DRUG FREE AFFIDAVIT.pdf

This is a Drug Free Workplace Conformance Affidavit form issued by the State of West Virginia in compliance with West Virginia Code 21-1D-5. The form serves as an attestation document that must be completed by an employee of a contracting company to verify the company's commitment to maintaining a drug-free workplace. The affidavit requires the employee to confirm under oath that the company maintains a written drug-free workplace policy that complies with the requirements outlined in West Virginia Code 21-1D. The document must be notarized and includes fields for the employee's printed name, signature, title, company name, and the date of execution.

The form requires notarization before a notary public, with the notary recording their commission expiration date, the county where the affidavit is sworn, and their printed name and title. This affidavit is a standard requirement for state and local contract opportunities in West Virginia and functions as a compliance verification tool rather than a pricing or service specification document. No pricing terms, set-asides, or funding information are included in this form, as it is exclusively a certification of the contractor's drug-free workplace policy compliance.