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Okaloosa County BOCC — November 4, 2012 — Colin Baenziger — reading text
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CERTIFICATION
THE BELOW SIGNED FIRM CERTIFIES that it has implemented a drug-free workplace program. In order to
have a drug-free workplace program, a business shall:
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 actions that
will be taken against employees for violations of such prohibition.
2. Inform employees about the dangers of drug abuse in the workplace, the business’s policy of maintaining a
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 quote 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 the
commodities or contractual services that are under quote, the employee will abide by the terms of the
statement and will notify the employer of any conviction of, or plea of guilty or 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 (5) days after such conviction.
5. Impose a sanction on, or require the satisfactory participation in, drug abuse assistance or rehabilitation
program if such is available in employee’s community, by any employee who is convicted.
6. Make a good faith effort to continue to maintain a drug-free workplace through implementation of this
section.
As the person authorized to sign this statement, I certify that this firm complies fully with the above requirements.
DATE: __December 10, 2012__________ SIGNATURE:
COMPANY: __Colin Baenziger & Associates__ NAME: ___Kathyrn Knutson_________________
(Typed or Printed)
ADDRESS: __12970 Dartford Trail • Suite 8 _ TITLE: __Vice President for Operations__
__Wellington, FL 33414_______
PHONE NO.: __(715) 282-3595____________
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INDEMNIFICATION AND HOLD HARMLESS
To the fullest extent permitted by law, CONTRACTOR shall indemnify and hold harmless COUNTY, its officers
and employees from liabilities, damages, losses, and costs including but not limited to reasonable attorney fees, to
the extent caused by the negligence, recklessness, or intentional wrongful conduct of the CONTRACTOR and other
persons employed or utilized by the CONTRACTOR in the performance of this Agreement.
___Colin Baenziger & Associates__ __
Firm’s Company Name Authorized Signature – Manual
___12970 Dartford Trail • Suite 8, Wellington, FL33414 __ Kathyrn Knutson ____________
Physical Address Authorized Signature – Typed
__Same as above___________________________ ___Vice President for Operations __
Mailing Address Title
___(715) 282-3595____________ _ _(888) 635-2430 or (888) 539-6531______
Phone Number FAX Number
___(561) 707-3537_________________________ _(561) 707-3537 or (715) 282-3595______
Cellular Number After-Hours Number(s)
___December 10, 2012________________________
DATE
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