7-Drug Free Workplace Form.doc.doc

DOC document 27 KB Posted

Attached to
Pavement Management Engineering Support Services
Solicitation number
RPS-27-00017
Issued by
Hillsborough County, Florida

About this file

This is a Drug-Free Workplace Certification Form required by Florida Statute 287.087 for vendors bidding on the Hillsborough County Technical Services Department's Pavement Management Engineering Support Services contract in Florida. The form mandates that the undersigned vendor certify compliance with 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 each employee engaged in the contract work with a copy of the prohibition statement; notifying employees that abidance by 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 rehabilitation programs for convicted employees; and maintaining good faith efforts to sustain a drug-free workplace. The authorized company representative must sign and date the form to certify full compliance with these requirements.

The Drug-Free Workplace Certification Form serves as a prerequisite compliance document for the Pavement Management Engineering Support Services solicitation, which seeks proposals from qualified consulting firms to provide professional engineering services supporting Hillsborough County's pavement and sidewalk asset management, evaluation, and planning programs. The total contract award is estimated at $1,500,000.00 to be divided among awarded firms. Questions and requests for interpretation regarding the solicitation must be received no later than 14 calendar days following the solicitation issuance date, site visit, or pre-bid conference, whichever occurs later, as specified in the Contract Terms and Conditions Document Paragraph 3.4. No set-asides, pricing terms, or other financial requirements are specified in this certification form.

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Text version

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’ 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 1893 or of any controlled substance law of the United States or any state, for violation occurring in the workplace no later than five (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 this section.

As the person authorized to sign the statement, I certify that this firm complies fully with the above requirements.

Offeror’s Signature

Date

DRUG-FREE WORKPLACE FORM

G:\Forms Library\0500-Forms\522_Drug Free Workplace Form.doc

File details come from the government source that posted it. Updated .