1-Drug Free Workplace Form.doc
DOC document 27 KB Posted
- Attached to
- Medical Stop-Loss Insurance Coverage
- Solicitation number
- ITB-25-00380
- Issued by
- Hillsborough County, Florida
About this file
This document is a Drug-Free Workplace Form related to a state contract opportunity for Hillsborough County, Florida. The form is a certification document that requires vendors to comply with Florida Statute 287.087, which mandates specific workplace drug prevention and reporting procedures. The vendor must commit to publishing a statement prohibiting controlled substance activities in the workplace, informing employees about drug abuse dangers, providing drug abuse policy details, and establishing consequences for violations.
The related contract opportunity involves medical stop-loss insurance coverage sought by the Hillsborough County Human Resources Department. The solicitation is for experienced and qualified insurance providers to provide medical stop-loss insurance coverage for a 10-year period, with an estimated project budget of $43,970,461.98. Vendors must demonstrate a proven and documented track record in providing such insurance services, and must agree to comprehensive drug-free workplace standards as outlined in the attached form, which includes publishing employee notifications, offering drug counseling resources, and implementing workplace substance abuse prevention measures.
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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 .