HomeMy WebLinkAboutPre-AttachmentBid No. 26-084R
Page 28 of 30 Pages
SECTION 6, ATTACHMENT 1
' THE SCHOOL BOARD OF BROWARD COUNTY, FLORIDA
Y W+R A EuENT P R UA TTS C ION 287.087 FLORIDA STATUT AS URRENTLYPENA TR+G-A,
+ IM + ► P�' EN TO B IN S W TH D:
KTHIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICIAL AUTHORIZED TO
ADMINISTER OATHS.
This sworn statement is submitted to The School Board of Broward County, Florida,
by
for
(Print idual's name and title)
(Print name of entity submitting sworn statement)
whose business address is
D OR A AMENDED FROM TIME .
and (if applicable) its Federal Employer Identification Number (FEIN) is
(If the entity has no FEIN, include the Social Security Number of the individual signing this sworn statement:
I certify that I have established a drug -free workplace program and have complied with the following:
1. Published a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance
is prohibited in the workplace and specifying the actions that will be taken against employees for violations of such prohibition.
ed employees about the dangers of drug abuse in the workplace, the business' policy of maintaining a drug -free workplace, any available employee
2. Inform assistance programs, and the penalties that may be imposed upon employees for drug abus
drug counseling, rehabilitation and
violations.
3. Given each employee engaged in providing the commodities or contractual services that are under bid a copy of the statement specified in
subsection (1).
4, In the statement specified in subsection (1), notified the employees temetnt and will condition
the erking on mpoyerthe of any conviction ofies or �ortpleaual services
af gutty or
that are under bid, the employee will abide by the terms of t
nolo contendere to, any violation of chapter 893 or of any controlled substance law of the United States or any state, for a violation occurring in
the workplace no later than five days after such conviction.
5. Will impose a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program if such is available in the
employee's community by, any employee who is so convicted.
6. Am making a good faith effort to continue to maintain a drug free workplace through implementation of this section.
Sworn to and subscribed before me this day of
Personally Known
OR Produced identification
(Type of identification)
FORM: #4530
3,93
VENDOR NAME:
MA/Ic
(Signature)
, 20.
Notary Public - State of
My commission expires
(Printed, typed or stamped commissioned name of notary public).