1-Drug Free Workplace Form.doc.doc
DOC document 27 KB Posted
- Attached to
- Hydrant Flusher Kits
- Solicitation number
- ITQ-26-00301
- 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 one-time purchase of 27 Hydrant Flusher Kits, valued at approximately $11,475.00, in Florida. The form serves as a compliance document under Florida Statute 287.087, mandating that vendors certify their adherence to drug-free workplace standards as a condition of contract eligibility. Vendors must acknowledge implementation of six key requirements: publishing a workplace statement prohibiting controlled substance manufacture, distribution, dispensing, possession, or use; informing employees of drug abuse dangers and company policy; distributing the workplace statement to all employees engaged in performing the contracted work; notifying employees of their obligation to report any drug-related 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 environment.
The certification must be signed by an authorized company representative and dated prior to bid submission. Vendors are required to certify full compliance with all stated requirements as part of their proposal package. This document represents a prerequisite compliance certification rather than a pricing or technical specification form, and failure to complete and submit it may result in bid rejection or contract ineligibility.
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| File | Type | Posted |
|---|---|---|
| 2-Substitute W9 Form.pdf.pdf | ||
| 3-Direct Deposit Authorization Form 5.15.2025.pdf.pdf | ||
| 4-ITQ-26-00301 Hydrant Flusher Kits.pdf |
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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 .