Page 144 - Personnel Policy and Procedures Manual

SUBSTANCE ABUSE COVERAGE FORM

I, ____________________________________, have read and understand the Augusta, Georgia Substance Abuse
Policy (the "Policy").

I further understand that the manufacture, use, possession, sale or distribution or presence in body of alcohol, drugs
or illegal substances in the work place is strictly prohibited and will lead to my immediate discharge from employment.

For purposes of this Policy, "drugs" or "illegal substances" or "controlled substances" is defined to include illegal
street drugs, legal drugs either taken for non-medical reasons or without a valid prescription and alcohol, but not to
include prescription medication taken in accordance with a physician's prescription and instructions. I also understand
that the presence of such substances in my system during work hours places unacceptable risk and burden on the safe
and efficient operation of my job, and, consequently, is strictly forbidden.

I understand that if I am a Transit employee or an employee required to have a CDL I will be tested in accordance
with testing requirements established by Federal regulations. I understand that if I work in a safety-sensitive position
(as that is defined in the Policy), I may be tested for illegal substances on a random basis. I also understand that Augusta,
Georgia has a zero tolerance policy for safety - sensitive employees, such that I will be terminated for any violation of
the Substance Abuse Policy.

I understand that based on reasonable suspicion, I may be tested for illegal substances (a "for-cause test").

I understand that if I successfully complete a rehabilitation program and return to work for the Augusta, Georgia
Commission, I may be tested for illegal substances on a random basis up to twelve times per year for three years and
that it is my responsibility to pay for these tests as a condition of my employment.

I understand that if I am involved in an accident, which results in property damage or injury to another person; or in
my requiring and/or receiving medical attention for injuries, I may be tested for illegal substances (a "post-accident
test"). I understand that Federal testing requirements, for Transit employees and holders of CDL licenses, may require
drug and/or alcohol testing in cases of vehicle accidents, even though there may be no injuries.

I also understand that my arrest and/or conviction for off-the-job drug and/or alcohol activities, including driving
under the influence, may constitute grounds for reasonable suspicion and a for-cause illegal substances screening, and
may cause me to have action taken against me, taking into consideration (among other things), the nature of the charges,
my job assignment and my record with the Augusta, Georgia Commission.

I understand that it is my responsibility to read the Augusta, Georgia Substance Abuse Policy entirely, and that my
cooperation with, and adherence to, policies and procedures regarding substance abuse are conditions of my
employment and that if I violate or am insubordinate by refusing to cooperate with any of these policies and procedures,
I am subject to discipline up to and including discharge.

Employee Signature ______________________________________________ Date ______________

FORM SA-2

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