1-Drug Free Workplace Form.doc
DOC document 27 KB Posted
- Attached to
- Weidmuller Power Supply State and local contract opportunity
- Solicitation number
- ITB-26-00117
- 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 vendors bidding on a Weidmuller power supply contract estimated at $39,959.40. The form mandates that bidding vendors certify compliance with Florida Statute 287.087 by implementing a comprehensive drug-free workplace program. Vendors must publish statements prohibiting unlawful manufacture, distribution, dispensing, possession, or use of controlled substances in the workplace; inform employees about drug abuse dangers and available counseling and rehabilitation programs; distribute the policy statement to all employees engaged in providing the commodities or services under bid; require employees to notify their employer within five days of any conviction or guilty plea related to controlled substance violations; and impose sanctions or require participation in drug abuse assistance programs for employees convicted of drug violations. The vendor's authorized representative must sign and date the certification, affirming full compliance with all stated requirements.
The form requires vendors to demonstrate a good faith effort to maintain a drug-free workplace through ongoing implementation of the prescribed measures. This certification is a mandatory compliance requirement for participation in the Hillsborough County competitive sealed bid process for the Weidmuller power supply procurement. No pricing information, payment terms, set-asides, incumbent information, or funding sources are addressed in this particular form, as it serves solely as a compliance certification document that vendors must complete and submit as part of their bid package.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| 3-Direct Deposit Authorization Form 5.15.2025.pdf.pdf | ||
| 4-ITB-26-00117 Weidmuller Power Supply.pdf | ||
| 2-Substitute W9 Form.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 .