6-004546 - Public Works Employment Verification Form.pdf
PDF 111 KB Posted
- Solicitation number
- US.256229
- Issued by
- Lancaster County, Pennsylvania
About this file
This Public Works Employment Verification Form pertains to the New Holland Pike Low-Pressure Force Main Replacement Project being administered by the Upper Leacock Township Municipal Authority in Lancaster County, Pennsylvania. The project involves the replacement of a low-pressure force main along New Holland Pike in Upper Leacock Township. Sealed bids for this public works project were accepted online through PennBid until 10:00 AM on November 5, 2026, with a voluntary pre-bid meeting scheduled for October 29, 2026 at 1:00 PM at 161 Newport Road, Leola, PA 17540. A certified check or bid bond equal to 10% of the total bid is required from all bidders. The successful bidder must complete the project within 315 calendar days of receiving the Notice to Proceed and shall furnish performance and payment bonds in the amount of 100% of the Contract Price. Bids remain open for 60 days from the bid opening date, or 120 days if award is delayed by governmental approval, bond sales, or grant awards.
All contractors and subcontractors on this public works project must comply with the Pennsylvania Public Works Employment Verification Act by utilizing the federal E-Verify Program (EVP) operated by the United States Department of Homeland Security. Contractors must verify that all employees hired after January 1, 2013 are authorized to work in the United States and must verify employment eligibility for all new hires within five business days of hire through the federal EVP. Documentation of EVP usage must be maintained throughout the contract duration for potential investigation or audit. This contract is subject to the Pennsylvania Prevailing Wage Act, Federal OSHA requirements, Pennsylvania Act 229 of 2002, the Pennsylvania One Call Act (Act 287 of 1974), the Pennsylvania Human Relations Act, and non-discrimination in employment and contract compliance requirements.
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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
Subcontractor (check one)
Contracting Public Body Upper Leacock Township Municipal Authority
Contract/Project No Contract No. 2026-04
Project Description New Holland Pike Low-Pressure Force Main Replacement Project
Project Location Upper Leacock Township, Lancaster County, PA
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 employees 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
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