Attachment O Payment of Employee Healthcare Expenses Certification.pdf
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- Solicitation number
- BPM059610
- Issued by
- Baltimore County, Capitol Heights Town, Maryland
About this file
This is a Payment of Employee Healthcare Expenses Certification form related to the Roof Replacement, Repair and Gutter Replacement project for Red Brick Cottages 1-4 in Maryland (Contract ID: SG-000-270-003). The certification document establishes requirements for contractors and subcontractors to provide attestation regarding employee healthcare expenses. The form serves as a compliance mechanism to ensure that workers employed on this state contract receive appropriate healthcare benefits or compensation as mandated by Maryland's prevailing wage and employee benefits regulations. Contractors must complete this certification as part of their bid submission or contract award process to demonstrate adherence to state employment benefit requirements for all employees assigned to the roofing and gutter replacement work.
The certification requirement reflects Maryland's commitment to protecting worker welfare on state-funded construction projects. Contractors are obligated to certify their compliance with healthcare expense payment obligations for all employees, including those working directly on the project and any subcontracted workers. This document functions as a verification mechanism during contract administration to ensure ongoing compliance throughout the project term. Failure to provide accurate certification or subsequent non-compliance with healthcare expense payment requirements could result in contract penalties or termination.
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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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