DrugFreeAff.pdf

This is a Drug Free Workplace Conformance Affidavit form issued by the State of West Virginia in compliance with West Virginia Code 21-1D-5, effective April 30, 2020. The affidavit serves as a mandatory attestation requirement for state and local contract opportunities within West Virginia. The form requires a designated employee of the contracting company to swear under penalty of perjury that their organization maintains a written drug-free workplace policy in full compliance with West Virginia Code 21-1D. The affidavit must be notarized before a notary public, with the notary providing their printed name, title, date, county of commission, and commission expiration date on the document.

This document functions as a compliance verification tool rather than a solicitation with pricing or service terms. Contractors bidding on West Virginia state and local contracts must complete and submit this notarized affidavit as part of their bid package to demonstrate their commitment to maintaining a drug-free workplace environment. The form contains sections for the employee's printed name, signature, title, company name, and date of execution, ensuring proper identification and accountability. No pricing information, contract term, renewal options, or financial considerations are included in this conformance document, as it solely addresses workplace drug policy compliance requirements.