4-Form - Drug Free.pdf
PDF 81 KB Posted
- Attached to
- Annual Bid to Furnish and Deliver Polymer
- Solicitation number
- 2027002
- Issued by
- Indian River County, Florida
About this file
This is a Drug-Free Workplace Certification form required by the State of Florida for vendors submitting bids on an annual contract to furnish and deliver polymer for the period October 1, 2026, through September 30, 2027. The certification must be completed and submitted with the bid as a condition of participation in this as-needed delivery contract.
The form requires the bidding vendor to certify compliance with Florida Statute 287.087 by documenting six specific drug-free workplace requirements: publishing a statement prohibiting unlawful manufacture, distribution, dispensing, possession, or use of controlled substances in the workplace; informing employees about drug abuse dangers and company policy; providing employees with a copy of the drug-free workplace statement; notifying employees of their obligation to report any drug-related convictions or guilty pleas within five days; imposing sanctions or requiring participation in rehabilitation programs for convicted employees; and making good faith efforts to maintain a drug-free workplace. The authorized company representative must sign and date the certification, confirming the firm's full compliance with these requirements.
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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 .