6-Drug Free Workplace Form.pdf
PDF 92 KB Posted
- Attached to
- Police Station Improvements
- Solicitation number
- ITB No. 2026-010
- 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 contractors bidding on the Police Station Improvements project. The certification outlines the contractor's commitment to maintaining a drug-free workplace in accordance with federal grant requirements. The contractor must 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 the dangers of drug abuse, the grantee's policy, available counseling and rehabilitation programs, and penalties for violations; provide a copy of the statement to each employee engaged in grant performance; and notify employees that compliance with the statement is a condition of employment. Additionally, employees must notify the employer of any criminal drug statute convictions related to workplace violations within five days of conviction.
The grantee must notify the Town of Palm Beach within ten days of receiving notice of any employee conviction and must take appropriate action within thirty days, which includes either terminating the employee or requiring participation in an approved drug abuse assistance or rehabilitation program. The form requires certification by an authorized agent of the firm, along with the firm's name, date, agent name and title, email, phone number, and signature. This certification demonstrates the contractor's good faith effort to maintain a drug-free workplace throughout the duration of the Police Station Improvements project and compliance with all applicable federal, state, and local drug-free workplace requirements.
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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 .