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SAK Construction <br />Pipe Rehab & Tunnel Contractor Health and Safety Plan <br />Substance Abuse Policy <br />'SAK <br />P�pcNne7n�restrucruro. Snhx•: <br />April 2017 <br />ACKNOWLEDGEMENT OF DRUG -FREE WORKPLACE AND SUBSTANCE ABUSE <br />POLICY AND CONSENT TO SEARCH OR INSPECTION IN ACCORDANCE WITH <br />POLICY. <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 />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 />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 />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 />Employee Signature <br />Date <br />Witness Signature <br />Date <br />101Page <br />