6-PWEmplymnt verificatnfm.pdf
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- Attached to
- Walnut Alley Drainage Improvements Project
- Solicitation number
- Not on record
- Issued by
- Lehigh County, Pennsylvania
About this file
This is a Public Works Employment Verification Form required by the Commonwealth of Pennsylvania for contractors and subcontractors working on public works projects. The form applies to Myerstown Borough's Walnut Alley Drainage Improvements Project, which involves the construction of approximately 1,030 linear feet of storm sewer. Bids for this project are due online through the PennBID portal by 2:00 PM on Wednesday, July 8, 2026, at which time all bids will be made available online. Questions must be submitted online through PennBID and received by 12:00 PM on Monday, July 6, 2026. All work must be completed in accordance with contract specifications, and the successful contractor must notify the Municipality prior to project start.
As a condition of contract award, all contractors and subcontractors must complete this verification form affirming compliance with the Public Works Employment Verification Act through the federal E-Verify Program (EVP). Contractors must verify that all employees hired after January 1, 2013, are authorized to work in the United States, with employment eligibility verified within five business days of each new hire's start date. Documentation confirming use of the federal EVP must be maintained for investigation or audit purposes. An authorized company representative must sign and attest that the information contained in the verification form is true and correct. A certified check or bid bond equal to 10 percent of the total bid amount, issued by a surety licensed in Pennsylvania, is required. The contract is subject to the Pennsylvania Prevailing Wage Act, OSHA requirements, Pennsylvania Act 229 of 2002, the Pennsylvania One Call Act, the Pennsylvania Human Relations Act, and non-discrimination employment regulations.
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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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