1-Drug Free Workplace Form.doc
DOC document 27 KB Posted
- Attached to
- Paramedic Helmets and RIT Packs
- Solicitation number
- ITB-26-00165
- 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 paramedic helmets and RIT packs procurement, with an estimated project value of $43,384.24. Vendors bidding on this contract must complete and sign this form as a condition of participation, certifying compliance with Florida Statute 287.087 requirements for maintaining a drug-free workplace. The form mandates that vendors publish statements to employees prohibiting unlawful manufacture, distribution, dispensing, possession, or use of controlled substances in the workplace; inform employees of drug abuse dangers and associated penalties; distribute copies of the drug-free workplace statement to all employees engaged in providing the commodities or services under bid; require employees to notify the 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 or rehabilitation programs for violating employees.
Vendors must certify they make a good faith effort to maintain a drug-free workplace through implementation of these requirements and that the firm complies fully with all provisions. The authorized signatory for the vendor organization must sign and date the form, confirming the vendor's adherence to these drug-free workplace standards as established under Florida law. This certification is a mandatory submission requirement for all bidders on this Hillsborough County procurement.
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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 .