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1011118 <br />,-� <br />CABARRUS COUNTY GOVERNMENT <br />ACKNOWLEDGMENT OF RECEIPT OF DRUG FREE WORK PLACE POLICY <br />I have been given a copy of and have read the Drug Free Workplace Policy (the "Policy") adopted by <br />CABARRUS COUNTY GOVERNMENT as well as post -accident information, procedures, and instructions to <br />enable me to comply with my obligations under the Policy and information concerning the effects of controlled <br />substances use and alcohol abuse on an individual's health, work, and personal life; signs and symptoms of a <br />controlled substances or alcohol problem (mine or a coworker's); and available methods of intervening when a <br />controlled substances or alcohol problem is suspected. I hereby acknowledge that I understand, accept, and <br />agree to be bound by the conditions specified in the Policy and these materials. <br />I further understand and agree that: <br />To be retained as an employee, the following will apply: <br />As a condition of employment and continued employment with CABARRUS COUNTY GOVERNMENT, I <br />may be required to provide blood, urine, saliva, breath, or other accepted scientific samples for drug and alcohol <br />testing under the circumstances described in the Policy, and I hereby consent to such testing. <br />Failure of a drug or alcohol test, my refusal to submit to drug or alcohol tests under the circumstances set forth <br />in the Policy, violation of the items listed in the "PROIdIBITED ACTS" section of the Policy and other <br />provisions of the Policy, and certain other occurrences described in the Policy may result in disciplinary action, <br />up to and including dismissal, as described in the Policy. <br />The Policy may be modified at any time and in any way at the discretion of CABARRUS COUNTY <br />GOVERNMENT and will become effective immediately upon posting of a notice indicating to me the changes <br />made therein. <br />The Policy is not a contract of employment with CABARRUS COUNTY GOVERNMENT but compliance <br />with its terms and conditions is a condition to my employment and continued employment with CABARRUS <br />COUNTY GOVERNMENT. <br />Date <br />Printed Name <br />Signature <br />HR reviewed 4/20/2009 <br />20 <br />Attachment number 1 \n <br />F-5 Page 75 <br />