Drug Free Affidavit.pdf

This document package consists of two forms issued by the State of West Virginia Purchasing Division that establish requirements for contractors to certify compliance with state drug-free workplace policies. The first form, WV-72 (Certified Drug-Free Workplace Report Coversheet), requires contractors to submit a certified drug-free workplace report annually or upon project completion for all state contracts. For contracts exceeding $25,000, the report must be submitted to the West Virginia Purchasing Division at 2019 Washington Street East, Charleston, WV 25305, while contracts of $25,000 or less require submission to the respective public authority issuing the contract.

The required report content mandates inclusion of four specific elements: information demonstrating education and training service provision regarding West Virginia Code §21-1D-5 requirements; the name of the laboratory certified by the United States Department of Health and Human Services that performs drug testing; the average number of employees involved in the construction on the public improvement; and detailed drug test results categorized by testing type (pre-employment and new hires, reasonable suspicion, post-accident, and random) showing both positive and negative test counts. The second form, WV-73 (Drug Free Workplace Conformance Affidavit), is a sworn affidavit that must be notarized, wherein an authorized company representative attests under penalty of perjury that the company maintains a written drug-free workplace policy in compliance with West Virginia Code §21-1D. Both forms serve as mandatory compliance documentation for all state contracting activities.