Worker's Protection Form.docx
DOCX document 32 KB Posted
- Attached to
- 1106-04628 Mattress Filling Machine
- Solicitation number
- 61000664914
- Issued by
- Luzerne County, Pennsylvania
About this file
This is a Worker's Protection and Investment Certification Form issued by the Commonwealth of Pennsylvania in accordance with Executive Order 2021-06, applicable to contractors and grantees conducting business with Pennsylvania state agencies, including the Department of Corrections at SCI Dallas. The form requires official certification of compliance with Pennsylvania's Unemployment Compensation Law, Workers' Compensation Law, and all applicable state labor and workforce safety laws, encompassing thirteen specific statutory areas including the Construction Workplace Misclassification Act, Employment of Minors Child Labor Act, Minimum Wage Act, Prevailing Wage Act, Equal Pay Law, and various other employment-related statutes. The certification must be executed by an authorized official of the contractor or grantee and submitted as part of the bid response for the mattress filling machine solicitation. All bidders for this procurement are required to complete and submit this form along with the reciprocal limitations form and other required documentation through electronic submission via the PA Supplier Portal.
The certification carries significant legal consequences for false statements, including potential contract termination and three-year ineligibility to bid on future Commonwealth contracts under the debarment or suspension provisions of 62 Pa.C.S. § 531. Certifying officials must acknowledge their understanding that any false certification is subject to penalties under 18 Pa.C.S. § 4904 for unsworn falsification to authorities. Additionally, contractors must report any change in their compliance status to the Purchasing Agency immediately upon discovery. The form serves as a mandatory compliance verification mechanism to ensure that all workers employed on state contracts maintain safe and healthy work environments and receive full protection under Pennsylvania labor laws.
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Other files
| File | Type | Posted |
|---|---|---|
| Solicitation Addendum 001 Bid 6100066491.docx | DOCX document | |
| Terms & Conditions.pdf | ||
| Reciprocal Form.doc | DOC document | |
| Bidders Instructions.pdf | ||
| Statement of Work CI Dallas Fill Machine.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 .