3-Public Works Employment Verification Form.pdf
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- Solicitation number
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- Montgomery County, Pennsylvania
About this file
This is a Public Works Employment Verification Form required by the Commonwealth of Pennsylvania for contractors and subcontractors bidding on public works projects. The form must be completed and submitted to the contracting public body prior to contract award. For the Oak Drive (T-370) Roadway and Pedestrian Improvements Project in Lower Salford Township, Montgomery County, Pennsylvania, sealed bids will be accepted until 11:00 AM on June 23, 2026, via PennBID. Questions must be submitted through PennBID by June 9, 2026, at 5:00 PM. Plans and specifications are available online at no charge through PennBID. All proposals must be accompanied by a bid bond or certified check equal to 10% of the total bid amount. No bid may be withdrawn within sixty (60) days after opening, during which time the Township will review bids and investigate bidder qualifications.
All bidders and subcontractors must comply with the Pennsylvania Prevailing Wage Act and must be PennDOT pre-qualified contractors in accordance with 67 PA Code Chapter 457 and PennDOT Form 408/2020, as supplemented and amended. Contractors and subcontractors are required to complete the Employment Verification Form affirming compliance with the Public Works Employment Verification Act through enrollment in the federal E-Verify Program operated by the United States Department of Homeland Security. Companies must verify that all employees hired are authorized to work in the United States and must utilize E-Verify to verify employment eligibility of each new hire within five (5) business days of the employee start date throughout the contract duration. Documentation confirming E-Verify usage must be maintained for potential investigations or audits. The Township reserves the right to waive minor informalities or reject any or all bids.
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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: |
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| Printed Name: |
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| Today's Date: |
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