4-02 Public Works Employment Verification Form.pdf
PDF 110 KB Posted
- Attached to
- North Wales Borough Road Improvement Program
- Solicitation number
- Not on record
- Issued by
- 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 applies to the North Wales Borough Road Improvement Program in Montgomery County, Pennsylvania, and must be completed and returned to the contracting public body prior to contract award. Contractors and subcontractors are required to affirm 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. Sealed bids for this road improvement project are due by 1:00 PM on August 6, 2026, submitted via PennBID, with all bids opened at that same time and date. Plans and specifications are available online through PennBID at no charge, and questions must be submitted by July 30, 2026, at 5:00 PM. All proposals must be accompanied by a bid bond or certified check equal to 10 percent of the total bid amount, and no bid may be withdrawn within sixty days after opening.
All bidders and subcontractors must be PennDOT pre-qualified contractors and must comply with the Pennsylvania Prevailing Wage Act and establish proof of competency and responsibility in accordance with 67 PA Code Chapter 457 and PennDOT Form 408/2026. As a condition of the contract, all contractors and subcontractors must utilize the federal E-Verify Program to verify employment eligibility of each new hire within five business days of the employee start date and maintain documentation of such verification throughout the duration of the public works contract. The North Wales Borough reserves the right to waive any minor informalities, irregularities, or defects in submitted bids or to reject any or all bids received.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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
| Company Legal Name: |
| Doing Business As: |
| Street Address 1: |
| Street Address 2: |
| City: |
| State: |
| Zip Code: |
| Contractor: Off |
| Subcontractor: Off |
| Contracting Public Body: |
| ContractProject Number: |
| Project Description: |
| Project Location: |
| Printed Name: |
| Phone Number: |
| Email: |
| Today's Date: |
| Name of Authorized Representative: |
| MM/DD/YYYY: |
File details come from the government source that posted it. Updated .