1-Drug Free Workplace Form.doc.doc
DOC document 27 KB Posted
- Attached to
- Kitchen & Laundry Appliances for Fire Stations
- Solicitation number
- ITQ-26-00290
- 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 for vendors bidding on a kitchen and laundry appliances procurement for Hillsborough County Fire Rescue (HCFR) fire stations in Florida. The form serves as a compliance document mandated under Florida Statute 287.087 and must be completed and signed by an authorized representative of any bidding firm. The one-time purchase project has an estimated value of $41,183.79 for kitchen and laundry appliances to be distributed across HCFR facilities.
The Drug-Free Workplace Form requires vendors to certify six specific compliance measures: publication of a workplace drug prohibition statement to employees, employee education regarding drug abuse dangers and company policies, distribution of the policy statement to all employees engaged in performing the contracted work, employee notification of their obligation to report controlled substance convictions within five days, implementation of sanctions or rehabilitation program participation for violating employees, and sustained good faith efforts to maintain a drug-free workplace. The certifying officer must sign and date the form, confirming the firm's full compliance with all stated requirements under Florida law.
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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 .