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Dale Time <br />This Substance Abuse'lesling Program has been ratified, signed and sealed as of <br />by the Local Unions ofLianneW International Union of <br />North America State of Indiana District Council <br />AUTHORIZATION FOR CONSENTTO DRUG AND ALCOHOL <br />ANALYSIS <br />AND <br />AUTHORIZATION FOR RELEASE OF RESULTS <br />1, the undersigned <br />do heraby authorize the resting of my body fluids and/or breath for employment reasons and <br />understand and agree that the results of any such testing will be fumed over to the Employer and <br />the Union, further that the testing procedures will be limited to tests forpnombiled and illegal <br />drugs, and controlled substances and alcohol <br />I understand that the results of these tests map be used for employment and disciplinary <br />reasons and herel,vauthorize the release of such information from the laboratories in the <br />designated Employer and Union representatives <br />I further certify that any urine specimen collected from me is mine and not adulterated or <br />uttered I. any manner. <br />I hai c been ad% ised that matters affecting me relative to the interpretation or application <br />of the Drug Policy are subject exclusively to the grievance and arbitration procedure under my <br />Collective Bargaining Agreement <br />Signature of'Prospective employee/Employee <br />do <br />LE'l-FER OF UNDERSTANDING FOR THE AGREEMENT by and between Indiana <br />Consimclors, Inc Labor Relations Division and the Local Unions of Laborers' International <br />Union of North America State of Indiana District Council concerning the Substance Abuse <br />Testing Program <br />In regard to the Substance Abuse Testing Program, it is understood between the parties that <br />under this program, the following guidelines will be followed when a person tests positive <br />First Positive Test <br />Results in immediate lentrumpion <br />For Reinstatement: <br />Provide anegative "5-panel US DOT" test result as interpreted by an MRO. <br />Sporadic testing for one (1) year following reinstatement <br />Second Positive Test <br />Results in immediate lermination <br />For Reinstatement: <br />Be evaluated by an SAP <br />Complete an SAP -recommended rehabilitation program <br />Secure written release from the SAP to return to work <br />Provide a negative "5-panel US DOT" test result us interpreted by an MRO. <br />Sporadic testing for one (1) year following numnalemerif <br />Third and Additional Positive Test <br />Results in immediate lerrumalion; not eligible for reinstatement for six (6) months <br />For Reinstatement: <br />Be evaluated by an SAP <br />Complete an SAP-recornmended rehabilitation program <br />Secure written release from the SAP to return to work <br />Provide a negative "5-panel US DOT" test result as interpreted by an MRO. <br />Sporadic locking for [%%,a (2) Years following reinstatement <br />FURTHER it is understood that any costs associated with the SAP, MRO, Rehabilitation <br />Program, and testing required to be reinstated, are the employee's responsibility, <br />74 <br />Im <br />