EXHIBIT 10 - CERTIFICATE OF COMPLIANCE WITH 49 CFR PART 655.pdf
PDF 62 KB Posted
- Solicitation number
- OP1435688370
- Issued by
- California
About this file
This is a Certificate of Compliance form related to 49 CFR Part 655 requirements for alcohol misuse and prohibited drug use prevention in transit operations, administered by LACMTA (Los Angeles County Metropolitan Transportation Authority). The document serves as a certification requirement for bidders and proposers to demonstrate compliance with federal drug and alcohol testing regulations. Bidders must indicate whether the work required under the contract will involve "Safety Sensitive Functions" as defined in 49 CFR Part 655. If safety-sensitive functions are not involved, bidders may proceed directly to signature sections. If safety-sensitive functions are involved, bidders must confirm establishment or planned establishment of both an anti-drug use and alcohol misuse program and a drug and alcohol testing program that comply with federal requirements.
For contracts involving safety-sensitive functions, bidders must submit their Anti-drug Use and Alcohol Misuse Program and Drug and Alcohol Testing Program to LACMTA for review and approval prior to contract award. Bidders have the option to certify that programs are either already established and implemented or will be established and implemented prior to contract award. The form requires authorization and signature from an authorized representative of the bidder/proposer along with title and date. This compliance certificate is a mandatory exhibit within the bidding process and must be completed accurately to satisfy federal transit authority requirements.
View the file
Other files
Show all 31
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
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: |
File details come from the government source that posted it. Updated .