13-Drug Free Workplace Form.pdf
PDF 92 KB Posted
- Attached to
- Moving Services
- Solicitation number
- RFB No. 2026-017
- Issued by
- Palm Beach County, Florida
About this file
This is a Drug Free Workplace Certification form required by the Town of Palm Beach, Florida for a moving services contract. The form documents the grantee's commitment to maintaining a drug-free workplace in compliance with federal requirements. The certification requires the contractor to publish a statement prohibiting unlawful manufacture, distribution, dispensing, possession, or use of controlled substances in the workplace; establish a drug-free awareness program informing employees about dangers of drug abuse, the contractor's policy, available counseling and rehabilitation programs, and penalties for violations; provide each employee engaged in grant performance with a copy of the prohibition statement; notify employees that compliance is a condition of employment and require notification of any criminal drug statute conviction within five days; report employee convictions to the agency within ten days of notice; and take appropriate personnel action, up to and including termination, or require participation in an approved rehabilitation program within 30 days of receiving notice of conviction. The authorized agent must certify full compliance with all requirements.
The form serves as a prerequisite compliance document for bidders on the Town of Palm Beach's moving services contract, which seeks qualified contractors to provide relocation of equipment and furnishings for governmental offices and facilities throughout Palm Beach County. Submission of this certification is mandatory for bid consideration, and the authorized representative must sign and date the form with contact information including title, email, and phone number. This document does not contain pricing information, set-asides, or financial terms, as it functions solely as a compliance certification requirement rather than a pricing or award mechanism.
View the file
Other files
Show all 14
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
TOWN OF PALM BEACH
DRUG FREE WORKPLACE
CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS The grantee certifies that it will provide a drug-free workplace by:
1. Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the grantee’s workplace and specifying the actions that will be taken against employees for violation of such prohibition;
2. Establishing a drug-free awareness program to inform employees about—
a. The dangers of drug abuse in the workplace;
b. The grantee’s policy of maintaining a drug-free workplace;
c. Any available drug counseling, rehabilitation and employee assistance programs, and
d. The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace.
3. Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of the statement required by paragraph (1);
4. Notifying the employee in the statement required by paragraph (1) that, as a condition of employment under the grant, the employee will—
a. Abide by the terms of the statement; and
b. Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after each conviction;
5. Notifying the agency within ten days after receiving notice under subparagraph (4b) from an employee or otherwise receiving actual notice of such conviction;
6. Taking one of the following actions, within 30 days of receiving notice under subparagraph (4b), with respect to any employee who is so convicted—
a. Taking appropriate personnel action against such an employee, up to and including termination; or
b. Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency;
7. Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs 1, 2, 3, 4, 5, 6.
As the person authorized to sign the statement, I certify that this firm complies fully with the above requirements.
Firm: Date:
Authorized Agent: Title:
Email: Phone:
Signature:
| Firm: |
| Date: |
| Name: |
| Title: |
| Email: |
| Phone: |
| eSignature: |
File details come from the government source that posted it. Updated .