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25J - AGMT - TELEPHONE SRVC REIMBURSEMENT
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08/20/2012
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25J - AGMT - TELEPHONE SRVC REIMBURSEMENT
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8/16/2012 10:50:04 AM
Creation date
8/16/2012 10:50:02 AM
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City Clerk
Doc Type
Agenda Packet
Agency
Community Development
Item #
25J
Date
8/20/2012
Destruction Year
2017
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CCC-307 <br />CERTIFICATION <br />I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am duly <br />authorized to legally bind the prospective Contractor to the clause(s) listed below. This <br />certification is made under the laws of the State of California. <br />Contractor/Bidder Firm Name (Printed) <br />City of Santa Ana - WORK Center Federal ID Number <br />95-6000 785 <br />By (Authorized Signature) <br />___.._....._.._..-_.-__..._._...-.-_-._.__...._..._..----..---..____....._...._.._..__.__..._.._.__..__......._.___.._...,._..__._......_...._... <br />._....----.. <br />. <br />. <br />..._..... <br />_ <br />._ <br />_._...._.____.______...__.._._.__.._.__.__...__..._.__---__- <br />Printed Name and Title of Person Signing <br />Nancy T. Edwards, Interim Executive Director <br />Date Executed Executed in the County of <br />Orange APPROVED AS TO F0 <br />,.. I <br />CONTRACTOR CERTIFICATION CLAUSES LISA E. ST RCK <br />Assistant City Attorney, <br />1. STATEMENT OF COMPLIANCE: Contractor has, unless exempted, complied with <br />the nondiscrimination program requirements. (Gov. Code § 12990 (a-f) and CCR, Title 2, <br />Section 8103) (Not applicable to public entities.) <br />2. DRUG-FREE WORKPLACE REQUIREMENTS: Contractor will comply with the <br />requirements of the Drug-Free Workplace Act of 1990 and will provide a drug-free <br />workplace by taking the following actions: <br />a, Publish a statement notifying employees that unlawful manufacture, distribution, <br />dispensation, possession or use of a controlled substance is prohibited and specifying <br />actions to be taken against employees for violations, <br />b. Establish a Drug-Free Awareness Program to inform employees about: <br />1) the dangers of drug abuse in the workplace; <br />2) the person's or organization's policy of maintaining a drug-free workplace; <br />3) any available counseling, rehabilitation and employee assistance programs; and, <br />4) penalties that may be imposed upon employees for drug abuse violations. <br />c. Every employee who works on the proposed Agreement will: <br />1) receive a copy of the company's drug-free workplace policy statement; and, <br />2) agree to abide by the terms of the company's statement as a condition of employment <br />on the Agreement. <br />Failure to comply with these requirements may result in suspension of payments under <br />the Agreement or termination of the Agreement or both and Contractor may be ineligible <br />for award of any future State agreements if the department determines that any of the <br />following has occurred: the Contractor has made false certification, or violated the <br />25J-11
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