DrugFreeAff.pdf

This is a Drug Free Workplace Conformance Affidavit form established by the State of West Virginia under West Virginia Code 21-1D-5, effective April 30, 2020. The affidavit serves as a sworn attestation requirement for state and local contract opportunities in West Virginia. The form requires an employee of the contracting company to certify under penalty of perjury that the company maintains a written drug-free workplace policy in compliance with West Virginia Code 21-1D. The document must be completed with the employee's printed name, signature, title, company name, and date, and subsequently notarized by a notary public who must provide their printed name, title, date, county of jurisdiction, and commission expiration date.

This affidavit is a mandatory compliance document for vendors and contractors seeking to do business with the State of West Virginia on state and local contracts. The form requires notarization to ensure the authenticity and legal binding nature of the attestation. No pricing terms, renewal options, or contract award dates are specified in this document, as it functions solely as a compliance verification tool rather than a contract solicitation or award notice. Companies bidding on West Virginia state and local contracts must submit this completed and notarized affidavit to demonstrate their adherence to federal and state drug-free workplace requirements.