5-03 Worker Protection and Investment Certification Form.pdf
PDF 70 KB Posted
- Attached to
- North Wales Borough Road Improvement Program
- Solicitation number
- Not on record
- Issued by
- Montgomery County, Pennsylvania
About this file
This Worker Protection and Investment Certification Form is required by the Commonwealth of Pennsylvania for all contractors and grantees bidding on state and local contracts, including the North Wales Borough Road Improvement Program in Montgomery County, Pennsylvania. Bidders must certify 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 eleven additional statutory requirements. The form must be signed by an authorized official of the contractor or grantee and submitted as part of the proposal process. For the North Wales Borough Road Improvement Program specifically, sealed proposals are due online via PennBID by 1:00 PM on August 6, 2026, with questions accepted until 5:00 PM on July 30, 2026.
All bidders and subcontractors must be PennDOT pre-qualified contractors and must comply with the Pennsylvania Prevailing Wage Act. Each proposal must be accompanied by a bid bond or certified check equal to ten percent of the total bid amount. Bidders have sixty days following bid opening to withdraw their proposals during the Borough's review period and investigation of bidder qualifications. The Worker Protection and Investment Certification Form carries significant penalties for false certification, including contract termination and three-year ineligibility to bid on Commonwealth contracts under 62 Pa. C.S. § 531, as well as potential criminal charges under 18 Pa. C.S. § 4904. Certifying officials must immediately report any changes in compliance status to the purchasing agency.
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
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 .