Worker Protection Form.pdf
PDF 142 KB Posted
- Attached to
- 7840610000, Landfill, Disposal
- Solicitation number
- 6100063986
- Issued by
- Bucks County, Pittsburgh City, Pennsylvania
About this file
The document is a Worker Protection and Investment Certification Form issued by the Commonwealth of Pennsylvania, mandated by Executive Order 2021-06. The form requires contractors and grantees to certify compliance with Pennsylvania's state labor and workforce safety laws, including 13 specific acts ranging from the Construction Workplace Misclassification Act to the Inspection of Employment Records Law. Contractors must affirm they are in compliance with these laws, including Unemployment Compensation Law and Workers' Compensation Law, and acknowledge potential penalties for false certification.
The certification form carries significant legal consequences, including potential contract termination and a three-year ineligibility to bid on contracts under 62 Pa. C.S. § 531 if false information is provided. The document requires the certifying official to sign and provide their name, title, and organization, confirming their understanding that the certification is subject to the provisions of 18 Pa. C.S. § 4904 regarding unsworn falsification to authorities. The form was published on 02/04/2022 and is designed to ensure worker protections and safe working environments across the Commonwealth of Pennsylvania.
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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
| WORKER PROTECTION AND INVESTMENT CERTIFICATION FORM |
| CERTIFICATION |
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