Drug Free Workplace Affidavit ARFQ DEP2200000001 Peeltree Road Portals.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 document serves as a sworn attestation that a company maintains a written drug-free workplace policy and operates in compliance with West Virginia Code 21-1D requirements. The affidavit is applicable to the contract opportunity ARFQ DEP2200000001 for Peeltree Road Portals. The form requires completion by an employee of the bidding company, who must provide their printed name, signature, title, and the company name. The document must be notarized before a Notary Public, who is required to provide their printed name, title, commission expiration date, and the county where the affidavit was sworn.

This affidavit is a mandatory compliance document that bidders must submit as part of their proposal package for state and local contract opportunities in West Virginia. There are no pricing terms, set-asides, or funding information contained in this document, as it functions solely as a conformance certification. The form was approved effective April 30, 2020, with the most recent revision dated July 7, 2017. Submission of this sworn and notarized affidavit demonstrates the bidding company's commitment to maintaining workplace drug-free policies as required by West Virginia state law.