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 an Employee Healthcare Expenses Certification form required by the Maryland Department of Health for bidders and subcontractors on state contracts under State Finance & Procurement Article Title 17, Subtitle 8. The certification applies to the Spring Grove Hospital Center snow removal services procurement (IFB BPM058032) and requires bidders to affirm compliance with employee healthcare expense requirements prior to contract award. Bidders must certify one of three options: paying aggregate employee healthcare expenses equal to at least 5% of aggregate social security wages; paying 50% or more of required premium costs for credible health care insurance plan coverage; or qualifying for exemption as a firm with 30 or fewer employees. The form must be completed by an authorized representative and signed with accompanying title, company address, and submission date information included.
False certification under Maryland Code 17-804 subjects bidders to civil penalties ranging from $2,500 to $25,000 per violation. This certification requirement applies to all bidders and subcontractors performing work on the project and must be submitted as part of the bid package for the three-year snow removal contract term (2026-2028) at Spring Grove Hospital Center's Catonsville campus. Bidders should ensure compliance documentation is prepared and reviewed before the August 10, 2026 bid submission deadline.
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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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