Page 144 - Personnel Policy and Procedures Manual

CONTRACTOR CERTIFICATE

I, of
(Contractor/Vendor's Certifying Official) (Company Name)

(Address)
certify that a drug-free workplace will be provided for the employees of this company during the performance
of this contract pursuant to section 50-24-3 of O.C.G.A.

I further certify that in accordance with O.C.G.A. 50-24-3 paragraph (a) subsection (2), that should this
company require the services of a subcontractor as part of this contract, that all subcontractors will be
required to provide this company with a certificate of compliance for the establishment of a Drug Free Work
Place. I understand that a drug-free work place may be provided by my:

(1) Publishing a statement notifying employees that the unlawful manufacture, sale, distribution,
dispensation, possession, or use of a controlled substance or marijuana is prohibited in the
contractor's/subcontractor's workplace and specifying the actions that will be taken against employees
for violations of such prohibition;

(2) Establishing a drug-free awareness program to inform employees about:
a. The dangers of drug abuse in the workplace;
b. The contractor's/subcontractor's policy of maintaining a drug-free workplace;
c. Any available drug counseling, rehabilitation, and employee assistance program; and
d. The penalties that may be imposed upon employees for drug abuse violations.

(3) Providing each employee with a copy of the statement provided for in paragraph (1) above.

(4) Notifying each employee in the statement provided for in paragraph (1) above, that as a condition of
employment, the employee shall:
a. Abide by the terms of the statement; and
b. Notify the contractor/subcontractor of any criminal drug statute conviction for a violation
occurring in the work place within five days of the conviction;

(5) Notifying the contracting principal representative within ten days after receiving from an employee or
a subcontractor a notice of conviction as provided under paragraph (4),b above or otherwise receiving
actual notice of such a conviction;

(6) Making a good faith effort on a continuing basis to provide a drug-free workplace for employees; and

(7) Requiring that such contractor/subcontractor include in any agreement or contract with a subcontractor
a provision that such subcontractor will provide a drug-free workplace for his employees by
complying with the provisions of paragraphs (1), (2), (3), (4), and (6) listed above.

(Signature)

(Printed Name & Title)
FORM SA-1

All Rights Reserved – As approved by the Commission on 05-07-2019 144 | P a g e