Domestic Workforce Utilization Certification Form.doc
DOC document 47 KB Posted
- Attached to
- On Call Vegetation
- Solicitation number
- 6100065057
- Issued by
- Fayette County, Pennsylvania
About this file
This is a Domestic Workforce Utilization Certification Form for Multiple Award Contracts issued by the Commonwealth of Pennsylvania, Department of General Services, for an On Call Vegetation services contract within PennDOT's Engineering District 12-0. The project encompasses general cleanup, herbicide application, mowing, landscape installation, and vegetation maintenance at various facilities and state route areas across Fayette, Greene, Washington, and Westmoreland counties. Services will be provided on an as-needed, on-call basis, with potential for new and replacement landscape installation projects. All bidders must submit bids electronically through the PA Supplier Portal at www.pasupplierportal.state.pa.us, with technical support available through the Supplier Service Center at (877) 435-7363.
Only DGS-certified small businesses are eligible to submit bids and receive awards under this Small Business Procurement Initiative contract designated by PennDOT pursuant to Executive Order 2011-09. Contractors must complete and sign the Domestic Workforce Utilization Certification form to receive consideration under the best value selection criteria; failure to complete the certification results in no consideration for this evaluation factor. Contractors must certify either that all direct labor will be performed exclusively within the United States or within countries party to the World Trade Organization Government Procurement Agreement (including Canada, the United Kingdom, and numerous European nations), or specify the percentage of direct labor to be performed within these approved jurisdictions and identify any work to be performed outside these areas. Misstatements in the certification are treated as fraudulent concealment under Pennsylvania law and are punishable under Section 4904 of the Pennsylvania Crimes Code.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| OS-501 Confirmation of Service form.pdf | ||
| On Call Vegetation Maintenance Statement of Work.doc | DOC document | |
| Worker Protection and Investment Certification Form (BOP 2201).docx | DOCX document | |
| Terms and Conditions.pdf | ||
| OS-52 Insurance Requirements.pdf | ||
| OS-34 IFB 6100065057 Addendum #1.docx | DOCX document | |
| Certified Pesticide Applicator Licensing Form.pdf |
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Text version
DOMESTIC WORKFORCE UTILIZATION CERTIFICATION FOR MULTIPLE AWARD CONTRACTS
To the extent permitted by the laws and treaties of the United States, this certification will be used by the Agency in making a best value selection for each particular assignment. Each quote will be evaluated for its commitment to use the domestic workforce in the fulfillment of the contract. Maximum consideration will be given to those suppliers who will perform the contracted direct labor exclusively within the geographical boundaries of the United States or within the geographical boundaries of a country that is a party to the World Trade Organization Government Procurement Agreement. Those who propose to perform a portion of the direct labor outside of the United States and not within the geographical boundaries of a party to the World Trade Organization Government Procurement Agreement will receive a correspondingly smaller score for this criterion. In order to be eligible for any consideration for this criterion, suppliers must complete and sign the following certification. This certification will be included as a contractual obligation when the contract is executed. Failure to complete and sign this certification will result in no consideration being given to the supplier for this criterion.
I, ______________________[title] of ____________________________________[name of Contractor] a _______________ [place of incorporation] corporation or other legal entity, (“Contractor”) located at ________________________________________________________________
[address], do hereby certify and represent to the Commonwealth of Pennsylvania (“Commonwealth”) (Check one of the boxes below):
All of the direct labor performed within the scope of services under the contract will be performed exclusively within the geographical boundaries of the United States or one of the following countries that is a party to the World Trade Organization Government Procurement Agreement: Armenia, Aruba, Austria, Belgium, Bulgaria, Canada, Chinese Taipei, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hong Kong, Hungary, Iceland, Ireland, Israel, Italy, Japan, Korea, Latvia, Liechtenstein, Lithuania, Luxemburg, Malta, Moldovia, Montenegro, New Zealand, the Netherlands, Norway, Poland, Portugal, Romania, Singapore, Slovak Republic, Slovenia, Spain, Sweden, Switzerland, Ukraine and the United Kingdom.
OR
________________ percent (_____%) [Contractor must specify the percentage] of the direct labor performed within the scope of services under the contract will be performed within the geographical boundaries of the United States or within the geographical boundaries of one of the countries listed above that is a party to the World Trade Organization Government Procurement Agreement. Please identify the direct labor performed under the contract that will be performed outside the United States and not within the geographical boundaries of a party to the World Trade Organization Government Procurement Agreement and identify the country where the direct labor will be performed:
[Use additional sheets if necessary]
The Department of General Services [or other purchasing agency] shall treat any misstatement as fraudulent concealment of the true facts punishable under Section 4904 of the Pennsylvania Crimes Code, Title 18, of Pa. Consolidated Statutes.
Attest or Witness:
Corporate or Legal Entity’s Name
Signature/Date
Signature/Date
Printed Name/Title
Printed Name/Title BOP-1301.Multiple Award
Revised 02/23/2018
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