Worker Protection Form.docx
DOCX document 33 KB Posted
- Attached to
- Dry Ice Blaster with After Cooler
- Solicitation number
- 6100066671
- Issued by
- Lehigh County, Allentown City, Pennsylvania
About this file
This is a Worker Protection and Investment Certification Form issued by the Commonwealth of Pennsylvania in accordance with Executive Order 2021-06, applicable to all contractors and grantees doing business with Pennsylvania state agencies, including the Department of Transportation Engineering District 5-0. The form requires contractors to certify compliance with Pennsylvania's Unemployment Compensation Law, Workers' Compensation Law, and a comprehensive list of state labor and workforce safety laws covering areas such as workplace misclassification, child labor, minimum wage, prevailing wage, equal pay, employment record inspections, and apprenticeship requirements. Contractors must have an authorized official execute the certification, which includes printed name, title, and signature, along with the contractor or grantee name and certification date.
The certification carries significant legal consequences for non-compliance, as Pennsylvania law imposes penalties including contract termination and three-year debarment from bidding on state contracts under 62 Pa. C.S. § 531. Contractors must report any changes in compliance status to the Purchasing Agency immediately upon occurrence. The form is subject to the provisions and penalties of 18 Pa. C.S. § 4904 regarding unsworn falsification to authorities, making false certification a criminal matter. The form was published on February 7, 2022 and applies to the Department of Transportation's contract for rental of a Dry Ice Blaster machine with after cooler and specified accessories.
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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 .