5-Employment Verification.pdf
PDF 57 KB Posted
- Attached to
- Commerce Street Improvement Project
- Solicitation number
- Not on record
- Issued by
- Adams County, Pennsylvania
About this file
This is a Public Works Employment Verification Form required by the Commonwealth of Pennsylvania for contractors and subcontractors on public works projects, specifically for the Commerce Street Improvement Project administered by New Oxford Borough. The form confirms that contractors comply with the Public Works Employment Verification Act by utilizing the federal E-Verify Program (EVP) operated by the United States Department of Homeland Security. All employees hired after January 1, 2013, must be verified as authorized to work in the United States, and contractors must verify employment eligibility for each new hire within five business days of the employee start date throughout the contract duration. The Commerce Street Improvement Project involves 2,750 square yards of milling, 700 tons of binder/leveling course, 260 tons of wearing course, and other specified work. Bids are due online by Thursday, April 23, 2026, at 2:00 PM, with a certified check or bid bond equal to 10 percent of the total bid required.
The contract is subject to Pennsylvania's Prevailing Wage Act, the Federal Occupational Safety and Health Act of 1970 (OSHA), Pennsylvania Act 229 of 2002, the Pennsylvania One Call Act, the Pennsylvania Human Relations Act, non-discrimination employment and contract compliance regulations, and the Public Works Employment Verification Act. Contractors must provide noncollusion affidavits and maintain documentation of E-Verify usage for all new hires in case of investigation or audit. Questions submitted online via PennBID after 4:00 PM on Tuesday, April 21, 2026, will not be acknowledged. New Oxford Borough Council reserves the right to accept or reject any or all bids. The surety bond must be issued by a surety licensed to do business in Pennsylvania.
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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 |
File details come from the government source that posted it. Updated .