5-05 Worker Protection and Investment Certification Form.pdf
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- Attached to
- 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 for contractors and grantees bidding on state and local contracts, including the Northampton Township 2026 Milling Project in Bucks County, Pennsylvania. The form requires all contractors and grantees to certify compliance with Pennsylvania's Unemployment Compensation Law, Workers' Compensation Law, and applicable state labor and workforce safety laws, including provisions related to workplace misclassification, child labor, minimum wage, prevailing wage, equal pay, employment medical examinations, seasonal farm labor, wage collection, industrial homework, employee verification, healthcare overtime limits, apprenticeship training, and employment record inspections. The certification must be executed by an authorized official of the contractor or grantee and submitted as part of the bidding process. For the Northampton Township 2026 Milling Project, bids are due by 1:00 PM on April 27, 2026, via PennBid, with questions due by April 20, 2026, at 5:00 PM. All bidders and subcontractors must be PennDOT pre-qualified and comply with the Pennsylvania Prevailing Wage Act. The successful contractor must complete all work within a specified timeline from the Notice to Proceed and is subject to liquidated damages of $975.00 per calendar day for delays beyond the 240-day completion period.
The Worker Protection and Investment Certification Form carries significant legal weight, as false certifications are subject to contract termination, three-year ineligibility to bid on future Commonwealth contracts under 62 Pa. C.S. 531 (debarment or suspension), and criminal penalties under 18 Pa. C.S. 4904 (unsworn falsification to authorities). Contractors must report any changes in compliance status to the purchasing agency immediately. All bidders must submit a bid bond or certified check equal to 10% of the total bid amount and maintain workers' compensation and public liability insurance. The Township reserves the right to waive minor informalities or reject any or all bids. No bid may be withdrawn within 60 days after opening.
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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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