1-Drug Free Workplace Form.doc
DOC document 27 KB Posted
- Solicitation number
- ITB-26-00390
- 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 Disposal, Pumping, Cleaning, and Transportation of Leachate contract opportunity in Florida. Vendors bidding on this project must complete and submit the form as part of their proposal requirements. The form certifies that the bidding contractor complies with Florida Statute 287.087 and maintains a drug-free workplace policy. The contractor must publish a statement prohibiting the unlawful manufacture, distribution, dispensing, possession, or use of controlled substances in the workplace and must communicate this policy and associated penalties to all employees engaged in providing the commodities or contractual services under the bid. Additionally, the contractor must inform employees about the dangers of drug abuse, available counseling and rehabilitation programs, and penalties for violations.
The form requires the contractor to implement specific compliance measures including distributing the drug-free workplace statement to each relevant employee, requiring employees to notify the employer of any drug-related convictions within five days of conviction, and imposing sanctions or requiring participation in drug abuse assistance programs for any convicted employees. The contractor must make a good faith effort to maintain a drug-free workplace through ongoing implementation of these requirements. An authorized company representative must sign and date the form to certify full compliance with all stated requirements under Florida law.
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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 .