1-Drug Free Workplace Form.doc
DOC document 27 KB Posted
- Attached to
- Corrugated Plastic Sign and Adhesive Decals
- Solicitation number
- ITB-26-00080
- Issued by
- Hillsborough County, Florida
About this file
This is a Drug-Free Workplace Certification Form required by Florida Statute 287.087 for vendors bidding on Hillsborough County Engineering & Operations Department contracts. The form applies to the Corrugated Plastic Sign and Adhesive Decals project, estimated at $129,900.00, and certifies that the vendor complies with Florida's drug-free workplace requirements. Vendors must publish a statement notifying employees that unlawful manufacture, distribution, dispensing, possession, or use of controlled substances is prohibited in the workplace and specify disciplinary actions for violations. Additionally, vendors must inform employees about the dangers of drug abuse, the company's drug-free workplace policy, available counseling and rehabilitation programs, and penalties for violations. Each employee engaged in providing commodities or services under the bid must receive a copy of the statement and agree to notify the employer of any conviction or guilty plea related to controlled substance violations occurring in the workplace within five business days.
The form requires vendors to impose sanctions on or require satisfactory participation in drug abuse assistance or rehabilitation programs for employees who are convicted of controlled substance violations, and to make a good faith effort to maintain a drug-free workplace through full implementation of these requirements. The authorized company representative must sign and date the certification, confirming complete compliance with all specified provisions. This certification is a mandatory prerequisite for bid consideration on this Hillsborough County contract opportunity in Florida.
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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 .