PWEV Form.pdf
PDF 63 KB Posted
- Attached to
- REBID of CD 50 7. 2C Ingram Foster Park
- Solicitation number
- Not on record
- Issued by
- Allegheny County, Pennsylvania
About this file
Public Works Employment Verification Form for Char-West COG Demolition Projects
This is a Commonwealth of Pennsylvania Public Works Employment Verification Form prepared for contractors and subcontractors bidding on comprehensive demolition projects solicited by the Char-West Council of Governments across multiple municipalities in Allegheny County. The projects involve complete demolition of eight residential structures located in Crescent Township, Ingram Borough, McKees Rocks Borough, Neville Township, North Fayette Township, and Stowe Township, with services including asbestos removal, utility termination and capping, off-site debris disposal, backfilling, pest control, and site restoration. Sealed bids for the initial phase are due by 11:00 am on January 8, 2026, with bids opened immediately thereafter, while a second phase requires submission by 11:00 am on Friday, July 31, 2026. Bidders must provide a bid bond or certified check equal to 10% of the bid amount, and successful contractors must submit Labor and Materials Payment Bonds, Performance Bonds, and Maintenance Bonds each valued at 100% of the bid amount, along with comprehensive insurance certificates including worker's compensation coverage.
The form requires all contractors and subcontractors hired after January 1, 2013, to be verified as authorized to work in the United States through the federal E-Verify Program operated by the Department of Homeland Security, with verification documentation required within five business days of hire and maintained for potential investigation or audit. The project is subject to compliance with the Davis-Bacon Act, Federal Labor Standard Provisions, Title VI of the Civil Rights Act of 1964, the Department of Labor Equal Opportunity Clause, and prevailing wage standards established by Pennsylvania wage determination Serial No. 25-10248. All recipients of funds must obtain a Data Universal Numbering System (DUNS) number and CAGE CODE. Liquidated damages of $500 per calendar day apply for failure to meet the stipulated completion date. The procurement appears to be funded through a Pennsylvania Department of Community and Economic Development Blight Remediation Program Grant, though specific budget ranges are not provided in the form.
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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 |
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