4-06 Public Works Employment Verification Form.pdf
PDF 110 KB Posted
- 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 working on public works projects. The form must be completed and submitted to the contracting public body prior to contract award. The form applies to the SR 73, SEC. MT2 (MPMS #81892): Skippack Pike (SR 0073) and School Road (SR 2016) Intersection Improvement Project in Whitpain Township, Montgomery County, Pennsylvania, with a sealed bid deadline of 11:00 AM on Thursday, February 5, 2026. The scope of work includes roadway widening, drainage system installation, traffic signal installation, stone masonry, traffic control, and signing and pavement marking installation. Responsible Contractor Certification (RCO) Forms must be submitted to the Township no later than January 22, 2026, at 11:00 AM, and questions regarding the project must be submitted via PennBid by January 22, 2026, at 5:00 PM. All proposals must be accompanied by a bid bond or certified check equal to 10% of the total bid price.
Contractors and subcontractors must affirm compliance with the Public Works Employment Verification Act through enrollment and utilization of the federal E-Verify Program (EVP) operated by the United States Department of Homeland Security. Companies are required to verify the employment eligibility of all employees hired and must maintain documentation confirming E-Verify usage for each new hire within five business days of the employee start date throughout the duration of the public works contract. The authorized company representative must attest under penalty of law that all information provided in the verification form is true and correct. The successful bidder is required to furnish all payment, performance, and maintenance bonds as referenced in the bid documents, with bonds issued by a surety licensed to do business in the Commonwealth of Pennsylvania. No bid may be withdrawn within sixty days after opening, during which time the Township may review bids and investigate bidder qualifications.
View the file
Other files
Show all 20
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 .