Worker Protection Form .docx
DOCX document 32 KB Posted
- Attached to
- 23WHM Deer Fence Installation NC-C
- Solicitation number
- 6100063412
- Issued by
- Warren County, Harveys Lake Borough, Pennsylvania
About this file
The Worker Protection Form is a certification document issued by the Commonwealth of Pennsylvania, specifically addressing worker protection and labor law compliance for contractors and grantees. The form requires contractors to certify adherence to various Pennsylvania state labor and workforce safety laws, including the Construction Workplace Misclassification Act, Employment of Minors Child Labor Act, Minimum Wage Act, Prevailing Wage Act, and twelve other specified labor regulations.
The document establishes serious penalties for non-compliance, including potential contract termination and a three-year prohibition on bidding on Commonwealth contracts. Contractors must sign and certify their compliance with these labor laws, acknowledging that providing false certification is subject to legal consequences under Pennsylvania law. The form was published on February 7, 2022, and requires the contractor's authorized official to sign, print their name, title, and the name of their organization, while also committing to immediately report any changes in compliance status to the purchasing agency.
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| Fence Install Contract NC-C 2025.docx | DOCX document | |
| Document (Terms and Conditions).pdf |
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Text version
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 .