WV73 Drug Free Affidavit.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 in order for bidders to remain eligible for state and local contract opportunities in West Virginia. The form requires an authorized employee of the bidding company to attest under oath, before a notary public, that the company maintains a valid written drug-free workplace policy in compliance with West Virginia Code 21-1D. Failure to include the completed and notarized affidavit with a bid submission will result in automatic disqualification of that bid.

The affidavit requires completion of standard fields including the employee's name and title, the company name, the county where the affidavit is sworn, the date of execution, and notarization information including the notary public's signature, seal, and commission expiration date. No pricing terms, set-asides, funding sources, or contract amounts are addressed in this compliance document, as it functions solely as a qualification and eligibility verification tool for bidders seeking to contract with West Virginia state and local government entities.