STD_21-_drug_free.pdf

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Attached to
California Brand Campaign
Solicitation number
0000037787
Issued by
California

About this file

This is a Drug-Free Workplace Certification form (STD. 21) issued by the State of California, applicable to contractors and grant recipients entering into agreements with state agencies. The certification requires contractors to comply with California Government Code Section 8355 by publishing a statement prohibiting unlawful manufacture, distribution, dispensation, possession, or use of controlled substances in the workplace and specifying disciplinary actions for violations. Contractors must establish a Drug-Free Awareness Program informing employees about the dangers of drug abuse, the organization's drug-free workplace policy, available counseling and rehabilitation resources, and penalties for drug abuse violations. Every employee working on the proposed contract or grant must receive a copy of the company's drug-free workplace policy statement and agree to abide by its terms as a condition of employment on the contract or grant.

The certification allows contractors or grantees to elect a validity period of up to 36 months from the date of execution, after which the certificate remains valid for all subsequent contracts or grants entered into with the state agency without requiring submission of a new individual certificate for each contract or grant. An authorized representative of the contractor or bidder firm must execute the certification under penalty of perjury, providing the firm name, federal identification number, authorized signature, date executed, printed name and title, telephone number, and mailing address. The form has been verified for accessibility compliance with no identified problems in document structure, tagged content, forms, alternate text, tables, lists, or headings.

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STATE OF CALIFORNIA

DRUG-FREE WORKPLACE CERTIFICATION

STD. 21 (Rev. 10/2019)

CERTIFICATION

I, the official named below, hereby swear that I am duly authorized legally to bind the contractor or grant recipient to the certification described below. I am fully aware that this certification, executed on the date below, is made under penalty of perjury under the laws of the State of California.

CONTRACTOR/BIDDER FIRM NAME FEDERAL ID NUMBER

BY(Authorized Signature)

DATE EXECUTED

PRINTED NAME AND TITLE OF PERSON SIGNING TELEPHONE NUMBER (Include Area Code)

TITLE

CONTRACTOR/BIDDER FIRM'S MAILING ADDRESS

The contractor or grant recipient named above hereby certifies compliance with Government Code Section 8355 in matters relating to providing a drug-free workplace. The above named contractor or grant recipient will:

1. Publish a statement notifying employees that unlawful manufacture, distribution, dispensation, possession, or use of a controlled substance is prohibited and specifying actions to be taken against employees for violations, as required by Government Code Section 8355(a).

2. Establish a Drug-Free Awareness Program as required by Government Code Section 8355(b), to inform employees about all of the following:

(a) The dangers of drug abuse in the workplace,

(b) The person's or organization's policy of maintaining a drug-free workplace,

(c) Any available counseling, rehabilitation and employee assistance programs, and

(d) Penalties that may be imposed upon employees for drug abuse violations.

3. Provide as required by Government Code Section 8355(c), that every employee who works on the proposed contract or grant:

(a) Will receive a copy of the company's drug-free workplace policy statement, and

(b) Will agree to abide by the terms of the company's statement as a condition of employment on the contract or grant.

4. At the election of the contractor or grantee, from and after the "Date Executed" and until

(DATE)

(NOT TO EXCEED 36 MONTHS), the state will regard this certificate as valid for all contracts or grants entered into between the contractor or grantee and this state agency without requiring the contractor or grantee to provide a new and individual certificate for each contract or grant. If the contractor or grantee elects to fill in the blank date, then the terms and conditions of this certificate shall have the same force, meaning, effect and enforceability as if a certificate were separately, specifically, and individually provided for each contract or grant between the contractor or grantee and this state agency.

Accessibility Report

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Summary

The checker found no problems in this document.

Needs manual check: 0

Passed manually: 2

Failed manually: 0

Skipped: 1

Passed: 29

Failed: 0

Detailed Report

Document

Rule Name Status Description

Accessibility permission flag Passed Accessibility permission flag must be set

Image-only PDF Passed Document is not image-only PDF

Tagged PDF Passed Document is tagged PDF

Logical Reading Order Passed manually Document structure provides a logical reading order

Primary language Passed Text language is specified

Title Passed Document title is showing in title bar

Bookmarks Passed Bookmarks are present in large documents

Color contrast Passed manually Document has appropriate color contrast

Page Content

Rule Name Status Description

Tagged content Passed All page content is tagged

Tagged annotations Passed All annotations are tagged

Tab order Passed Tab order is consistent with structure order

Character encoding Passed Reliable character encoding is provided

Tagged multimedia Passed All multimedia objects are tagged

Screen flicker Passed Page will not cause screen flicker

Scripts Passed No inaccessible scripts

Timed responses Passed Page does not require timed responses

Navigation links Passed Navigation links are not repetitive

Forms

Rule Name Status Description

Tagged form fields Passed All form fields are tagged

Field descriptions Passed All form fields have description

Alternate Text

Rule Name Status Description

Figures alternate text Passed Figures require alternate text

Nested alternate text Passed Alternate text that will never be read

Associated with content Passed Alternate text must be associated with some content

Hides annotation Passed Alternate text should not hide annotation

Other elements alternate text Passed Other elements that require alternate text

Tables

Rule Name Status Description

Rows Passed TR must be a child of Table, THead, TBody, or TFoot

TH and TD Passed TH and TD must be children of TR

Headers Passed Tables should have headers

Regularity Passed Tables must contain the same number of columns in each row and rows in each column

Summary Skipped Tables must have a summary

Lists

Rule Name Status Description

List items Passed LI must be a child of L

Lbl and LBody Passed Lbl and LBody must be children of LI

Headings

Rule Name Status Description

Appropriate nesting Passed Appropriate nesting

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