Worker's Protection Form.docx
DOCX document 32 KB Posted
- Attached to
- 1110 HUN 12145929
- Solicitation number
- 6100066624
- Issued by
- Indiana County, Luzerne County, Pennsylvania
About this file
This is a Worker Protection and Investment Certification Form issued by the Commonwealth of Pennsylvania for contractors and grantees bidding on state contracts, specifically related to Invitation for Bid (IFB) 1110 HUN 12145929 for the Department of Corrections at Huntington. The certification requires contractors to confirm compliance with Pennsylvania's Unemployment Compensation Law, Workers' Compensation Law, and 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, Employer to Pay Employment Medical Examination Fee Act, Seasonal Farm Labor Act, Wage Payment and Collection Law, Industrial Homework Law, Construction Industry Employee Verification Act, Act 102 regarding excessive overtime in healthcare, Apprenticeship and Training Act, and Inspection of Employment Records Law. A duly authorized official must sign the certification, confirming the contractor's compliance status and understanding that any changes in compliance must be reported immediately to the Purchasing Agency.
The certification is subject to Pennsylvania law penalties for false certifications, including contract termination and three-year ineligibility to bid on contracts under 62 Pa. C.S. 531 for debarment or suspension. Signatories must also confirm understanding that false certification is subject to penalties under 18 Pa. C.S. 4904 for unsworn falsification to authorities. The form requires the printed name and title of the certifying official, the contractor or grantee name, the signature of the authorized representative, and the date of certification. This form was published on February 7, 2022, and serves as a mandatory compliance document for all contractors seeking to do business with the Commonwealth of Pennsylvania.
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Other files
| File | Type | Posted |
|---|---|---|
| 6100066624 Solicitation Addendum 001.pdf | ||
| Statement of Work Blank License Plates.docx | DOCX document | |
| Terms and Conditions.pdf | ||
| Reciprocal Form.doc | DOC document | |
| Executive Order 2021-06.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: 02/07/2022 image1.png
File details come from the government source that posted it. Updated .