This government document is issued by General Services for use in Pennsylvania
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https://www.google.com/url?client=internal-element-cse&cx=007572080359491747877:xg1tju_bfd4&q=https://www.dgs.pa.gov/Documents/Real%2520Estate%2520Forms/GSRE-42M%2520Contractor%2520Responsibility%2520Certification.pdf&sa=U&ved=2ahUKEwju64elk-6FAxUTgP0HHaSPA_o4RhAWegQICRAB&usg=AOvVaw3sY15czf1MsQVmu_6sHWlZ