1-Drug Free Workplace Form.doc

DOC document 27 KB Posted

Attached to
Stationary High Head Diesel Pump Maintenance
Solicitation number
ITB-26-00129
Issued by
Hillsborough County, Florida

About this file

This is a Drug-Free Workplace Form from Florida, required under Florida Statute 287.087, applicable to the Hillsborough County Board of County Commissioners' competitive sealed bid solicitation for Stationary High Head Diesel Pump Maintenance. The form establishes compliance requirements for vendors bidding on the five-year contract, estimated at $1,437,500.00, for maintenance and service of stationary diesel-driven, high-head pump systems located at selected wastewater pump stations throughout Hillsborough County.

The form mandates that vendors certify they publish workplace statements prohibiting unlawful manufacture, distribution, dispensing, possession, or use of controlled substances; inform employees about drug abuse dangers and available assistance programs; provide copies of the policy to all employees engaged in contract work; require employees to report 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 to certify full compliance with all requirements as a condition of bid submission.

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Other files

File Type Posted
11-ITB-26-00129 Stationary High Head Diesel Pump Maintenance.pdf PDF
5-Attachment C.pdf PDF
7-Attachment E.pdf PDF
8-Attachment D.pdf PDF
2-Insurance Certificate.doc DOC document
6-ITB-26-00129 Insurance Requirements.pdf PDF
3-Substitute W9 Form.pdf.pdf PDF
4-Direct Deposit Authorization Form 5.15.2025.pdf.pdf PDF
10-Attachment B.pdf PDF
9-Attachment A.pdf 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 .