EXHIBIT 11 - CERTIFICATE OF COMPLIANCE WITH 49 CFR PART 655.pdf
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- Attached to
- LIQUID WASTE REMOVAL SERVICES
- Solicitation number
- OP145195
- Issued by
- California
About this file
This is a Certificate of Compliance with 49 CFR Part 655 required by the Los Angeles County Metropolitan Transportation Authority (LACMTA) for bidders and proposers on transit-related contracts involving safety-sensitive functions. The document establishes a certification framework whereby bidders must determine whether the work requires performance of safety-sensitive functions as defined in 49 CFR Part 655. Bidders selecting that safety-sensitive functions are not required may proceed directly to the signature section, while those indicating that safety-sensitive functions are required must complete additional compliance sections prior to contract award.
Bidders whose work involves safety-sensitive functions 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 programs prior to contract award. Similarly, bidders must certify compliance with drug and alcohol testing program requirements under 49 CFR Part 655, either through existing programs or commitments to establish compliant programs before award. Bidders marking that safety-sensitive functions apply to their contract must submit both their anti-drug use and alcohol misuse program and their drug and alcohol testing program to LACMTA for review and approval prior to contract award, with the authorized representative acknowledging this requirement through their signature.
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Text version
BIDDER/PROPOSER: ______________________
EXHIBIT 11 - 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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