must be completed and submitted to the contracting public body prior to contract award. The related contract opportunity involves Traffic Signal Upgrades along Pottstown Pike (State Route 0100) and Commerce Drive within West Whiteland Township, Chester County, Pennsylvania. Sealed proposals are being accepted via PennBid until 1:00 PM on December 1, 2026, with bid day one commencing at 5:00 PM on November 2, 2026. Questions must be submitted through PennBid by November 9, 2026, at 1:00 PM. Plans and specifications are available online at no charge through PennBid. The Board of Supervisors will make the award decision at their public meeting on December 9, 2026, or at a subsequent board meeting. All proposals must be accompanied by a bid bond or certified check equal to ten percent of the total bid amount. No bid may be withdrawn within sixty days after opening.
All bidders and subcontractors must comply with the Pennsylvania Prevailing Wage Act and obtain PennDOT prequalification in accordance with 67 PA Code Chapter 457 and PennDOT Form 408/2026. The contractor must verify employment eligibility through the federal E-Verify Program operated by the United States Department of Homeland Security and confirm that all employees hired are authorized to work in the United States. Documentation of E-Verify usage for each new hire must be maintained throughout the contract duration. The township reserves the right to waive minor informalities or reject any or all bids and requires all bidders and subcontractors to establish proof of competency and responsibility. Contractors must ensure non-discrimination in employment based on race, color, religion, sex, national origin, or handicap.
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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: |
| Project Description: |
| Project Location: |
| Printed Name: |
| Phone Number: |
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| Today's Date: |
| Name of Authorized Representative: |
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