Attachment A - Workers Protection and Investment Certification Form.pdf

PDF 76 KB Posted

Attached to
PennDOT Sign Shop-Sign Stiffeners
Solicitation number
6100066614
Issued by
Dauphin County, Harveys Lake Borough, Pennsylvania

About this file

This is a Worker Protection and Investment Certification Form required by the Commonwealth of Pennsylvania for contractors and grantees seeking to enter into agreements with the state. The form mandates compliance with Pennsylvania's Unemployment Compensation Law, Workers' Compensation Law, and a comprehensive list of state labor and workforce safety laws, including provisions related to workplace misclassification, child labor, minimum wage, prevailing wage, equal pay, healthcare overtime limits, apprenticeship requirements, and employment record inspection standards. The certification must be executed by an authorized official of the contractor or grantee and submitted in connection with contract opportunities such as the PennDOT Sign Shop-Sign Stiffeners solicitation.

The certification process carries significant legal consequences for non-compliance. Contractors providing false certifications face contract termination and three-year ineligibility to bid on state contracts under 62 Pa. C.S. § 531 regarding debarment or suspension. Additionally, falsification of the certification is subject to penalties under 18 Pa. C.S. § 4904 for unsworn falsification to authorities. Contractors must report any changes in their compliance status to the purchasing agency immediately upon discovery. The form was published on February 4, 2022, and applies to all state and local contract opportunities issued by Pennsylvania agencies.

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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 and grantees of the Commonwealth must certify that they are in compliance with Pennsylvania’s Unemployment

Compensation Law, Workers’ Compensation Law, and 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 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 am duly authorized to execute this certification on behalf of the contractor/grantee identified below, and certify that the contractor/grantee identified below is compliant with 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 contractor/grantee’s compliance status to the Purchasing Agency 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)

Title of Certifying Official (Printed)

Contractor/Grantee Name (Printed)

BOP-2201

Published: 02/04/2022

File details come from the government source that posted it. Updated .