Attachment E - BOP-2201 EO 2021-06 Worker Protection Form BOP FINAL.pdf
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- Solicitation number
- 6100066274
- Issued by
- Pennsylvania
About this file
This is a Worker Protection Form (EO 2021-06) associated with a bagged de-icing materials procurement by the Commonwealth of Pennsylvania. The form applies to the supplemental solicitation for 50-pound bags of de-icing materials (IFB 6100060797 and 6100061430) intended for use by various state agencies during winter weather events for snow and ice management.
The Worker Protection Form implements Executive Order 2021-06 requirements, establishing mandatory compliance standards for contractors and subcontractors throughout the contract term. The form requires documentation and attestation regarding worker protections, including wage and hour compliance, safe working conditions, and adherence to applicable labor laws. Contractors must complete and submit the form as part of their bid proposal, with acknowledgment that failure to comply with the outlined worker protection requirements may result in contract termination or other remedial action. The form serves as a binding commitment by bidders to maintain specified labor standards during performance of the de-icing materials supply contract.
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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
| WORKER PROTECTION AND INVESTMENT CERTIFICATION FORM |
| CERTIFICATION |
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