Attachment-O.-Payment-of-Employee-Healthcare-Expenses-Certification.pdf
PDF 180 KB Posted
- Attached to
- SGHC - Snow Removal Services
- Solicitation number
- BPM058032
- Issued by
- Maryland
About this file
This is a Payment of Employee Healthcare Expenses Certification form required under Maryland State Finance & Procurement Article Title 17, Subtitle 8, applicable to the Spring Grove Hospital Center snow removal services procurement. Bidders and subcontractors must certify their compliance with employee healthcare expense requirements prior to contract award. The certification must be completed and submitted with the bid for IFB BPM058032, with bids due August 10, 2026 at 12:00 PM ET. The contract term is three years (2026-2028), covering snow removal and de-icing services at the hospital's Catonsville campus.
Bidders must select one of three certification options: (1) paying aggregate employee healthcare expenses equal to at least 5 percent of aggregate social security wages; (2) paying 50 percent or more of required premiums for credible health insurance plan coverage; or (3) qualifying for exemption if the firm has 30 or fewer employees. The certification requires signature by an authorized representative and must include the company's name, address, and title of the signatory. False certification carries civil penalties ranging from $2,500 to $25,000 per violation under Maryland Annotated Code 17-804. This Small Business Reserve procurement is restricted to businesses certified by the Maryland Department of Social and Economic Mobility's Office of Small, Minority & Women Business Affairs, with award going to the lowest responsive and responsible bidder.
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Attachment O. Payment of Employee Healthcare Expenses Certification effective date: July 2024
Attachment O. Payment of Employee Healthcare Expenses Certification Under State Finance & Procurement Article Title 17, Subtitle 8
In connection with Solicitation Number _________I, ___________________[Name] hereby certify that ___________________ [Firm Name] is ☐ the bidder/☐ a subcontractor on this project (indicate whether the firm is the bidder or a subcontractor). I further certify that, with respect to employees who will work on or at the site of the project:
[CHOOSE ONLY ONE OPTION BELOW. Note that for purposes of this Certification, “Credible Health Insurance Plan” means any group policy, contract, or program that is written or administered by a disability insurer, health care service plan, fraternal benefits society, self-insured employer plan, or any other entity, in the state of Maryland or elsewhere, that arranges or provides medical, hospital, and surgical coverage not designated to supplement other private or governmental plans.]
1. ☐ The firm pays aggregate employee healthcare expenses of at least 5% of the aggregate social security wages paid.
OR
2. ☐ The firm pays 50% or more of the required premium necessary to obtain employee coverage by a credible health care insurance plan (as defined above).
OR
3. ☐ The firm has 30 or fewer employees and is therefore exempt.
Further, I acknowledge that under §17-804 of the State Finance and Procurement Article, Maryland Annotated Code, a person or entity providing false information regarding this requirement may be subject to a civil penalty of not less than $2,500 and not exceeding $25,000 for each violation.
Signature of Authorized Representative Date
Title of Authorized Representative
Company Street Address
City, State, ZIP Code
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