Drug Free Affidavit.pdf

This is a Drug Free Workplace Conformance Affidavit required by the State of West Virginia pursuant to West Virginia Code 21-1D-5. The affidavit serves as a mandatory compliance document that must be submitted with all bids in response to state and local contract opportunities. The form requires an employee of the bidding company to attest under oath that their employer maintains a written drug-free workplace policy in compliance with West Virginia Code 21-1D. The affidavit must be notarized and includes fields for the employee's printed name, signature, title, company name, date, and the notary public's information including commission expiration date. Failure to include the completed and notarized affidavit with a bid results in automatic disqualification of that bid.

The document is a standardized form (WV-73) revised as of August 1, 2015, and contains no pricing terms, set-asides, or funding information, as it is purely a compliance and certification document. There are no specific response dates, due dates, or contract terms outlined in this affidavit, as it functions solely as a prerequisite attestation requirement. All bidders participating in West Virginia state and local contract opportunities are required to complete and submit this form to demonstrate their organization's commitment to maintaining a drug-free workplace environment.