C8 WC2608 PW EmploymentVerification FORM.pdf
PDF 59 KB Posted
- Attached to
- WC2608 SWOPE Stormwater Basin Retrofit Project
- Solicitation number
- Not on record
- Issued by
- Chester 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 requires contractors to affirm compliance with the Public Works Employment Verification Act through participation in the federal E-Verify Program (EVP) operated by the United States Department of Homeland Security. Contractors must verify that all employees hired after January 1, 2013, are authorized to work in the United States and commit to utilizing the federal EVP to verify employment eligibility of each new hire within five business days of the employee start date throughout the duration of the public works contract. Documentation confirming use of the federal EVP must be maintained for investigation or audit purposes. The form requires the signature and attestation of an authorized company representative, who acknowledges that submission of false or misleading information is subject to sanctions provided by law.
This form is specifically associated with the WC2608 SWOPE Stormwater Basin Retrofit Project at West Chester University of Pennsylvania, a prevailing wage project with a contract cost range of $450,000 to $550,000 and contract duration from December 7, 2026, through July 3, 2027 (208 calendar days). The pre-bid site visit is scheduled for November 6, 2026, at 11:00 AM. The project involves retrofit of an existing detention basin including clearing and grubbing, installation of amended soils, an underdrain system, outlet structure replacement, and associated drainage infrastructure. All contractors and subcontractors on this public works project must complete and submit this employment verification form as a compliance requirement prior to contract award or execution.
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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 |
File details come from the government source that posted it. Updated .