DrugFreeAff.pdf

This is a Drug Free Workplace Conformance Affidavit form (WV-73) approved by the State of West Virginia as of April 30, 2020, required under West Virginia Code 21-1D-5. The affidavit is a notarized document in which an employee of a bidding company attests that their employer maintains a written drug-free workplace policy in compliance with West Virginia Code 21-1D. The form requires completion of the employee's printed name, signature, and title; the company name; and the date of attestation. A notary public must witness and notarize the affidavit, with the notary providing their printed name, title, county of jurisdiction, commission expiration date, and signature with seal.

This document serves as a mandatory compliance requirement for bidders on the Resident Haircuts contract for J.M. Chick Buckbee Juvenile Center in West Virginia. Contractors must submit a completed and notarized Drug Free Workplace Conformance Affidavit as part of their bid proposal to demonstrate adherence to West Virginia's drug-free workplace standards. No pricing information, set-asides, or contract terms are specified within this particular form; it functions solely as a conformance certification document required during the bidding process.