ARFQ DEP2200000011 Drug-Free Affidavit.pdf

This is a Drug-Free Workplace Conformance Affidavit form (WV-73) issued by the State of West Virginia in compliance with West Virginia Code 21-1D-5. The affidavit is required as part of contract opportunity ARFQ DEP2200000011 and serves as attestation documentation for bidders and contractors. The form requires an authorized employee of the bidding company to swear under penalty of perjury that the company maintains a written drug-free workplace policy and that such policy complies with West Virginia Code 21-1D. The affidavit must be notarized and includes fields for the employee's printed name, signature, title, company name, and date of execution, along with notary public certification and seal.

This document is a mandatory compliance requirement rather than a pricing or service specification document. Bidders must complete and submit the affidavit as part of their proposal response to demonstrate their organization's commitment to maintaining a drug-free workplace environment. The form was approved on April 30, 2020, with the most recent revision dated July 7, 2017. No specific pricing, set-asides, incumbency information, or funding details are contained in this affidavit form.