1-Drug Free Workplace Form.doc
DOC document 27 KB Posted
- Attached to
- Appliance Maintenance and Repair Services
- Solicitation number
- ITB-26-00130
- 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 the Appliance Maintenance and Repair Services contract opportunity. The form mandates that vendors certify compliance with Florida Statute 287.087 by implementing a comprehensive drug-free workplace program. Vendors must publish statements prohibiting the unlawful manufacture, distribution, dispensing, possession, or use of controlled substances in the workplace and must inform all employees engaged in providing the bid commodities or contractual services about drug abuse dangers, company policy, available counseling and rehabilitation programs, and applicable penalties. The resulting contract is for a two-year term with an estimated project value of $170,030.00 for installation, repair, and routine annual preventative maintenance services for commercial-grade ranges and other appliances at Fire Rescue Stations throughout Hillsborough County.
The vendor must ensure each affected employee receives a copy of the drug-free workplace statement and understands that compliance is a condition of employment on the contract. Employees are required to notify their employer of any conviction or guilty plea related to controlled substance violations within five days of such conviction. Vendors must impose sanctions on or require satisfactory participation in drug abuse assistance or rehabilitation programs for any convicted employee and must 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 form, attesting that the firm complies fully with all stated requirements.
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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 .