25-84131500-ITN DFS BOR Attachment J Cert of DFWorkplace.pdf
PDF 100 KB Posted
- Attached to
- Insurance Broker of Record - Reinsurance Broker for Property and Casualty lines, Risk Management and
- Solicitation number
- ITN-13124
- Issued by
- St. Johns County, Florida
About this file
Attachment J is a Certification of Drug-Free Workplace form associated with Invitation to Negotiate (ITN) No. 25-84131500-ITN issued by the Florida Department of Management Services on behalf of the Department of Financial Services' Division of Risk Management. The document provides a certification template for respondents to affirm they have implemented a comprehensive drug-free workplace program, which includes publishing employee statements about controlled substance prohibitions, informing employees about drug abuse dangers and assistance programs, distributing policy statements, requiring employee notification of drug-related convictions, and maintaining ongoing drug-free workplace efforts.
The form is specifically designed to be used in the context of the state's competitive procurement process, with a provision that if the Department receives equal offers in terms of price, quality, and service, preference will be given to respondents who have signed and submitted this drug-free workplace certification. The document outlines six specific requirements for a drug-free workplace program, including employee notifications, information sharing, policy distribution, conviction reporting, potential sanctions, and continuous maintenance of drug-free workplace standards. The certification includes a warning that false statements are punishable under law, and provides space for the respondent's name, authorized signature, title, printed name, and date.
View the file
Other files
Show all 27
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
ITN No.: 25-84131500-ITN
ITN No.: 25-84131500-ITN
Attachment J
Certification of Drug Free Workplace
In the event there is no multiple awards contemplated in the ITN, and the Department receives equal Offers eligible for award, the Department will comply with Florida Statutes in accordance with the ‘Equal Offers’ section of the ITN. When the Department receives equal Offers eligible for award, with respect to price, quality and service, the Department will apply a preference in accordance with Section 287.087, F.S., to the Respondent that has signed and submitted this form with its Offer certifying it has implemented a drug-free workforce program in accordance with the provisions below.
I certify that the Respondent has implemented a drug-free workplace program that includes the following:
(1) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the workplace and specifies the actions that will be taken against employees for violations of such prohibition.
(2) Informing employees about the dangers of drug abuse in the workplace, the business's 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) Giving each employee engaged in providing the commodities or contractual services that are provided under the Offer a copy of the statement specified in (1) above.
(4) In the statement specified in (1), above, notifying the employees that, as a condition of working on the commodities or contractual services that are being competitively procured, the employees 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 893 or of any controlled substance law of the United States or any State, for a violation occurring in the workplace no later than five days after such conviction.
(5) Imposing a sanction on or requiring 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) Making a good faith effort to continuing to maintain a drug-free workplace through implementation of these provisions.
As the person authorized by the Respondent to sign the attachment, I certify that the Respondent complies fully with the above requirements. False statements are punishable under law.
Respondent’s Name: _______________________________________________________
By: ________________________________________ Signature of person authorized to submit Offer
Title: _______________________________________
Name: ______________________________________ Print Name of person authorized to submit Offer
Date: _______________________________________
File details come from the government source that posted it. Updated .