Drug Free Workplace Affidavit ARFQ DEP22-81 STEELE RUN II WELL PLUG.pdf

This is a Drug Free Workplace Conformance Affidavit form required by the State of West Virginia for contract opportunity ARFQ DEP22-81 Steele Run II Well Plug. The affidavit serves as a mandatory compliance document under West Virginia Code 21-1D-5, requiring an authorized company employee to attest that their organization maintains a written drug-free workplace policy in compliance with state regulations. The form must be completed, notarized, and submitted with the bid submission. Failure to include the properly executed affidavit with the bid submission will result in automatic disqualification of the bid. The document requires the affiant to provide their printed name, signature, title, company name, date of execution, and the notary public's information including commission expiration date.

No specific pricing terms, funding sources, or contract amounts are identified in this affidavit form. This document functions solely as a compliance verification tool and prerequisite for bid eligibility rather than addressing financial or service delivery aspects of the contract opportunity. Bidders must ensure completion of all required fields and proper notarization before submission to meet West Virginia's drug-free workplace statutory requirements.