1-Drug Free Workplace Form.doc

DOC document 27 KB Posted

Attached to
Sidewalk Repair and Replacement (SBE Set Aside)
Solicitation number
ITB-26-00103
Issued by
Hillsborough County, Florida

About this file

Written by GovTribe AI ·

This is a Drug-Free Workplace Certification Form required by the Hillsborough County Board of County Commissioners in Florida for the Sidewalk Repair and Replacement (SBE Set Aside) contract opportunity, which is governed by Florida Statute 287.087. The form mandates that vendors certify compliance with six specific drug-free workplace requirements, including publishing a statement prohibiting unlawful manufacture, distribution, dispensing, possession, or use of controlled substances in the workplace; informing employees of drug abuse dangers and available counseling and rehabilitation programs; providing employees with copies of the drug-free workplace statement; notifying employees that compliance is a condition of employment on the contract and requiring reporting of drug-related convictions within five days; and imposing sanctions or requiring participation in rehabilitation programs for violations. The vendor's authorized representative must sign and date the certification to confirm full compliance with these requirements.

The Sidewalk Repair and Replacement contract, valued at an estimated $591,250.00, is a three-year Small Business Enterprise (SBE) Set-Aside contract restricted to bidders registered with Hillsborough County's Small Business Enterprises Division as of the bid due date. All work must comply with the Hillsborough County Public Works Standard Specifications for Construction (October 2017) and the Florida Department of Transportation Standard Specifications for Road and Bridge Construction (January 2021). The project encompasses repair, replacement, and maintenance of transportation-related assets throughout the county, including sidewalks, concrete curbs, root pruning, and incidental items on county right-of-way.

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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 .