3-MS944 Workers Comp Aff.pdf

This is a Workers' Compensation Affidavit form required by Hanover Borough, Pennsylvania for the Downtown Route 94/116/194 Traffic Congestion & Pedestrian Safety Improvements project. The affidavit confirms that the contractor has accepted the provisions of the Workmen's Compensation Act of 1915 of the Commonwealth of Pennsylvania and has secured appropriate insurance liability coverage in accordance with the Act's terms. The document requires the contractor's signature, a surety company name, and notarization before submission. Bids for this traffic signal improvement project are due by Tuesday, April 21, 2026, at 2:00 PM, with submission and updates available online through PennBID. A certified check or bid bond equal to 10 percent of the total bid amount is required, with bonds to be issued by a surety licensed to operate in Pennsylvania. Questions regarding the project must be submitted online via PennBID by 4:00 PM on Friday, April 17, 2026.

The contract is subject to Pennsylvania Prevailing Wage requirements, the Federal Occupational Safety and Health Act of 1970, Pennsylvania Act 229 of 2002, the Pennsylvania One Call Act (Underground Utility Line Protection Law), the Pennsylvania Human Relations Act, noncollusion affidavit requirements, non-discrimination in employment and contract compliance regulations, and the Public Works Employment Verification Act. Hanover Borough Council retains the right to accept or reject any or all bids submitted for this project.