P-Drug Free - fillable.pdf
PDF 616 KB Posted
- Attached to
- TYS RW 5R-23L Rehab Project 1
- Solicitation number
- IFB-MKAA-0000000002
- Issued by
- Bradley County, Tennessee
About this file
The document is a Drug Free Workplace Affidavit for the McGhee Tyson Airport Runway 5R-23L Rehabilitation - Project 1 in Alcoa, Tennessee. The affidavit is required pursuant to T.C.A. Section 50-9-113 for employers with five or more employees who contract with the state or local government to provide construction services. The document requires the company to certify that it has a drug-free workplace program that complies with Title 50, Chapter 9 of the Tennessee Code Annotated.
The affidavit serves as a formal declaration by a principal officer of the company, attesting to their compliance with Tennessee state law regarding drug-free workplace requirements. The document includes spaces for notarization, including the signature of a notary public who can verify the identity of the principal officer making the declaration. This form is part of the bidding documentation for the runway rehabilitation project, issued on February 9, 2025, and is designed to ensure workplace safety and regulatory compliance for contractors involved in the airport infrastructure project.
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Text version
DRUG FREE WORKPLACE AFFIDAVIT B-34
DRUG FREE WORKPLACE AFFIDAVIT
STATE OF _____________________________
COUNTY OF___________________________
____________________________________ being first duly sworn, deposes and says as follows:
1. The undersigned is a principal officer of ___________________________ hereinafter referred to as the “Company”, and is duly authorized to execute this Affidavit on behalf of the Company.
2. The Company submits this Affidavit pursuant to T.C.A. Section 50-9-113, which requires each employer with no less than five (5) employees receiving pay who contracts with the state or any local government to provide construction services to submit an affidavit stating that such employer has a drug free workplace program that complies with Title 50, Chapter 9 of the Tennessee Code Annotated.
3. The company is in compliance with T.C.A. Section 50-9-113.
Further affiant saith not.
Principal Officer
STATE OF____________________________________________
COUNTY OF__________________________________________
Before me personally appeared _________________________________________________, with whom I am personally acquainted (or proved to me on the basis of satisfactory evidence) and who acknowledged that he/she is the _____________________ of the Company a _________________________ and that he/she, being authorized so to do, executed this affidavit for the purposes therein contained, by signing the name of the Company by himself/herself as ____________________________.
Witness my hand and seal at office this ______day of _____________________20______, Notary Public
My Commission Expires______________________________
MCGHEE TYSON AIRPORT
ALCOA, TENNESSEE
RUNWAY 5R-23L REHABILITATION - PROJECT 1
ISSUED FOR BID - FEBRUARY 9, 2025
INTENTIONALLY LEFT BLANK
MCGHEE TYSON AIRPORT
ALCOA, TENNESSEE
RUNWAY 5R-23L REHABILITATION - PROJECT 1
ISSUED FOR BID - FEBRUARY 9, 2025
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File details come from the government source that posted it. Updated .