1-Drug Free Workplace Form.doc
DOC document 27 KB Posted
- Attached to
- Dirt Screeners
- Solicitation number
- ITB-26-00318
- 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 vendors bidding on a one-time purchase of two (2) MGL Engineering HS96 HandyScreen Dirt Screeners or equivalent, with a project estimate of $220,000.00 in Florida. The form serves as a mandatory compliance document under Florida Statute 287.087, requiring the vendor to certify adherence to drug-free workplace policies and practices. Vendors must demonstrate that they have published workplace statements prohibiting unlawful manufacture, distribution, dispensing, possession, or use of controlled substances; informed employees of drug abuse dangers and company policies; distributed the drug-free workplace statement to all employees involved in the commodities or services being bid; notified employees that compliance is a condition of employment on the contract; and committed to imposing sanctions or requiring participation in rehabilitation programs for violations.
The certification form requires the authorized company representative to sign and date the document, affirming good faith implementation and maintenance of drug-free workplace requirements throughout the contract period. No pricing information, set-asides, or contract renewal terms are specified within this form itself, as it functions solely as a pre-bid compliance certification document. Vendors must complete and submit this form as part of their bid package to demonstrate eligibility and commitment to maintaining a drug-free workplace environment for all employees working on this Hillsborough County project.
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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 .