1-Drug Free Workplace Form.doc
DOC document 27 KB Posted
- Solicitation number
- ITB-26-00212
- Issued by
- Hillsborough County, Florida
About this file
This is a Drug Free Workplace Certification Form required by Florida Statute 287.087 for the Hillsborough County Board of County Commissioners Fire Rescue Department's procurement of SemTech/Sierra Wireless Mobile Data Terminals. The form must be completed and signed by vendors bidding on this contract opportunity. The certification requires vendors to document their compliance with drug-free workplace policies, including publishing statements to employees prohibiting unlawful manufacture, distribution, dispensing, possession, or use of controlled substances in the workplace; informing employees about drug abuse dangers and available counseling and rehabilitation programs; providing copies of the policy statement to all employees engaged in providing the commodities or services under bid; requiring employees to notify the employer within five days of any conviction or guilty plea related to controlled substance violations; and imposing sanctions or requiring participation in drug abuse assistance programs for violating employees. Vendors must certify in writing that they maintain a good faith effort to continue implementing and maintaining a drug-free workplace in accordance with all specified requirements.
The form serves as a mandatory compliance document for all bidders participating in this competitive sealed bid process for the purchase, installation, licensing, support, and consulting services of Mobile Data Terminals over a five-year contract period with an estimated value of $987,240.00. Submission of a completed and signed Drug Free Workplace Certification Form is a prerequisite for bid acceptance, and failure to provide this certification may result in bid rejection or contract disqualification.
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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 .