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<br />ACKNOWLEDGMENT OF RECEIPT <br /> <br />OF <br /> <br />. <br /> <br />EMPLOYEE DRUG AND ALCOHOL POLICY <br />FOR DRIVERS OF COMMERCIAL VEmCLES <br /> <br />I have received a copy of the Transportation Employee Drug and Alcohol Policy and <br />have been provided information on the following: <br /> <br />1. The person designated by the City to answer questions about these <br />materials. <br /> <br />2. Who is subject to alcohol misuse and controlled substance requirements. <br /> <br />3. Explanation of a safety-sensitive function. <br /> <br />4. What driver conduct is prohibited. <br /> <br />5. Circumstances for drug and/or alcohol testing. <br /> <br />6. Procedures used to test for the presence of drugs and/or alcohol. <br /> <br />7. <br /> <br />The requirement that drivers submit to controlled substance and alcohol <br />testing. <br /> <br />. <br /> <br />8. An explanation of what constitutes a refusal to submit to testing. <br /> <br />9. The consequences for drivers violating the prohibitions of this rule, including <br />the immediate removal of the driver from safety-sensitive functions. <br /> <br />10. The consequences for drivers found to have an alcohol concentration of 0.02 <br />or greater, but less than 0.04. <br /> <br />11. Information concerning the effects of alcohol and controlled substances use <br />on an individual's health, work, and personal life. Signs and symptoms of an <br />alcohol or controlled substances problem and available methods of <br />intervening when an alcohol or a controlled substances problem is suspected, <br />including confrontation, referral to an employee assistance program, and/or <br />referral to management. <br /> <br />Signature: <br /> <br /> <br />. <br /> <br />Date: <br /> <br />Please Print Name: <br /> <br />. <br /> <br />page 15 <br />