8-Public Works Employment Verification Form.pdf
PDF 125 KB Posted
- Attached to
- 2026 Street Paving Program
- Solicitation number
- Not on record
- Issued by
- Bucks County, Pennsylvania
About this file
This is a Public Works Employment Verification Form issued by the Commonwealth of Pennsylvania for use by contractors and subcontractors on public works projects. The form is required to be completed and submitted to the contracting public body prior to contract award. Contractors and subcontractors must affirm compliance with Pennsylvania's Public Works Employment Verification Act through enrollment in the federal E-Verify Program operated by the United States Department of Homeland Security. All contractors and subcontractors are required to verify the employment eligibility of each new hire within five business days of the employee's start date and maintain documentation of such verification throughout the duration of the public works contract. The form requires the authorized representative to attest that all information provided is true and correct, with understanding that submission of false or misleading information is subject to legal sanctions.
The form applies to the Traffic Signal Improvements at Various Locations project in Solebury Township, Bucks County, Pennsylvania, with sealed proposal submissions due by 10:00 AM on March 6, 2026, via PennBid. All bidders and subcontractors must be PennDOT prequalified in accordance with 67 PA Code Chapter 457 and PennDOT Form 408/2020. Proposals must be accompanied by a bid bond or certified check equal to 10% of the total bid amount. The successful bidder must comply with the Pennsylvania Prevailing Wage Act. No bid may be withdrawn within sixty days after opening. Questions regarding the project must be submitted via PennBID by February 23, 2026, at 5:00 PM. Plans and specifications are available online at no charge via PennBid.
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Text version
Street Address 2
City State Zip Code
Doing Business As:
(if different from Legal Name)
Commonwealth of Pennsylvania Public Works Employment Verification Form
Complete and return the form to the contracting Public Body prior to the award of the contract.
Company Legal Name: ___________________________________________________________
Mailing Address: ______________________________________________________
Check one: Contractor Subcontractor
Contracting Public Body: _________________________________________________________
Contract/Project Number: ________________________________________________________
Project Description: _____________________________________________________________
Project Location: _______________________________________________________________
Date Enrolled in E-Verify (MM/DD/YYYY): ___________________________________________ As a contractor/subcontractor for the above referenced public works contract, I hereby affirm that as of today’s 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 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 of Signature
Printed Name: _________________________________________________________________
Phone Number: ______________________ Email: ____________________________________
Street Address 1
| Company Legal Name: |
| Doing Business As: |
| Street Address 1: |
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| City: |
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| Zip Code: |
| Contractor: Off |
| Subcontractor: Off |
| Contracting Public Body: |
| ContractProject Number: |
| Project Description: |
| Project Location: |
| Printed Name: |
| Phone Number: |
| Email: |
| Today's Date: |
| Name of Authorized Representative: |
| MM/DD/YYYY: |
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