ARFQ DCR27 13 Drug Free Affidavit.pdf

This is a Drug Free Workplace Conformance Affidavit required by the State of West Virginia under West Virginia Code 21-1D-5 for the Barber/Cosmetology Services contract for Sam Perdue. The affidavit serves as a compliance document wherein a company employee attests under oath that their employer maintains a written drug-free workplace policy in accordance with West Virginia Code 21-1D. The form requires completion by an employee of the contracting company and must be notarized, with the affiant providing their printed name, signature, title, company name, and the date of execution.

The affidavit must be sworn before a notary public and include the notary's commission expiration date and county information. This documentation is a prerequisite requirement for bid submission or contract award and demonstrates the contractor's commitment to maintaining a drug-free workplace as mandated by West Virginia state law. The form is the approved version dated April 30, 2020, and contractors must ensure completion and notarization prior to contract execution.