6-TOPB Drug Free Workplace Form.pdf
PDF 81 KB Posted
- Solicitation number
- SS No. 2026-22
- Issued by
- Palm Beach County, Florida
About this file
This is a Drug Free Workplace Certification form for the Town of Palm Beach, Florida, related to Bid #6000-2021-05 for Electrical Work, Undergrounding Project, Phase 5. The certification requires the grantee to establish and maintain a drug-free workplace by publishing a statement prohibiting unlawful manufacture, distribution, dispensing, possession, or use of controlled substances; establishing a drug-free awareness program that informs employees about the dangers of drug abuse, the grantee's policy, available counseling and rehabilitation programs, and penalties for violations; and ensuring all employees engaged in grant performance receive a copy of the workplace statement. Employees must be notified that compliance with the drug-free workplace policy is a condition of employment and that they are required to report any criminal drug statute convictions occurring in the workplace within five days of conviction.
The grantee must notify the agency within ten days of receiving notice of any employee conviction and take appropriate action, including termination or requiring participation in an approved drug abuse assistance or rehabilitation program, within 30 days of receiving notice. The certification form requires completion by an authorized agent of the firm with the firm name, date, authorized agent name and title, email address, phone number, and signature. No specific pricing, set-asides, or funding information is contained in this certification document, as it serves solely as a compliance requirement for bidders on the electrical undergrounding project.
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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 .