Worker Protection Form .docx
DOCX document 32 KB Posted
- Attached to
- 23BLE Athlon Thermal Devices
- Solicitation number
- 610066586
- Issued by
- Dauphin County, Harveys Lake Borough, Pennsylvania
About this file
This is a Worker Protection and Investment Certification Form issued by the Commonwealth of Pennsylvania in compliance with Executive Order 2021-06, applicable to the Pennsylvania Game Commission's procurement of two hundred Athlon Cronus Thermal Monocular (Model: Athlon Cronus ATS Thermal Monocular 35M-400) units. The certification requirement applies to all contractors and grantees conducting business with the Commonwealth and must be completed and submitted as part of the bidding process for this Invitation for Bid (IFB). The form establishes mandatory compliance verification across thirteen categories of Pennsylvania labor and workplace safety laws, including the Construction Workplace Misclassification Act, Employment of Minors Child Labor Act, Minimum Wage Act, Prevailing Wage Act, Equal Pay Law, and various other statutory requirements governing worker protection and compensation.
A duly authorized official of the bidding contractor must execute the certification, affirming full compliance with all applicable Pennsylvania state labor and workforce safety laws and regulations. The certifying official acknowledges personal liability under 18 Pa.C.S. § 4904 (Unsworn Falsification to Authorities) for any false statements and understands that false certifications carry severe penalties, including contract termination and three-year debarment from future Commonwealth procurement opportunities under 62 Pa.C.S. § 531. Additionally, the contractor must notify the Purchasing Agency immediately of any changes to its compliance status during contract performance. For technical questions regarding the thermal monocular procurement, interested bidders should contact Captain Jeffrey Mock, Enforcement Division Chief, at the Pennsylvania Game Commission.
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Other files
| File | Type | Posted |
|---|---|---|
| IFB-Athlon Thermal Devices.docx | DOCX document | |
| Terms and Conditions.pdf | ||
| ReciprocalLimitationsAct .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 .