1-Drug Free Workplace Form.doc.doc

DOC document 27 KB Posted

Attached to
Intersection Improvements for East County Line Road at Grand Hampton Drive
Solicitation number
IFB-26-00398
Issued by
Hillsborough County, Florida

About this file

This is a Drug-Free Workplace Certification Form required by Hillsborough County, Florida, in connection with the Intersection Improvements for East County Line Road at Grand Hampton Drive project, valued at $1,239,930.07. The form mandates that the undersigned vendor certify compliance with Florida Statute 287.087 by publishing a workplace statement prohibiting the unlawful manufacture, distribution, dispensing, possession, or use of controlled substances and specifying disciplinary actions for violations. The vendor must inform employees about drug abuse dangers, 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 under the bid must receive a copy of the workplace statement and acknowledge that as a condition of employment on the project, they will abide by the statement's terms and notify their employer of any conviction or guilty plea related to controlled substance violations within five business days.

The vendor is required to impose sanctions on or require satisfactory participation in a drug abuse assistance or rehabilitation program for any convicted employee and must demonstrate good faith effort to maintain a drug-free workplace through full implementation of these requirements. An authorized company representative must sign and date the certification form to attest that the firm fully complies with all specified requirements. This certification is a mandatory compliance document for all bidders on this Hillsborough County intersection improvement project and serves as a prerequisite for contract award eligibility.

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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 .