Worker Protection Form.docx

DOCX document 32 KB Posted

Attached to
23NC Night Vision Goggles
Solicitation number
6100060239
Issued by
Lycoming County, Juniata Terrace Borough, Pennsylvania

About this file

The document is a Worker Protection and Investment Certification Form from the Commonwealth of Pennsylvania. It requires contractors and grantees of the Commonwealth to certify compliance with various Pennsylvania state labor and workplace safety laws, including the Construction Workplace Misclassification Act, Minimum Wage Act, Prevailing Wage Act, and others. The certification is mandatory for all contractors and grantees seeking to do business with the Commonwealth.

The related state and local contract opportunity is for the Pennsylvania Game Commission, Northcentral Region, requesting bids for 15 sets of PVS-14, gen 3, white phosphor night vision goggles or any other comparable models that meet the specified requirements. The minimum FOM for the L3 tubes is 2300. Bidders offering comparable models must have them approved by the Project Manager prior to award. The contract will serve Lycoming County and Harrisburg City.

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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 .