5-05 Public Works Verification.pdf
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- Attached to
- 2026-2029 - Lower Makefield Township Facilities Trash & Recyclable Materials Collections & Disposal
- Solicitation number
- Not on record
- Issued by
- Bucks County, Pennsylvania
About this file
This document is a Public Works Employment Verification Form issued by the Commonwealth of Pennsylvania, designed for contractors and subcontractors engaged in public works projects within the state. The form serves as attestation of compliance with Pennsylvania's Public Works Employment Verification Act, requiring all contractors and subcontractors to utilize the federal E-Verify Program (EVP) operated by the United States Department of Homeland Security. Contractors must affirm that all employees hired after January 1, 2013, are authorized to work in the United States and commit to verifying employment eligibility for each new hire within five business days of the employee's start date throughout the duration of the public works contract. The form requires documentation of E-Verify usage to be maintained for investigation or audit purposes, with an authorized company representative signing and attesting to the accuracy of the information provided.
The form applies to the Lower Makefield Township Traffic Signal and ADA Improvements project in Bucks County, Pennsylvania, with sealed proposals due by 10:00 AM on February 23, 2026, via PennBID. All bidders and subcontractors must be PennDOT pre-qualified contractors and comply with the Pennsylvania Prevailing Wage Act. A bid bond or certified check equal to 10 percent of the total bid amount is required with proposal submission. No bid may be withdrawn within sixty days following the bid opening, during which time the Township will review qualifications and investigate bidder competency. Questions must be submitted via PennBID by February 16, 2026, at 5:00 PM.
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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 {dzōŎƻƴǘNJŀŎǘƻNJ όŎƘŜŎƪ ƻƴŜύ
Contracting Public Body _______________________________________________________________
Contract/Project No ___________________________________________________________________
Project Description ____________________________________________________________________
Project Location ______________________________________________________________________
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 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: |
| Address: |
| City: |
| State: |
| Zip Code: |
| Contracting Public Body: |
| ContractProject No: |
| Project Description: |
| Project Location: |
| Name: |
| Business or Organization Name - Employer: |
| Signature: |
| Check Box1: Off |
| Check Box2: Off |
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