1-Drug Free Workplace Form.doc.doc

DOC document 27 KB Posted

Attached to
Awning Replacement for Nature Center
Solicitation number
ITQ-26-00272
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 Awning Replacement project at Upper Tampa Bay Park. Vendors bidding on this one-time purchase and installation of a fabricated galvalume awning with aluminum framing, estimated at $25,500.00, must complete and submit this certification form as part of their bid package. The form documents the contractor's commitment to maintaining a drug-free workplace in compliance with Florida Statute 287.087 and establishes the contractor's policies and procedures for preventing controlled substance abuse among employees engaged in performing the contracted commodities or services.

The contractor must certify compliance with six specific requirements: publishing a workplace drug prohibition statement to employees, informing employees about drug abuse dangers and available assistance programs, distributing the policy statement to all employees involved in the project, notifying employees of their obligation to report any controlled substance convictions or guilty pleas within five days, imposing sanctions or requiring participation in rehabilitation programs for violating employees, and maintaining good faith efforts to sustain a drug-free workplace. The authorized company representative must sign and date the form to attest full compliance with these requirements prior to contract 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 .