Attachment_F_Notarized_Drug_Free_Workplace_Certification.pdf
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- Attached to
- Body Shop Repairs
- Solicitation number
- ITB 0029-24
- Issued by
- Lee County, Fort Lauderdale City, Florida
About this file
Attachment F is a Notarized Drug Free Workplace Certification form for the City of Fort Myers' Fleet Auto Body Repair contract opportunity in Florida. The document is a standardized certification form that requires businesses responding to the solicitation to affirm their compliance with Florida Statute 287.087, which mandates specific workplace drug prevention and reporting protocols.
The certification requires respondents to demonstrate a comprehensive drug-free workplace policy, including publishing a written statement prohibiting controlled substance activities, informing employees about drug abuse dangers, providing drug counseling resources, and establishing consequences for workplace drug violations. Respondents must commit to notifying the employer within five days of any employee drug-related convictions, impose sanctions or rehabilitation requirements for convicted employees, and make a good faith effort to maintain a drug-free workplace. The form must be completed, signed by an authorized company representative, and notarized to be considered valid for the contract opportunity.
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Text version
ATTACHMENT F
Notarized Affidavit
DRUG FREE WORKPLACE CERTIFICATION
I the undersigned, in accordance with Florida Statute 287.087, hereby certify that, _________________________________________________________(Print or Type Name of Respondent)
1. Publishes a written statement notifying that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the workplace named above, and specifying actions that will be taken against violations of such prohibition.
2. Informs employees about the dangers of drug abuse in the workplace, the Respondent’s policy of maintaining a drug free working environment, and available drug counseling, rehabilitation, and employee assistance programs, and the penalties that may be imposed upon employees for drug use violations.
3. Gives each employee engaged in providing commodities or contractual services that are under Solicitation or submittal, a copy of the statement specified above.
4. Notifies the employees that as a condition of working on the commodities or contractual and will notify the employer of any conviction of, plea of guilty or nolo contendere to, any violation of Chapter 1893, or of any controlled substance law of the State of Florida or the United States, for a violation occurring in the work place, no later than five (5) days after such conviction, and requires employees to sign copies of such written (*) statement to acknowledge their receipt.
5. Imposes a sanction on, or requires 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. Makes a good faith effort to continue to maintain a drug free workplace through the Implementation of the drug free workplace program.
As a person authorized to sign this statement, I certify that the above-named business, Respondent or corporation complies fully with the requirements set forth herein.
This Certificate must be signed by a person authorized to bind the company.
Company Name Date
_____________________________________ _________________________________ Printed Name and Title Signature County of:__________________________ State of:__________________________
Sworn to and subscribed before me, a Notary Public, for the above State and County on this
_____________ Day of _____________________, 20____.
(Affix Official Seal) Notary Public Commission Expiration
File details come from the government source that posted it. Updated .