1-Drug Free Workplace Form.doc
DOC document 27 KB Posted
- Attached to
- Tire Disposal Services
- Solicitation number
- ITB-26-00424
- 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 in Florida for vendors bidding on the Tire Disposal Services contract, which is valued at $1,635,000.00 for a three-year period. The form mandates that vendors certify compliance with Florida Statute 287.087 by publishing workplace statements prohibiting unlawful manufacture, distribution, dispensing, possession, or use of controlled substances. Vendors must inform employees of drug abuse dangers, the company's drug-free workplace policy, available counseling and rehabilitation programs, and penalties for violations. Each employee working on the contracted commodities or services must receive a copy of the workplace statement and acknowledge their agreement to comply with its terms and report any controlled substance convictions or guilty pleas within five days of occurrence.
Vendors must impose sanctions on or require satisfactory participation in drug abuse assistance or rehabilitation programs for any convicted employee and make a good faith effort to maintain a drug-free workplace through ongoing implementation of these requirements. The authorized company representative must sign and date the certification form, attesting that the firm fully complies with all six enumerated requirements. This form serves as a prerequisite compliance document for bid submission and does not contain pricing information, set-asides, incumbent details, or other financial terms related to the tire disposal services contract itself.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 2-Insurance Certificate.doc | DOC document | |
| 5-ITB-26-00424 Insurance Requirements.pdf | ||
| 3-Substitute W9 Form.pdf.pdf | ||
| 4-Direct Deposit Authorization Form 5.15.2025.pdf.pdf | ||
| 6-ITB-26-00424 Tire Disposal.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 .