Worker Protection Form .docx

DOCX document 32 KB Posted

Attached to
23WHM SGL 164 New Building Pad General
Solicitation number
6100060987
Issued by
Butler County, Pennsylvania

About this file

This document is a Worker Protection and Investment Certification Form required for contractors and grantees of the Commonwealth of Pennsylvania. It certifies that the contractor/grantee is compliant with applicable Pennsylvania state labor and workplace safety laws, including the Construction Workplace Misclassification Act, Minimum Wage Act, and Prevailing Wage Act, among others. Providing false certification can result in contract termination and three-year ineligibility to bid on state contracts.

The related state and local contract opportunity is for the Pennsylvania Game Commission (PGC) to solicit electronic bids for a new 50' x 70' stone building pad, expanding the existing access road and parking area, and providing miscellaneous erosion and sedimentation controls on State Game Lands #164 in Clearfield Township, Butler County. This project is in preparation for the future construction of a storage building. Bids will be opened on May 8, 2024, at 2:00 PM. Separate bids are required for the general construction contract.

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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 image1.png

File details come from the government source that posted it. Updated .