1-Drug Free Workplace Form.doc.doc
DOC document 27 KB Posted
- Attached to
- Benefits Consulting and Actuarial Services
- Solicitation number
- RFP-27-00026
- Issued by
- Hillsborough County, Florida
About this file
This is a Drug-Free Workplace Certification Form required by Florida Statute 287.087 for the Hillsborough County Board of County Commissioners' Benefits Consulting and Actuarial Services contract opportunity in Florida. Vendors responding to this five-year competitive sealed proposal solicitation, estimated at $1,208,376.34, must complete and submit this certification as part of their bid requirements. The form serves as the vendor's attestation of compliance with Florida's drug-free workplace standards and must be signed by an authorized representative of the offeror's firm.
The certification requires vendors to demonstrate six core compliance elements: publishing a workplace drug prohibition statement to employees, informing employees about drug abuse dangers and company policy, providing a copy of the statement to all employees engaged in performing the contract work, notifying employees of their obligation to report controlled substance convictions within five days, imposing sanctions or requiring rehabilitation program participation for violations, and maintaining good faith effort in sustaining a drug-free workplace. Submission of this form is mandatory for all vendors bidding on this contract opportunity and represents a condition of eligibility to compete for the award.
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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 .