EXHIBIT 10 - CERTIFICATE OF COMPLIANCE WITH 49 CFR PART 655.pdf

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Attached to
Maintenance Agreement - Vertical Lift Machines (Kardex, Modula, White)
Solicitation number
PS138225
Issued by
California

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This document is a Certificate of Compliance with 49 CFR Part 655 issued by the Los Angeles County Metropolitan Transportation Authority (LACMTA) for bidders and proposers on transit operations contracts. The certificate requires bidders to certify their compliance status regarding prevention of alcohol misuse and prohibited drug use in transit operations. Bidders must first determine whether the contract work will require the performance of "Safety Sensitive Functions" as defined in 49 CFR Part 655. If safety-sensitive functions are not required, bidders may proceed directly to the signature section. If safety-sensitive functions are required, bidders must complete additional compliance sections prior to contract award.

For contracts involving safety-sensitive functions, bidders must certify either that they have already established and implemented an anti-drug use and alcohol misuse program meeting 49 CFR 655 requirements, or that they will establish and implement such a program prior to contract award. Similarly, bidders must certify regarding their drug and alcohol testing program compliance status. Bidders selecting safety-sensitive function requirements must understand that they are obligated to submit both their anti-drug use and alcohol misuse program and their drug and alcohol testing program to LACMTA for review and approval before contract award can be granted. An authorized representative must sign the certificate with title and date, acknowledging these compliance obligations.

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BIDDER/PROPOSER: ______________________

EXHIBIT 10 - CERTIFICATE OF COMPLIANCE WITH 49 CFR PART 655,

PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN

TRANSIT OPERATIONS

Bidder/Proposer hereby certifies that:

A. Safety Sensitive Functions Requirement

(Choose one of the following alternatives by checking the appropriate box)

1.

To the best of my knowledge and belief the Work required under the Contract WILL NOT require the performance of “Safety Sensitive Functions” as defined in 49 CFR Part 655.

OR

2.

To the best of my knowledge and belief the Work required under the Contract WILL require the performance of “Safety Sensitive Functions” as defined in 49 CFR Part 655.

If alternative A.1 was chosen, Bidder/Proposer shall proceed directly to Section D.

If alternative A.2 was chosen, Bidder/Proposer must complete Section B, parts 1 and 2, and Section C, prior to proceeding to Section D.

B. Required Drug and Alcohol Programs

1. Anti-drug Use and Alcohol Misuse Program

(Choose one of the following alternatives by checking the appropriate box)

a. Bidder/Proposer has established and implemented an anti-drug use and alcohol misuse program meeting the requirements on 49 CFR 655.

OR

b.

Bidder/Proposer will establish and implement an anti-drug use and alcohol misuse program meeting the requirements on 49 CFR 655 prior to contract award.

2. Drug and Alcohol Testing Program

(Choose one of the following alternatives by checking the appropriate box)

a. Bidder/Proposer has established and implemented a drug and alcohol testing program that complies with 49 CFR Part 655.

OR

b. Bidder/Proposer will establish and implement a drug and alcohol testing program that will comply with 49 CFR Part 655 prior to contract award.

BIDDER/PROPOSER: ______________________

C. Submittals

If Bidder/Proposer marked Section A.2 above, Bidder/Proposer understands and acknowledges that it must submit (1) its Anti-drug Use and Alcohol Misuse Program and

(2) its Drug and Alcohol Testing Program to LACMTA for review and approval prior to contract award.

Bidder/Proposer Initials ___________

D. Signatures

Bidder/Proposer:

Authorized Representative:

Signature of Authorized Representative:

Title:

Date:

EXHIBIT - CERTIFICATE OF COMPLIANCE WITH 49 CFR PART 655, PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT OPERATIONS

Authorized Representative:
Title:
Date:
A:
1: Off
2: Off
B:
1:
a: Off
b: Off
2:
a: Off
b: Off
Bidder/Proposer2:
BIDDER/PROPOSER:

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