Drug Free Workplace Act.pdf

THE DRUG-FREE WORKPLACE ACT CERTIFICATION FORM

S.C. Code Ann. §44-107-30 provides that no one "may receive a domestic contract for the procurement of any goods, construction, or services for a stated or estimated value of fifty thousand dollars or more from any state agency unless the person has certified to the using agency that it will provide a drug-free workplace" by complying with the requirements as set forth in the "Certification Statement for Person" below.

S.C. Code Ann. §44-107-40 provides that "[n]o state agency may enter into a domestic contract or make a domestic grant with any individual for a stated or estimated value of fifty thousand dollars or more unless the contract or grant includes a certification by the individual that the individual will not engage in the unlawful manufacture, distribution, dispensation, possession, or use of a controlled substance in the performance of the contract."

Please indicate whether you are an entity or individual certifying compliance by selecting the box beside the certification statement that applies to you, and sign and date this form.

□ CERTIFICATION STATEMENT FOR PERSON (BUSINESS ENTITIES)

I hereby certify to the South Carolina Department of Disabilities and Special Needs (SCDDSN) that I will provide a drug-free workplace by:

1. Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensation, 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 the prohibition;

2. Establishing a drug-free awareness program to inform employees about:

a. the dangers of drug abuse in the workplace;

b. the policy of maintaining a drug-free workplace;

c. any available drug counseling, rehabilitative, and employee assistance programs; and

d. the penalties that may be imposed upon employees for drug violations;

3. Making it a requirement that each employee engaged in the performance of the contract be given a copy of the statement required by item 1;

4. Notifying the employee in the statement required by item 1 that, as a condition ofemployment on the contract or 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 the conviction;

5. Notifying SCDDSN within ten days after receiving notice under item 4. b. from an employee or otherwise receiving actual notice of the conviction;

6. Imposing a sanction on, or requiring the satisfactory participation in a drug abuse assistance or rehabilitation program by, any employee convicted as required by Section 44-107-50; and

7. Making a good faith effort to continue to maintain a drug-free workplace through implementation of items 1, 2, 3, 4, 5 and 6.

I also agree that, in compliance with Section 44-107-50, I shall, within thirty days after receiving notice from an employee of a conviction pursuant to Title 44, Chapter 53, Article 3, Narcotics and Controlled Substances, of the South Carolina Code of Laws:

1. Take appropriate personnel action against the employee up to and including termination; or

2. Require the employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for the purposes by a federal, state, or local health, law enforcement, or other appropriate agency.

□ CERTIFICATION STATEMENT FOR INDIVIDUALS

I hereby certify that I will not engage in the unlawfal manufactu.re, distribution, dispensation, possession, or use of a controlled substance in the performance of this contract.

Date Authorized Signature