Worker Protection Form .docx

DOCX document 32 KB Posted

Attached to
23WHM SGL129 Wood World Road
Solicitation number
6100063650
Issued by
Monroe County, Harveys Lake Borough, Pennsylvania

About this file

The Worker Protection and Investment Certification Form is a document from the Commonwealth of Pennsylvania that requires contractors and grantees to certify compliance with state labor and workforce safety laws. The form mandates adherence to 13 specific labor regulations, including the Construction Workplace Misclassification Act, Employment of Minors Child Labor Act, Minimum Wage Act, Prevailing Wage Act, and others that protect workers' rights and workplace safety.

The certification carries significant legal implications, with potential penalties for false statements including contract termination and a three-year prohibition from bidding on Commonwealth contracts. Contractors must sign and confirm their compliance with these labor laws, with an ongoing obligation to report any changes in their compliance status to the purchasing agency. The form was published on February 7, 2022, and requires the certifying official's signature, printed name, title, and the name of the contractor or grantee, emphasizing the Commonwealth's commitment to maintaining high standards of worker protection and workplace safety.

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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 .