Attachment_O_Payment_of_Employee_Healthcare_Expenses_Certification.pdf
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- Attached to
- (IQC) E-500-260-003 - Replace (9) Nine AHU Humidifiers at the Main Hospital - Cambridge, MD
- Solicitation number
- BPM058339
- Issued by
- Dorchester County, Capitol Heights Town, 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 bidders and subcontractors on state and local contract opportunities in Maryland. The certification applies to firms bidding on or providing services to projects such as the Replace (9) Nine AHU Humidifiers at the Main Hospital project in Cambridge, Maryland. Bidders and subcontractors must certify their compliance with employee healthcare expense requirements by selecting one of three qualifying options: paying aggregate employee healthcare expenses of at least 5% of aggregate social security wages paid to employees who will work on the project; paying 50% or more of the required premium for employee coverage through a credible health insurance plan as defined by the state; or qualifying for exemption as a firm with 30 or fewer employees.
Submission of this certification is mandatory for contract consideration, and false information provided on the form exposes the bidder or subcontractor to civil penalties ranging from $2,500 to $25,000 per violation under Maryland Annotated Code 17-804. The form requires the signature and title of an authorized representative along with the company's complete address information. This certification requirement applies to all bidders on the Master Contractors Eastern Region contract opportunity, which is restricted to Small Business Enterprises.
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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
File details come from the government source that posted it. Updated .