ARFQ DEP2100000006 Drug-Free Affidavit.pdf

This is a Drug Free Workplace Conformance Affidavit form (WV-73) required by the State of West Virginia under West Virginia Code 21-1D-5. The form applies to all state and local contract opportunities in West Virginia and serves as a compliance document for contractors and their employees. The affidavit requires an authorized employee of the contracting company to attest under penalty of perjury that the company maintains a written drug-free workplace policy and plan that complies with West Virginia Code 21-1D. The form must be notarized and includes signature lines for the employee, company name, and the notary public administering the oath.

This affidavit is a mandatory compliance requirement for state and local contract opportunities in West Virginia and must be submitted as part of the contracting process. There are no pricing terms, set-asides, or funding information included in this document, as it is solely a certification form confirming adherence to state drug-free workplace regulations. The form serves as evidence that the contractor has established and maintains appropriate workplace policies to ensure a drug-free environment in accordance with state law.