EXHIBIT 15 - CERTIFICATE OF COMPLIANCE WITH 49 CFR PART 655, PREVENTION OF ALCOHOL MISUSE A.pdf
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- Attached to
- Exhaust Tube Assembly
- Solicitation number
- SD143358
- Issued by
- California
About this file
This is an Exhibit 15 Certificate of Compliance form issued by LACMTA (Los Angeles County Metropolitan Transportation Authority) regarding compliance with 49 CFR Part 655, which governs the prevention of alcohol misuse and prohibited drug use in transit operations. The document serves as a certification requirement for bidders and proposers on LACMTA contracts and establishes whether the work involves safety-sensitive functions as defined in federal regulations. Bidders must indicate whether their proposed work will require the performance of safety-sensitive functions and, if so, must complete additional sections addressing anti-drug use and alcohol misuse programs as well as drug and alcohol testing programs. The form requires bidders to certify either that they have already established compliant programs or that they will establish such programs prior to contract award.
If a bidder indicates that safety-sensitive functions will be required under the contract, the bidder must submit both its Anti-Drug Use and Alcohol Misuse Program and its Drug and Alcohol Testing Program to LACMTA for review and approval before contract award. The certification must be signed by an authorized representative of the bidder/proposer. This document is a standard compliance requirement for transit-related contracts and does not specify pricing, award dates, contract terms, or other project-specific details.
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BIDDER/PROPOSER: ______________________
EXHIBIT 15 - 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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