1-Drug Free Workplace Form.doc
DOC document 27 KB Posted
- Attached to
- Reciprocating Saw Blades
- Solicitation number
- ITB-26-00199
- Issued by
- Hillsborough County, Florida
About this file
This is a Drug-Free Workplace Form certification document required by the Hillsborough County Board of County Commissioners for competitive sealed bids related to the procurement of reciprocating saw blades in Florida. The form mandates that vendors certify compliance with Florida Statute 287.087 requirements for maintaining a drug-free workplace. Vendors must publish statements notifying employees that unlawful manufacture, distribution, dispensing, possession, or use of controlled substances is prohibited in the workplace and specify the actions taken against employees for violations. The form requires vendors to inform employees about the dangers of drug abuse, the business's drug-free workplace policy, available drug counseling and rehabilitation programs, and penalties for violations. Additionally, vendors must provide each employee engaged in providing the commodities or contractual services under bid a copy of the statement and require employees to notify the employer within five days of any conviction or guilty plea related to controlled substance violations occurring in the workplace.
The certification requires vendors to impose sanctions on or require satisfactory participation in drug abuse assistance or rehabilitation programs for convicted employees and to make a good faith effort to continue maintaining a drug-free workplace through implementation of these requirements. The authorized representative of the firm must sign and date the form to certify full compliance with all stated requirements. This form is a mandatory compliance document for the reciprocating saw blades procurement project, which carries an estimated value of $78,367.00 for a two-year period.
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| 2-Substitute W9 Form.pdf.pdf | ||
| 3-Direct Deposit Authorization Form 5.15.2025.pdf.pdf | ||
| 4-ITB-26-00199 Reciprocating Saw Blades.pdf |
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Text version
The undersigned vendor in accordance with Florida Statute 287.087 hereby certifies that
________________________________________________________ does:
(Name of Business)
1. Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the workplace and specifying the actions that will be taken against employees for violations of such prohibition.
2. Inform employees about the dangers of drug abuse in the workplace, the business’ policy of maintaining a drug-free workplace, any available drug counseling, rehabilitation, and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations.
3. Give each employee engaged in providing the commodities or contractual services that are under bid a copy of the statement specified in subsection (1).
4. In the statement specified in subsection (1), notify the employees that, as a condition of working on the commodities or contractual services that are under bid, the employee will abide by the terms of the statement and will notify the employer of any conviction of, or plea of guilty or nolo contendere to, any violation of Chapter 1893 or of any controlled substance law of the United States or any state, for violation occurring in the workplace no later than five (5) days after such conviction.
5. Impose a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program, if such is available in the employee’s community, by any employee who is so convicted.
6. Make a good faith effort to continue to maintain a drug-free workplace through implementation of this section.
As the person authorized to sign the statement, I certify that this firm complies fully with the above requirements.
Offeror’s Signature
Date
DRUG-FREE WORKPLACE FORM
G:\Forms Library\0500-Forms\522_Drug Free Workplace Form.doc
File details come from the government source that posted it. Updated .