6-TOPB Drug Free Workplace Form.pdf
PDF 81 KB Posted
- Attached to
- Elevator Maintenance and Inspection
- Solicitation number
- ITB No. 2025-030
- Issued by
- Palm Beach County, Florida
About this file
This document is a Drug-Free Workplace Certification form from the Town of Palm Beach for Bid #6000-2021-05, specifically for an Electrical Work, Undergrounding Project, Phase 5. The certification outlines a comprehensive set of requirements for maintaining a drug-free workplace environment for contractors and employees involved in the project.
The document details seven specific requirements for ensuring a drug-free workplace, including publishing employee statements about controlled substance prohibitions, establishing a drug-free awareness program, requiring employees to receive and acknowledge the drug-free policy, mandating reporting of any workplace drug-related criminal convictions, and outlining potential actions such as personnel disciplinary measures or requiring participation in drug rehabilitation programs. The form is designed to be completed by the authorized agent of the firm, who will certify compliance with these workplace drug prevention standards.
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Text version
TOWN OF PALM BEACH
DRUG FREE WORKPLACE
BID #: 6000-2021-05 BID TITLE: Electrical Work, Undergrounding Project, Phase 5
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:
File details come from the government source that posted it. Updated .