RFA 67-211 Worker Protection Certification Form.pdf
PDF 142 KB Posted
- Attached to
- Spinal Cord Injury Research Grant
- Solicitation number
- RFA 67-2011
- Issued by
- Dauphin County, Harveys Lake Borough, Pennsylvania
About this file
This is a Worker Protection and Investment Certification Form (RFA #67-211, Attachment II) issued by the Commonwealth of Pennsylvania in compliance with Executive Order 2021-06, requiring all contractors and grantees to certify compliance with Pennsylvania labor and workplace safety laws. The certification applies to the Spinal Cord Injury Research Grant, which supports research aimed at improving the health of Pennsylvanians living with spinal cord injuries under Act 77 of 2001. Contractors and grantees must verify compliance with thirteen specific Pennsylvania statutes and regulations, including the Construction Workplace Misclassification Act, Employment of Minors Child Labor Act, Minimum Wage Act, Prevailing Wage Act, Equal Pay Law, Employer to Pay Employment Medical Examination Fee Act, Seasonal Farm Labor Act, Wage Payment and Collection Law, Industrial Homework Law, Construction Industry Employee Verification Act, Act 102 regarding excessive overtime in healthcare, Apprenticeship and Training Act, and the Inspection of Employment Records Law, as well as Pennsylvania's Unemployment Compensation Law and Workers' Compensation Law.
The certification must be executed by an authorized official of the contractor or grantee organization and submitted as part of the grant application or contract award process. False certification carries significant penalties under Pennsylvania law, including contract termination and three-year ineligibility to bid on Commonwealth contracts under 62 Pa. C.S. §531 (Debarment or Suspension). Additionally, unsworn falsification to authorities is subject to penalties under 18 Pa. C.S. §4904. The certifying official must report any changes in the contractor or grantee's compliance status to the Purchasing Agency immediately upon discovery. The form requires signature, date, printed name, title of certifying official, and contractor or grantee name.
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Text version
RFA # 67-211
Attachment II
WORKER PROTECTION AND INVESTMENT CERTIFICATION FORM
A. Pursuant to Executive Order 2021-06, Worker Protection and Investment (October 21, 2021), the Commonwealth is responsible for ensuring that every worker in Pennsylvania has a safe and healthy work environment and the protections afforded them through labor laws. To that end, contractors and grantees of the Commonwealth must certify that they are in compliance with Pennsylvania’s Unemployment Compensation Law, Workers’
Compensation Law, and all applicable Pennsylvania state labor and workforce safety laws including, but not limited to:
1. Construction Workplace Misclassification Act
2. Employment of Minors Child Labor Act
3. Minimum Wage Act
4. Prevailing Wage Act
5. Equal Pay Law
6. Employer to Pay Employment Medical Examination Fee Act
7. Seasonal Farm Labor Act
8. Wage Payment and Collection Law
9. Industrial Homework Law
10. Construction Industry Employee Verification Act
11. Act 102: Prohibition on Excessive Overtime in Healthcare
12. Apprenticeship and Training Act
13. Inspection of Employment Records Law
B. Pennsylvania law establishes penalties for providing false certifications, including contract termination; and three-year ineligibility to bid on contracts under 62 Pa. C.S. § 531 (Debarment or suspension).
CERTIFICATION
I, the official named below, certify I am duly authorized to execute this certification on behalf of the contractor/grantee identified below, and certify that the contractor/grantee identified below is compliant with applicable Pennsylvania state labor and workplace safety laws, including, but not limited to, those listed in Paragraph A, above. I understand that I must report any change in the contractor/grantee’s compliance status to the Purchasing Agency immediately. I further confirm and understand that this Certification is subject to the provisions and penalties of 18 Pa. C.S. § 4904
(Unsworn falsification to authorities).
Signature Date
Name (Printed)
Title of Certifying Official (Printed)
Contractor/Grantee Name (Printed)
BOP-2201
Published: 02/07/2022
| Name PrintedRow1: |
| Title of Certifying Official PrintedRow1: |
| ContractorGrantee Name Printed: |
| Signature1_es_:signer:signature: |
| Date2_es_:signer:date: |
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