Annual Contract for Medical Waste Pickup and Disposal Services ...

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any public entity, or has been listed on the state Convicted Vendor List, within thirty-six months prior tothe date of Bidder’s Bid.(Signed) ________________________________________(Print Name) ________________________________________(Title) ________________________________________The foregoing Affidavit of Bidder regarding Non-Collusion and Public Entity Crime was acknowledged beforeme this ______________________________ (Date)by: _____________________________________ who is personally known to me or______who has produced _________________________________ as identificationand who did/(did not) take an oath.________________________________________________Notary Public (print & sign name)Commission No. _________________________________ITB 12-13-109 Annual Contract for Medical Waste Pickup and Disposal Services Page 20 of 28
City of West Palm BeachDRUG FREE WORKPLACE CERTIFICATIONThe undersigned Bidder, in accordance with Florida Statute 287.087 hereby certifies that_________________________________________________________________ does:(Name of Business)1. Publish 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 actionsthat will be taken against employees for violation of such prohibition.2. Inform employees about the dangers of drug abuse in the workplace, the business' policy of maintaininga drug-free workplace, any available drug counseling, rehabilitation, and employee assistance programs,and the penalties that may be imposed upon employees for drug abuse violations.3. Give each employee engaged in providing the commodities or contractual services that are under thisbid a copy of the statement specified in subsection (1).4. In the statement specified in subsection (1), notify the employees that, as a condition of working on thecommodities, or contractual services that are under bid, the employee will abide by the terms of thestatement, and will notify the employer of any conviction of, or plea of guilty, or nolo contendre to anyviolation of Chapter 1893, or of any controlled substance law of the United States, or any State, for aviolation occurring in the workplace no later than five (5) days after such conviction.5. Impose a sanction on, or require the satisfactory participation in a drug abuse assistance, orrehabilitation program, if such is available in the employee's community, by any employee who is soconvicted.6. Make a good faith effort to continue to maintain a drug-free workplace through implementation of thissection.As the person authorized to sign the statement, I certify that this firm complies fully with the aboverequirements.______________________________Authorized Signature______________________________Print Name__________________________DateITB 12-13-109 Annual Contract for Medical Waste Pickup and Disposal Services Page 21 of 28
Page 1 and 2: Procurement Division401 Clematis St
Page 3 and 4: 6. Delivery and installation of an
Page 5 and 6: Photo No. 3 - 55 lbs. Biohazardous
Page 7 and 8: Photo No. 5 - Bio-Hazardous Lockabl
Page 9 and 10: C. The obligations of the City of W
Page 11 and 12: 14. INVOICE & PAYMENT DOCUMENTATION
Page 13 and 14: 18. INQUIRIES AND ADDENDAExcept as
Page 15 and 16: 27. INDEMNIFICATIONConsultant agree
Page 17 and 18: SCHEDULE OF BID ITEMS(Form B 1)ITB
Page 19: AFFIDAVIT OF PRIME BIDDERRe Non-col
Page 23 and 24: Procurement Division/Small Business
Page 25 and 26: City of West Palm BeachGOOD FAITH E
Page 27 and 28: ITB 12-13-109Annual Contract for Me

Annual Contract for Medical Waste Pickup and Disposal Services ...

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