Drug Free Workplace Form.docx
DOCX document 89 KB Posted
- Attached to
- AGGREGATE-HOT LAID - COLD LAID - PICKUP
- Solicitation number
- 5400020189
- Issued by
- South Carolina
About this file
This is a Drug-Free Workplace Certification Form issued by the South Carolina Department of Transportation (SCDOT) as required under S.C. Code Ann. 44-107-10 through -90. The form applies to any person, partnership, corporation, or governmental agency seeking to receive a contract or grant from a state agency for the procurement of goods, construction, or services with a stated or estimated value of fifty thousand dollars or more. Bidders and contractors must complete and submit the certification form prior to contract award.
The form requires the applicant to certify either that they will provide a drug-free workplace or that they will not engage in the unlawful manufacture, distribution, dispensation, possession, or use of a controlled substance in the performance of the contract. The applicant must select the appropriate certification statement, provide their signature, date, printed name, and company address. The South Carolina Department of Transportation Procurement Manager for Commodities & Service Contracts is Jeffery C. Schwalk, who can be contacted at (803) 737-1018 or via fax at (803) 737-2046. Submission of this certification is a mandatory prerequisite for contract eligibility on all qualifying procurements.
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Other files
| File | Type | Posted |
|---|---|---|
| AWARD DATE EXTENSION.pdf | ||
| Pricing and Bid Agreement.pdf | ||
| AGPA Pricing Form.doc | DOC document | |
| CLPA Pricing Form.doc | DOC document | |
| HLPA Pricing Form.doc | DOC document | |
| Letter to Contractors.pdf |
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Text version
Procurement Manager Commodities & Service Contracts Jeffery C. Schwalk
(803) 737-1018 Fax (803) 737-2046
THE DRUG-FREE WORKPLACE ACT
S.C. Code Ann. §§44-107-10 through -90 (1990) As provided by S.C. Code Ann. §44-107-30, no person (a partner, corporation organized or united for a business purpose, or a governmental agency) may receive a contract or grant “…for the procurement of any goods, construction, or services for a stated or estimated value of fifty thousand dollars or more…” from a state agency unless the person has certified to the agency that it will provide a drug-free workplace as set forth in the “Certification Statement for Person” set forth below.
S.C. Code Ann. §44-107-40 provides that no individual may receive a contract or grant “…for a stated or estimated value of fifty thousand dollars or more…” from a state agency unless the contract or grant includes the “Certification Statement for Individual” set forth below. Please check the box beside the certification statement that applies to you and sign and date this form.
I hereby certify to the South Carolina Department of Transportation that I will provide a drug-free workplace.
I hereby certify that I will not engage in the unlawful manufacture, distribution, dispensation, possession, or use of a controlled substance in the performance of this contract.
SIGNATURE: ______________________________________________ DATE: _____/_____/_______
PRINTED NAME: ___________________________________________
COMPANY ADDRESS
| www.scdot.org | ||
| Post Office Box 191 | An Equal Opportunity | |
| 955 Park Street | Affirmative Action Employer | |
| Columbia, SC 29202-0191 | 855-GO-SCDOT (855-467-2368) | |
| www.scdot.org | ||
| Post Office Box 191 | An Equal Opportunity | |
| 955 Park Street | Affirmative Action Employer | |
| Columbia, SC 29202-0191 | 855-GO-SCDOT (855-467-2368) |
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