4-004546 - Public Works Employment Verification Form.pdf
PDF 134 KB Posted
- Attached to
- Gabion Wall Repair
- Solicitation number
- Not on record
- Issued by
- Mercer County, Pennsylvania
About this file
This is a Public Works Employment Verification Form submitted by a contractor or subcontractor to the Hermitage Municipal Authority for the Gabion Wall Repair project located in Hermitage, Pennsylvania (Mercer County). The project, identified by contract number 1010905199, involves repair work on a gabion wall structure. Sealed bids for this project are being accepted online through PennBid.bonfire.com until 10:00 AM on January 27, 2026. The successful bidder must substantially complete the project within 180 calendar days of receiving the Notice to Proceed. A certified check or bid bond equal to 10% of the total bid amount is required at submission, with bonds to be issued by a surety licensed in Pennsylvania. The successful bidder will be required to furnish performance and payment bonds equal to 100% of the contract price.
The contract is subject to the Pennsylvania Prevailing Wage Act, Federal OSHA requirements, the Pennsylvania Public Works Employment Verification Act, the Pennsylvania One Call Act (Underground Utility Line Protection Law), the Pennsylvania Human Relations Act, and non-discrimination in employment and contract compliance regulations. All contractors and subcontractors must be in compliance with the Public Works Employment Verification Act and must utilize the federal E-Verify Program to confirm employment eligibility for all new hires within five business days of their start date. Documentation of E-Verify usage must be maintained for investigation or audit purposes. All bidders must submit a Non-Collusion/Sexual Harassment Affidavit and bid on all items listed on the Bid Form. Bids remain valid for 60 days from the date of bid opening, or 120 days if award is delayed due to governmental approvals, bond sales, or grant awards.
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Text version
COMMONWEALTH OF PENNSYLVANIA
PUBLIC WORKS EMPLOYMENT VERIFICATION FORM
Date
Business or Organization Name (Employer)
Address
City State Zip Code
Contractor
Subcontractor (check one)
Contracting Public Body Hermitage Municipal Authority
Contract/Project No 1010905199
Project Description Gabion Wall Repair
Project Location City of Hermitage, Mercer County, Hermitage, Pennsylvania
As a contractor/subcontractor for the above referenced public works contract, I hereby affirm that as of the above 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 post January 1, 2013 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 employees 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
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