ATTACHMENT #5 - BOP-2201 Worker Protection and Investment Certification Form.pdf
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- PLCB REGIONAL OFFICES DOOR ACCESS CONTROL SYSTEM
- Solicitation number
- 272437
About this file
This is a Worker Protection and Investment Certification Form from the Pennsylvania Department of General Services, Public Works, published on February 8, 2022. The form is required pursuant to Executive Order 2021-06 and requires contractors to certify compliance with 13 specific Pennsylvania state labor and workplace safety laws, including the Construction Workplace Misclassification Act, Employment of Minors Child Labor Act, Minimum Wage Act, Prevailing Wage Act, and other key labor regulations.
The certification requires an authorized official's signature confirming their firm's compliance with all applicable labor laws, with an obligation to report any changes in compliance status immediately to DGS Public Works. The form includes serious penalties for false certifications, including civil penalties, contract termination, and a three-year debarment from bidding on contracts under 62 Pa. C.S. § 531. The certification is subject to penalties under 18 Pa. C.S. § 4904 regarding unsworn falsification to authorities.
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Text version
Department of General Service, Public Works
Published: 02/08/2022
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 of the Commonwealth must certify that they are in compliance with 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 civil penalties; 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 have read and understand this Worker Protection and Certification Form and I am duly authorized to execute this certification on behalf of the firm identified below, and the firm identified below is compliant with all 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 firm’s compliance status to the DGS
Public Works 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)
Firm Name (Printed)
DGS Project Number
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