1-Drug Free Workplace Form.doc.doc
DOC document 27 KB Posted
- Attached to
- Cape Seal Pavement Preservation
- Solicitation number
- IFB-26-00111
- Issued by
- Hillsborough County, Florida
About this file
This is a Drug-Free Workplace Certification Form required by Hillsborough County, Florida for the Cape Seal Pavement Preservation project, a pavement preservation initiative estimated at $2,010,823.90. The project involves cape seal treatment at four designated locations throughout Hillsborough County: Imperial Key (Group ID: 11680), Wyndham Lakes Drive (Group ID: 12330), Tarpon Drive (Group ID: 16180), and River Close Boulevard (Group IDs: 22640 & 22660). Minor milling and resurfacing operations may be performed in specific segments where pavement deterioration cannot be adequately addressed by cape seal treatment alone. All vendors bidding on this project must complete and submit the Drug-Free Workplace Certification Form as a condition of contract award.
The Drug-Free Workplace Certification Form mandates that vendors comply with Florida Statute 287.087 by publishing workplace policies prohibiting controlled substance use, informing employees of drug abuse dangers and available assistance programs, distributing policy statements to all employees engaged in the project, and requiring employees to report any drug-related convictions within five days. Vendors must impose sanctions or require participation in rehabilitation programs for employees found in violation and demonstrate good faith efforts to maintain a drug-free workplace. The authorized company representative must sign and date the certification form, confirming full compliance with all specified requirements. Completion and submission of this form is mandatory for all bidders on the Cape Seal Pavement Preservation project.
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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 .