WV73 Drug Free Affidavit.pdf

This is a Drug Free Workplace Conformance Affidavit required by the State of West Virginia for a construction paving project at Welch Community Hospital under ARFQ 0512 WEH2700000003. The affidavit must be completed and notarized by a company employee attesting that the bidder maintains a valid written drug-free workplace policy in compliance with West Virginia Code 21-1D. The form requires the employee to provide their name, title, company name, and date, along with notarization by a public notary. Submission of the completed affidavit with the bid is mandatory; failure to include the affidavit will result in automatic bid disqualification. The affidavit was last revised in August 2013.

This affidavit document serves as a compliance requirement for the parking lot repair and paving project with proposals due September 1, 2026, at 10:00 a.m. EST. The procurement involves federal funding and therefore includes compliance requirements under 2 C.F.R. 200.317-200.327. No pricing information, set-asides, or other salient terms are specified within the affidavit itself; however, bidders must understand that submission of this notarized document is a prerequisite condition for bid acceptance. Vendors should contact Roberta A. Wagner, buyer, at (304) 558-0437 or roberta.a.wagner@wv.gov for additional information regarding the overall procurement requirements.