Worker Protection and Investment Certification Form.pdf

PDF 94 KB Posted

Attached to
District 3 Uniform/Shop Towel Rental
Solicitation number
6100066103
Issued by
Lycoming County, Monument CDP, Pennsylvania

About this file

This is a Worker Protection and Investment Certification Form related to a uniform and shop towel rental procurement for the Pennsylvania Department of Transportation (PennDOT) across three engineering districts: District 3-5 in Snyder County, District 3-8 in Union County, and District 3-4 in Northumberland County. The form serves as a certification document for contractors bidding on the District 3 Uniform/Shop Towel Rental contract, requiring vendors to attest to compliance with worker protection and investment standards as a condition of bid submission and contract award.

The document establishes mandatory compliance requirements that bidders must certify prior to contract execution. Contractors must demonstrate adherence to specified worker protection protocols and investment certifications as outlined in the form, which functions as both a pre-bid qualification tool and a contractual obligation. Failure to complete and submit the certification form as part of the bid package may result in bid rejection or disqualification from the procurement process.

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Title1_es_:signer:title:
Date:
Title of Certifying Official (Printed):
Name (Printed):
Contractor/Grantee Name (Printed):

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