1-Drug Free Workplace Form.doc.doc

DOC document 27 KB Posted

Attached to
Roadway Resurfacing Repair and Preservation Districts 3&4 WORCS
Solicitation number
IFB-26-00363
Issued by
Hillsborough County, Florida

About this file

This is a Drug-Free Workplace Certification Form required by Hillsborough County, Florida, for the Roadway Resurfacing Repair and Preservation Districts 3&4 WORCS contract opportunity. The form mandates that vendors certify compliance with Florida Statute 287.087 by implementing a comprehensive drug-free workplace program. Vendors must publish a statement prohibiting unlawful manufacture, distribution, dispensing, possession, or use of controlled substances in the workplace and specify disciplinary actions for violations. Additionally, vendors are required to inform employees about the dangers of drug abuse, the company's drug-free workplace policy, available drug counseling and rehabilitation programs, and penalties for violations. Each employee engaged in providing commodities or contractual services must receive a copy of the workplace statement and acknowledge their commitment to comply with its terms and notify their employer of any drug-related convictions within five business days of occurrence.

Vendors must impose sanctions on or require satisfactory participation in drug abuse assistance or rehabilitation programs for any convicted employees and make a good-faith effort to maintain a drug-free workplace throughout the contract period. The certification must be signed by an authorized company representative and submitted as part of the bid for the $16,000,000 roadway resurfacing and preservation project covering Districts 3 and 4 in Hillsborough County. This drug-free workplace requirement applies to all bidders regardless of size, though the contract includes a 5% Small Business Enterprise (SBE) subcontractor participation goal.

View the file

Other files

File Type Posted
12-Direct Deposit Authorization Form 5.15.2025.pdf.pdf PDF
13-SBE Subcontractors Material Suppliers List SBE-1 Form.pdf PDF
23-Agreement - Construction - Term Contract IFB-26-00363.pdf PDF
17-SBE Goal Participation SBE-1 Form Tutorial.mp4 MP4 file
7-Subcontractors Statement of Satisfaction.pdf.pdf PDF
16-Subcontractor Letter of Intent .pdf PDF
4-Allowance Authorization Release Form.pdf.pdf PDF
31-14 - Attachment G eFlex PDS Emulsion-Spec.pdf PDF
15-AFFIDAVIT OF COMPLIANCE - Denying Doing Business with a Foreign Country of Concern 02.26.2026.docx DOCX document
20-Bid Bond.doc.doc DOC document
18-Attachment J - Supplemental Specifications.pdf PDF
6-Consent of Surety-Change Order.pdf.pdf PDF
29-12 - Attachment E Thermoplastic,RemovalPavtMarkings.pdf PDF
21-Payment Bond.pdf PDF
33-13 - Attachment F Cape Seal Specifications.pdf PDF
27-11 - Attachment D Fuel and Bituminous Index.pdf PDF
11-Substitute W9 Form.pdf.pdf PDF
22-Performance Bond.pdf PDF
10-Insurance Certificate.doc.doc DOC document
3-Vendor Eligibility Check Prior to Contract Award.pdf.pdf PDF
25-8- Attachment A - Hillsborough County (4x6) Construction Sign Specs 202507.pdf PDF
19-Attachment K - Insurance Requirements.pdf PDF
2-Florida Trench Safety Act, Certification and Disclosure Statement.pdf.pdf PDF
14-Contractors Affidavit for Payment of Debts and Claims 02.18.2026.pdf PDF
26-9 - Attachment B Traffic Control Officer-2.03R.pdf PDF
28-16- Attachment I Intersection Valley Gutter Typical Detail.pdf PDF
30-10- Attachment C Full Depth Reclaimation (FDR).pdf PDF
5-Application for Payment.pdf.pdf PDF
8-Consent of Surety to Final Payment.pdf.pdf PDF
32-15-Attachment H Speed Hump Replacement.pdf PDF
9-Change Order Form.pdf.pdf PDF
24-1. Terms Conditions (u).pdf PDF
Show all 32

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

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 .