3-Worker Protection and Investment Certification Form.pdf

PDF 87 KB Posted

Attached to
Intersection Improvement Project - Layfield Road (S. R. 0663) and Schoolhouse Road (T-239)/Montgomery Avenue
Solicitation number
Not on record
Issued by
Montgomery County, Pennsylvania

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This is a Worker Protection and Investment Certification Form established by the Commonwealth of Pennsylvania under Executive Order 2021-06, applicable to the Intersection Improvement Project at Layfield Road (S.R. 0663) and Schoolhouse Road (T-239)/Montgomery Avenue in Upper Hanover Township, Montgomery County, Pennsylvania. The form requires contractors and grantees to certify compliance with Pennsylvania's Unemployment Compensation Law, Workers' Compensation Law, and applicable state labor and workforce safety laws, including but not limited to the Construction Workplace Misclassification Act, Employment of Minors Child Labor Act, Minimum Wage Act, Prevailing Wage Act, Equal Pay Law, Wage Payment and Collection Law, Construction Industry Employee Verification Act, and the Apprenticeship and Training Act. Sealed bids for the intersection improvement project are due by 1:00 PM on October 30, 2026, via PennBID, with all bids opened at that same time and date. All bidders and subcontractors must be PennDOT pre-qualified in accordance with 67 PA Code Chapter 457 and PennDOT Form 408/2026, with prevailing wage rates determined on September 2, 2026, under Serial Number 26-08009.

The certification must be executed by an official duly authorized to bind the contractor or grantee and submitted with sealed proposals accompanied by a bid bond or certified check equal to 10 percent of the total bid amount. Contractors must immediately report any changes in compliance status to the purchasing agency. Pennsylvania law establishes penalties for false certifications, including contract termination and three-year ineligibility to bid on contracts under 62 Pa. C.S. 531, as well as criminal penalties under 18 Pa. C.S. 4904 for unsworn falsification to authorities. The Township reserves the right to waive minor informalities or reject any or all bids, and no bid may be withdrawn within sixty days after opening while the Township reviews qualifications and investigates bidder responsibility.

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WORKER PROTECTION AND INVESTMENT CERTIFICATION FORM

A. Pursuant to Executive Order 2021-06, Worker Protection and Investment (October 21, 2021), the

Commonwealth is responsible for ensuring that every worker in Pennsylvania has a safe and healthy work environment and the protections afforded them through labor laws. To that end, contractors and grantees of the Commonwealth must certify that they are in compliance with Pennsylvania’s Unemployment

Compensation Law, Workers’ Compensation Law, and all applicable Pennsylvania state labor and workforce safety laws including, but not limited to:

1. Construction Workplace Misclassification Act

2. Employment of Minors Child Labor Act

3. Minimum Wage Act

4. Prevailing Wage Act

5. Equal Pay Law

6. Employer to Pay Employment Medical Examination Fee Act

7. Seasonal Farm Labor Act

8. Wage Payment and Collection Law

9. Industrial Homework Law

10. Construction Industry Employee Verification Act

11. Act 102: Prohibition on Excessive Overtime in Healthcare

12. Apprenticeship and Training Act

13. Inspection of Employment Records Law

B. Pennsylvania law establishes penalties for providing false certifications, including contract termination; and three-year ineligibility to bid on contracts under 62 Pa. C.S. § 531 (Debarment or suspension).

CERTIFICATION

I, the official named below, certify I am duly authorized to execute this certification on behalf of the contractor/grantee identified below, and certify that the contractor/grantee identified below is compliant with applicable Pennsylvania state labor and workplace safety laws, including, but not limited to, those listed in

Paragraph A, above. I understand that I must report any change in the contractor/grantee’s compliance status to the Purchasing Agency immediately. I further confirm and understand that this Certification is subject to the provisions and penalties of 18 Pa. C.S. § 4904 (Unsworn falsification to authorities).

Signature Date

Name (Printed)

Title of Certifying Official (Printed)

Contractor/Grantee Name (Printed)

BOP-2201

Published: 02/04/2022

Name Printed:
Name PrintedRow1:
Title of Certifying Official PrintedRow1:

File details come from the government source that posted it. Updated .