Domestic Workforce Utilization Certification Form.doc
DOC document 33 KB Posted
- Attached to
- 7840630000, Maintenance, SCM Delaware
- Solicitation number
- 6100066487
- Issued by
- Delaware County, Pennsylvania
About this file
This is a Domestic Workforce Utilization Certification Form submitted to the Pennsylvania Department of Transportation for a stormwater control measures maintenance contract in Delaware County, District 6-0. The form serves as a certification document requiring contractors to document their commitment to utilizing domestic workers on the project. The document establishes requirements and procedures for contractors to demonstrate compliance with workforce utilization standards applicable to state and local transportation projects. Contractors must complete and submit this certification form as part of their bid package, confirming their understanding of and agreement to meet domestic workforce requirements throughout the contract period.
The certification form establishes baseline expectations for contractor workforce composition and domestic worker employment. The form requires detailed information regarding contractor plans for domestic worker utilization, including projected percentages and specific workforce management strategies. Contractors must certify their ability to meet or exceed specified domestic worker thresholds as a condition of contract award. This certification is a mandatory compliance document that impacts contractor eligibility and may influence contract award decisions based on demonstrated commitment to domestic workforce standards for the maintenance services to be performed under this contract.
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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], having a Social Security or Federal Identification Number of ________________________, do hereby certify and represent to the Commonwealth of Pennsylvania ("Commonwealth") (Check one of the boxes below):
FORMCHECKBOX
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, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hong Kong, Hungary, Iceland, Ireland, Israel, Italy, Japan, Korea, Latvia, Liechtenstein, Lithuania, Luxemburg, Malta, the Netherlands, Norway, Poland, Portugal, Romania, Singapore, Slovak Republic, Slovenia, Spain, Sweden, Switzerland, and the United Kingdom
OR
FORMCHECKBOX
________________ 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
File details come from the government source that posted it. Updated .