1-Drug Free Workplace Form.doc
DOC document 27 KB Posted
- Attached to
- Portable Toilet Rentals and Maintenance Services
- Solicitation number
- ITB-26-00150
- 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 portable toilet rentals and maintenance services. Vendors must certify compliance with Florida Statute 287.087 by completing this form as a condition of bid submission. The certification requires vendors to implement comprehensive drug-free workplace policies, including publishing statements to employees prohibiting unlawful manufacture, distribution, dispensing, possession, or use of controlled substances; informing employees about drug abuse dangers and available counseling or rehabilitation programs; providing copies of the policy statement to all employees engaged in performing the contracted services; and notifying employees of their obligation to report any conviction or plea related to controlled substance violations occurring in the workplace within five days of such conviction.
Vendors must certify that they will impose sanctions on or require satisfactory participation in drug abuse assistance or rehabilitation programs for any employee convicted of drug violations and commit to making good faith efforts to maintain a drug-free workplace through implementation of these requirements. The form requires signature and date from an authorized company representative. This certification is a mandatory compliance document for all bidders on the Hillsborough County portable toilet rental and maintenance services contract, which has an estimated project value of $246,994.50 for a two-year term.
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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 .