Attachment O Payment of Employee Healthcare Expenses Certification.pdf
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- Attached to
- Task Order - TA-000-232-002A IQC Re-Bid - Pistol Range Modifications & Repairs - DGS-23-306-IQC
- Solicitation number
- BPM055461
- Issued by
- Maryland
About this file
This is an Employee Healthcare Expenses Certification document for the State of Maryland, specifically related to a task order for pistol range modifications and repairs through the Department of General Services (DGS-23-306-IQC). The certification requires contractors to attest to their compliance with state requirements regarding the payment of employee healthcare expenses as a condition of contract award and performance.
The document establishes that contractors must certify they are current in paying all employee health insurance premiums and other healthcare-related expenses, or provide documentation explaining any delinquencies. This certification is mandatory for all bidders and must be submitted with their proposals. The requirement applies throughout the contract term and serves as verification of the contractor's financial responsibility and ability to maintain employee benefits in compliance with Maryland state regulations and contract obligations.
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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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