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Van Fleet Water Production Facility Improvements BVP 13-196 EXHIBIT 5 DRUG FREE WORKPLACE FORM The undersigned Contractor in accordance with Florida Statute 287.087 hereby certifies that does: (Name of Business) I. Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use N 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 contract a copy of the statement specified in subsection(a). i 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 contract, 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 1892 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 a drug abuse assistance or rehabilitation program, if such is available in the employee's community,by any employee who is so 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 the statement,I certify that this firm complies fully with the above requirements. Contractor's Signature Date 44 164