WV73 Drug Free Affidavit (1).pdf

This is a Drug Free Workplace Conformance Affidavit required by the State of West Virginia under West Virginia Code 21-1D-5. The affidavit serves as a mandatory compliance document that must be submitted with all bids to state and local contract opportunities in West Virginia. The form requires an authorized employee of the bidding company to attest under oath that the company maintains a valid written drug free workplace policy that complies with West Virginia Code 21-1D. The affidavit must be notarized and signed by both the company representative and a notary public. Failure to include this completed affidavit with a bid submission results in automatic disqualification of the bid.

The affidavit contains standard legal components including the deponent's sworn statement, company identification, policy compliance certification, and notarization requirements. No pricing information, set-asides, funding sources, or contract-specific terms are included in this document, as it functions solely as a compliance verification tool. The form was last revised in August 2013 and applies uniformly to all bidding entities seeking to contract with West Virginia state and local government agencies.