3-Form - Drug Free.pdf
PDF 81 KB Posted
- Attached to
- Annual Bid for Liquid Carbon Dioxide
- Solicitation number
- 2026023
- Issued by
- Indian River County, Florida
About this file
This is a Drug-Free Workplace Certification form required by Florida Statute 287.087 for a bid submission related to an Annual Bid for Liquid Carbon Dioxide in Florida. The certification must be completed and included with the bid submission. The vendor is required to certify compliance with six specific drug-free workplace requirements, including publishing a statement prohibiting unlawful manufacture, distribution, dispensing, possession, or use of controlled substances in the workplace; informing employees about the dangers of drug abuse and the company's drug-free workplace policy; providing each employee engaged in providing the commodities or services under bid with a copy of the prohibition statement; notifying employees that compliance with the drug-free workplace terms is a condition of employment on the contract and requiring notification of any drug-related convictions within five days; imposing sanctions or requiring participation in drug abuse assistance or rehabilitation programs for convicted employees; and maintaining a good faith effort to continue drug-free workplace practices through implementation of the statute's requirements.
The authorized representative of the bidding firm must sign and date the certification, attesting that the company fully complies with all stated requirements. The form requires the company name, bidder's signature, date of signature, and name of the business submitting the bid. This certification is a mandatory compliance document for all vendors bidding on state and local contract opportunities in Florida and does not include specific pricing terms, set-asides, or funding information relevant to the liquid carbon dioxide procurement itself.
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Text version
DRUG-FREE WORKPLACE CERTIFICATION
(Please include this form with your bid)
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’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. 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 893 or of any controlled substance law of the United States or any state, for a violation occurring in the workplace no later than 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 Section 287.087.
As the person authorized to sign the statement, I certify that this firm complies fully with the above requirements.
Company Name
Bidder's Signature
Date:
| Name of Business: |
| Textfield: |
| Date: |
File details come from the government source that posted it. Updated .