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SAK Construction <br />Pipe Rehab & Tunnel Contractor Health and Safety Plan April 2017 <br />Substance Abuse Policy <br /> <br /> <br /> 10 | P a g e <br /> <br /> <br /> <br /> <br />ACKNOWLEDGEMENT OF DRUG-FREE WORKPLACE AND SUBSTANCE ABUSE <br />POLICY AND CONSENT TO SEARCH OR INSPECTION IN ACCORDANCE WITH <br />POLICY. <br /> <br /> It is the policy of SAK Construction, LLC to absolutely prohibit the use, possession, <br />concealment, sale or distribution or being under the influence of illegal or unauthorized drugs <br />and/or alcohol while entering, on or departing Company property, work areas, work locations <br />or while in the course and scope of employment as a Company employee. <br /> <br /> For your protection and for the protection of other employees (and in compliance with law), <br />you are required upon request to submit your person, personal effects, vehicle, belongings <br />and all items to a search or inspection in accordance with the Company’s Drug-Free <br />Workplace and Substance Abuse Policy. If any items prohibited on Company property are <br />found or if you refuse to submit to an inspection or search of yourself and/or your effects, you <br />will be denied access to Company property. The Company will also undertake such <br />disciplinary action as set forth in its Drug-Free Workplace and Substance Abuse Policy. <br /> <br /> The Company’s Drug-Free Workplace and Substance Abuse Policy is posted at various <br />locations and you should carefully read and understand the Policy prior to signing this <br />Consent Form. Contact Angie Hirtz if you have not reviewed the Drug-Free Workplace and <br />Substance Abuse Policy. <br />****************************************************************************** <br /> I acknowledge that I have been provided the SAK Construction, LLC Drug-Free <br />Workplace and Substance Abuse Policy. I have read and understand the Policy, and I <br />agree to fully abide by the Policy. <br /> <br /> Also, I agree and consent to any search and inspection of my person, personal effects <br />and property, including my vehicle and its contents, under the Policy. I further agree <br />to hold the Company, its agents, directors, officers and employees harmless from any <br />liability in connection with any search or inspection pursuant to the Company’s Drug - <br />Free Workplace and Substance Abuse Policy. <br /> <br /> <br />________________________________ <br />Employee Signature <br /> <br />________________________________ <br />Date <br /> <br /> <br /> <br />____________________________ <br />Witness Signature <br />____________________________ <br /> Date