Worker Protection Form .docx
DOCX document 32 KB Posted
- Attached to
- 23SW SGL285 Watts Mill and Cannelton Rd
- Solicitation number
- 6100066745
- Issued by
- Beaver County, Harveys Lake Borough, Pennsylvania
About this file
This Worker Protection and Investment Certification Form is required by the Commonwealth of Pennsylvania for all contractors and grantees working on state contracts, including those with the Pennsylvania Game Commission. The form mandates that contractors certify compliance with Pennsylvania's Unemployment Compensation Law, Workers' Compensation Law, and all applicable state labor and workforce safety laws, including but not limited to the Construction Workplace Misclassification Act, Employment of Minors Child Labor Act, Minimum Wage Act, Prevailing Wage Act, Equal Pay Law, and the Construction Industry Employee Verification Act, among others. The certifying official must be duly authorized to execute the certification on behalf of the contractor or grantee and must sign and date the form with their printed name and title. Any change in the contractor's compliance status must be reported to the Purchasing Agency immediately.
The certification is binding and subject to Pennsylvania law provisions and penalties, including contract termination and three-year ineligibility to bid on future contracts under 62 Pa. C.S. § 531 (Debarment or Suspension). False certifications are prosecutable under 18 Pa. C.S. § 4904 (Unsworn Falsification to Authorities). The form was published on February 7, 2022, and serves as a prerequisite compliance document for the access road maintenance project on State Game Lands #285 in Beaver County, with bids due by November 3, 2026.
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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 .