1-Drug Free Workplace Form.doc
DOC document 27 KB Posted
- Attached to
- Laboratory Courier Services
- Solicitation number
- ITB-27-00003
- 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 the Laboratory Courier Services contract opportunity. Vendors bidding on this three-year laboratory courier services contract, estimated at $150,061.13, must complete and submit this certification form as part of their bid package. The form certifies that the bidding contractor complies with Florida Statute 287.087 requirements regarding workplace drug policies and employee notification procedures.
The certification requires vendors to publish a statement prohibiting unlawful drug manufacture, distribution, dispensing, possession, or use in the workplace; inform employees of drug abuse dangers and available assistance programs; distribute the policy statement to all employees engaged in performing the contract services; require employees to notify the employer of any drug-related convictions within five days; impose sanctions or require participation in rehabilitation programs for violations; and maintain good faith efforts to sustain a drug-free workplace. The authorized company representative must sign and date the form, certifying full compliance with all six requirements outlined in the statute.
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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 .