4-Worker Protection and Investment Certification Form.pdf
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- Pavement Marking Improvements Project
- Solicitation number
- Not on record
- Issued by
- Bucks County, Pennsylvania
About this file
This is a Worker Protection and Investment Certification Form required by the Commonwealth of Pennsylvania under Executive Order 2021-06, applicable to contractors and grantees working on state and local contract opportunities including projects administered by Northampton Township in Bucks County, Pennsylvania. The certification requires contractors to confirm compliance with Pennsylvania's Unemployment Compensation Law, Workers' Compensation Law, and applicable state labor and workforce safety laws including the Construction Workplace Misclassification Act, Employment of Minors Child Labor Act, Minimum Wage Act, Prevailing Wage Act, Equal Pay Law, and other specified labor statutes. A duly authorized official of the contractor or grantee must sign and date the certification form, confirming the organization's compliance status and understanding that any changes in compliance must be reported immediately to the Purchasing Agency. The certification carries legal weight under 18 Pa. C.S. Section 4904, with penalties for false certification including contract termination and three-year ineligibility to bid on Commonwealth contracts under 62 Pa. C.S. Section 531 (Debarment or suspension).
This certification form is a mandatory compliance document with no pricing, bid amount, or financial terms associated with it. The form serves as a prerequisite requirement for all contractors and subcontractors bidding on projects such as Northampton Township's New Road ADA Improvement Project (bid deadline June 17, 2026), Pedestrian Crossing Improvement Project (bid deadline January 19, 2026), 2026 Milling Project (bid deadline April 27, 2026), and Hauling Services contract (bid deadline April 27, 2026). All bidders and subcontractors must complete and submit this certification alongside their bids to demonstrate labor law compliance and worker protection adherence as a condition of contract eligibility.
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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
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