Worker Protection Form .docx
DOCX document 32 KB Posted
- Attached to
- 23WHM FY26 Deer Fence NE-B
- Solicitation number
- 6100066819
- Issued by
- Susquehanna County, 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 the Pennsylvania Game Commission's Bureau of Wildlife Habitat Management project for deer fence installation on State Game Lands in Sullivan and Bradford Counties. The certification document requires all contractors and grantees to comply with Pennsylvania's Unemployment Compensation Law, Workers' Compensation Law, and thirteen specific state labor and workforce safety statutes, including provisions related to construction workplace misclassification, child labor, minimum wage, prevailing wage, equal pay, employment medical examination fees, seasonal farm labor, wage payment and collection, industrial homework, construction industry employee verification, healthcare overtime restrictions, apprenticeship and training, and inspection of employment records. The form requires an authorized official to certify the contractor's compliance with all applicable labor and workplace safety laws and mandates immediate notification to the Purchasing Agency of any changes in compliance status.
The certification is a mandatory requirement for contract award and carries significant penalties for false statements, including contract termination and three-year ineligibility to bid on future Commonwealth contracts under 62 Pa. C.S. § 531. Providers must understand that the certification is subject to the provisions and penalties of 18 Pa. C.S. § 4904 regarding unsworn falsification to authorities. The form was published on February 7, 2022 and serves as a critical compliance verification document that must be completed and signed by an authorized representative of any entity seeking to contract with Pennsylvania for the approximately 45,192 linear feet of woven wire deer enclosure fence installation project.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| FY26 Deer Fence Install NE-B Contract.docx | DOCX document | |
| FY26 Deer Fence Install NE-B.xlsx | XLSX spreadsheet | |
| FY26 Deer Fence Install NE-B Maps.pdf | ||
| GSPUR-89 Reciprocal_Limitations_Act_Reqirements.docx | DOCX document |
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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 .