Drug and Alcohol Policy Standard for Contractors

APPENDIX D Acknowledgement Form

(For execution by all Employees upon introduction of a new policy or upon commencement of employment and to be retained in the Employee’s human resource file.) I acknowledge and confirm that I: (a) Have been provided with a copy of the SaskEnergy Incorporated Drug & Alcohol Policy; (b) Understand the Policy and my responsibilities under it; (c) Understand that my employment requires me to comply with the Policy.

Employee Signature

Company Representative (signature)

Print Name

Print Name

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