1-Drug Free Workplace Form.doc
DOC document 27 KB Posted
- Attached to
- Comprehensive Occupational Wellness Examinations
- Solicitation number
- ITB-26-00315
- Issued by
- Hillsborough County, Florida
About this file
This is a Drug-Free Workplace Certification Form required by the Hillsborough County Board of County Commissioners for the Comprehensive Occupational Wellness Examinations contract opportunity in Florida. The form mandates that all vendors bidding on this three-year medical services contract, with an estimated value of $2,480,940.00, must certify compliance with Florida Statute 287.087 regarding drug-free workplace requirements. Vendors must publish statements notifying employees that unlawful manufacture, distribution, dispensing, possession, or use of controlled substances is prohibited in the workplace and must specify actions taken against violators. Additionally, vendors are required to inform employees about the dangers of drug abuse, company drug-free workplace policies, available counseling and rehabilitation programs, and penalties for violations.
The certification requires vendors to provide all employees engaged in delivering the contracted commodities or services with a copy of the drug-free workplace statement and to notify employees that compliance with the statement is a condition of employment on the bid work. Employees must also report any conviction or guilty plea related to controlled substance violations within five days of the conviction. Vendors must impose sanctions on or require satisfactory participation in drug abuse assistance or rehabilitation programs for any convicted employee and must demonstrate good faith efforts to maintain a drug-free workplace. As an authorized representative, the offeror must sign and date the certification attesting to full compliance with all requirements outlined in this form.
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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 .