Application for Drug-Free Safety Program (U-140)
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Introduction The Drug-Free Safety Program (DFSP) offers a premium rebate to eligible employers for implementing a loss-prevention strategy to address workplace use and misuse of alcohol and other drugs, including prescription, over-the-counter and illegal drug abuse within the context of a holistic safety program. Below you'll find additional information for state construction contractors or subcontractors wanting to understand their requirements prior to providing labor services or on-site supervision of labor services on a State of Ohio public improvement/construction project. Additional information DFSP info State construction contractor information Drug-Free Vendor Directory Program Discount Compatibility |
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Required information
- Name of employer
- Doing business as (DBA) name
- Address
- Telephone number
- Federal tax ID number
- Employer contact person
- Employer contact telephone number
- Average number of employees
| - Employer has Internet access and is willing to receive correspondence via e-mail
- E-mail address to which BWC can send correspondence to drug-free contact person
- Requested DFSP program year
- Advanced, basic or comparable program
- Name of designated employer representative and e-signature
| Note: In addition to completing the application, you must submit the Safety Management Self-Assessment (SH-26). If your company has not submitted the SH-26 within the last 12 months for either the DFSP Basic or Advanced levels, or another program, we will redirect you to the SH-26 to complete first, and then return you to the application. |
State Contractors List If you are applying to be placed on the Contractors List, you must submit your drug free policy, and proof of training and testing for employees who will work on state contracts. If you have not yet completed these requirements, you can submit details of when you anticipate completion and the credentialed professional vendor you will use for these services. Failure to submit these required documents will prohibit inclusion on the contractors list. |
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If you have all the required information on hand, simply click the start button to begin. |
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