Worker Protection Form.pdf
PDF 78 KB Posted
- Attached to
- Montour County Flagging
- Solicitation number
- 6100058793
- Issued by
- Susquehanna County, Pennsylvania
About this file
The document is a Worker Protection and Investment Certification Form that must be completed by contractors and grantees of the Commonwealth of Pennsylvania. It requires the contractor/grantee to certify compliance with various Pennsylvania state labor and workplace safety laws, including the Unemployment Compensation Law, Workers' Compensation Law, and other applicable laws. The form outlines the penalties for providing false certifications, including contract termination and three-year ineligibility to bid on Commonwealth contracts.
The related state and local contract opportunity is for Montour County, Pennsylvania to procure a contractor to perform temporary traffic control/flagging services. The contract is open to all qualified bidders, and the jurisdiction involved is Montour County. No additional details are provided regarding the specific products or services requested, response dates, award dates, or contract term.
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Other files
| File | Type | Posted |
|---|---|---|
| Contractor Information Form.pdf | ||
| Statement of Work - Montour.pdf | ||
| OS-52.pdf | ||
| T&C - Montour.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: 02/04/2022
| Signature DateRow1: |
| Name PrintedRow1: |
| Title of Certifying Official PrintedRow1: |
| ContractorGrantee Name Printed: |
File details come from the government source that posted it. Updated .