1-Drug Free Workplace Form.doc
DOC document 27 KB Posted
- Attached to
- Sulzer Brand- ABS Piranha Grinder Pumps
- Solicitation number
- ITB-26-00134
- Issued by
- Hillsborough County, Florida
About this file
This is a Drug-Free Workplace Certification Form required by the Hillsborough County Water Resources Department in Florida for vendors bidding on the supply of Sulzer ABS Piranha 09/2D Grinder Pumps. The resulting contract will be in effect for a two-year period with an estimated project value of $270,270.00. The form certifies that the bidding vendor complies with Florida Statute 287.087 requirements regarding workplace drug policies and employee notifications.
The vendor must certify compliance with six specific requirements: publishing a statement prohibiting unlawful manufacture, distribution, dispensing, possession, or use of controlled substances in the workplace; informing employees about drug abuse dangers and available assistance programs; distributing the policy statement to all employees engaged in providing the commodities or services under bid; notifying employees that compliance with the drug-free workplace policy is a condition of employment on the contract and requiring notification of any drug-related convictions within five days; imposing sanctions or requiring participation in rehabilitation programs for violating employees; and making a good faith effort to maintain a drug-free workplace. The authorized company representative must sign and date the certification to confirm full compliance with these 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 .