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					                         INVITATION TO PARTICIPATE IN
                  MARYLAND STATE HIGHWAY ADMINISTRATION’S
                  SAFETY SHOE ALLOWANCE/VOUCHER PROGRAM


TO:           Manager/Owner of Safety shoe business

FROM:         Ms. Galina M. Bocharov
              Maintenance Work Uniform Program Manager
              State Highway Administration

DATE:         April 8, 2013

SUBJECT:      Purchase of Safety Shoes Using Vouchers for FY11 and FY 12


        The Maryland State Highway Administration (SHA) is interested in using your company
as a source of supply for steel toe safety shoes meeting ANSI Standards F 2412 / F 2413 and the
SHA Safety Shoe Policy (attached). Purchase of the shoes will be done using a voucher system
as explained below.

        Employees will be issued a voucher worth no more than $125.00, which your company
will accept in lieu of cash. This voucher is to be used to purchase one pair of approved safety
shoes, and is not to be used toward any accessories i.e. socks, shoestrings, shoe polish etc. Any
shoe expenditure above $125.00 will be the responsibility of the employee.

        Upon receipt of the voucher, the employee will select shoes meeting the above standard
and SHA Safety Shoe Policy. Vendor’s representative will complete the right side of the
voucher when the shoes are provided to the employee. It is understood that the vendor will keep
the original (white) and yellow copies and return the pink copy to the employee when the shoes
are received. The original copy will be matched with corresponding receipts and mailed to the
State Highway Administration Facility listed on the voucher. The yellow copy is the vendor’s
copy and will be kept by the vendor, if desired.

       In order to insure the proper use of these vouchers, we are advising all employees that
they must present their State ID card before you will accept their voucher. For new employees
that haven’t been issued an ID card, another employee that does have a State ID card will
accompany the employee. YOU WILL NOT accept any voucher presented if the employee
does not present an ID card as explained above.

       If you have read the above explanation of the proposed voucher system along with the
SHA Safety Shoe Policy and agree to participate in this program, please complete the attached
Safety Shoe Allowance/Voucher Program Agreement and return it to me, to be included in
SHA’s list of Approved Safety Shoe suppliers.

       This FY11/FY12 agreement will be valid through June 30, 2012
             SAFETY SHOE ALLOWANCE/VOUCHER PROGRAM
                            AGREEMENT
                                            April 8, 2013

MEMORANDUM


TO:            Ms. Galina Bocharov
               Manager, Maintenance Work Uniform Program
               State Highway Administration
               Office of Maintenance
               7491 Connelley Drive
               Hanover, MD 21076

FROM:          Vendor’s business name:
               Federal ID/SSN Number
               Name of the owner/manager:
               Street address:
               City/State/Zip code:
               Phone:
               E-mail:
               Fax:
               Cell/second Phone:
               P.O. Box:


SUBJECT:       Safety Shoes Vouchers FY11 & FY12

        This memo is to acknowledge that we (the above vendor) agree to accept shoe vouchers
from the Maryland State Highway Administration (SHA). Vendor’s representative has read the
State Highway Administration’s Invitation to Participate in the Safety Shoe Allowance/Voucher
Program and the Safety Shoe Policy. Vendor’s representative will complete the right side of the
voucher when the shoes are provided to the employee. It is understood that the vendor will keep
the original (white) and yellow copies and return the pink copy to the employee when the shoes
are received. The original copy will be matched with corresponding receipts and mailed to the
State Highway Administration Facility listed on the voucher. The yellow copy is the vendor’s
copy and will be kept by the vendor, if desired.

       It is further understood that upon receipt of the original copies of the shoe vouchers,
together with the receipt, the SHA will immediately process the bills for payment.

         This FY11/FY12 agreement will be valid through June 30, 2012

Signed:                                                          Date:
               Vendor

               Print Signature
Title:
                            STATE HIGHWAY ADMINISTRATION
                                  SAFETY SHOE POLICY

State Highway Administration’s (SHA) Safety Shoe Allowance/Voucher Program has been
established to provide steel toed (or nonmetallic toed) safety shoes that comply with ANSI
Standards F 2412 / F 2413 for SHA maintenance employees. An allowance of up to $125.00 in
the form of a voucher will be issued for the purchase of these safety shoes, through vendors who
have agreed to comply with SHA’s Safety Shoe Guidelines and criteria.

Following is a list of the approved features and criteria:

REQUIRED FEATURES                                       SOLE CRITERIA
                                            Excellent Rating in  Good Rating in
*6” – 8”                                    Oil                  Heat
Leather Uppers                              Outdoor traction     Chemical
Laced                                       Indoor Traction
Impact & Compression (I/75 C/75)            Abrasion
Electrical Hazard

* Loafer and oxford style shoes are permissible for SAT, RME, & ARME Classifications only.

Vouchers are to be used toward approved safety shoes only. Vouchers are not to be used to
purchase Athletic style shoes (tennis shoe, etc.); Wellington style shoes (cowboy boot, pull
on, etc.); or any accessories (socks, shoestrings, shoe polish etc.)

All employees must present their State ID card before vendor will accept their voucher. For new
employees that haven’t been issued an ID card, another employee that does have a State ID card
will accompany the employee. VENDOR WILL NOT accept any voucher presented if the
employee does not present an ID card as explained above.

				
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