Public Works Employment Verification Form.docx
DOCX document 28 KB Posted
- Attached to
- Roof Replacement at Lickdale Facility
- Solicitation number
- 6100061948
- Issued by
- Lawrence County, Pennsylvania
About this file
The document is a Public Works Employment Verification Form from the Commonwealth of Pennsylvania. As a contractor or subcontractor for a public works contract, the employer must affirm compliance with the Public Works Employment Verification Act through utilization of the federal E-Verify Program to verify the employment eligibility of each new hire within five business days of the employee start date for the duration of the public works contract. Documentation confirming the use of the federal E-Verify Program upon each new hire must be maintained.
The form requires the authorized representative of the company to attest that the information provided is true and correct, and understand that the submission of false or misleading information may result in sanctions provided by law.
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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 Subcontractor (circle one)
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 image1.png
File details come from the government source that posted it. Updated .