DrugFreeAff.pdf

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

This affidavit is a compliance document rather than a procurement with pricing or contract terms. It is a mandatory submission requirement for contractors bidding on state and local contracts in West Virginia and does not involve pricing terms, set-asides, or renewal options. The form ensures that all contractors maintain drug-free workplace policies as mandated by state law. No funding, incumbent information, or project-specific details are contained within this standardized attestation form, which was approved and effective as of July 7, 2017.