1-Drug Free Workplace Form.doc.doc
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- Attached to
- Insurance Consulting and Brokerage Services
- Solicitation number
- RFP-26-00292
- 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 the Insurance Consulting and Brokerage Services contract in Florida, as mandated by Florida Statute 287.087. The form establishes compliance requirements for all contractors seeking to provide ongoing and as-needed insurance consulting and brokerage services for a five-year period valued at $1,000,000.00. Vendors must certify that they maintain a drug-free workplace policy by publishing a statement prohibiting unlawful manufacture, distribution, dispensing, possession, or use of controlled substances; informing employees of drug abuse dangers and available assistance programs; distributing the policy statement to all employees engaged in performance of contract work; notifying employees of their obligation to report workplace-related controlled substance convictions within five days; and imposing sanctions or requiring participation in rehabilitation programs for violating employees.
The certification requires the authorized company representative to sign and attest that the firm fully complies with all drug-free workplace requirements under Florida Statute 287.087. This form represents a mandatory compliance document that must be completed and submitted as part of the proposal process. No pricing terms, set-asides, or financial arrangements are specified within this form itself, as it functions solely as a certification mechanism to establish the contractor's commitment to maintaining a drug-free workplace environment during the performance of contractual services.
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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 .