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Name: <br />Date: <br />PLACE OF PERFORMANCE <br />FOR CERTIFICATION REGARDING DRUG -FREE <br />WORKPLACE REQUIREMENTS <br />Girls Inc. of Orange County <br />12/14/21 <br />The Contractor shall insert in the space provided below the site(s) expected to be used <br />for the performance of work under the contract covered by the certification: <br />Place of Performance (include street address, city, county, state, zip code for each site): <br />1801 E. Edinger Avenue, Suite 255-A, Santa Ana, CA 92705 <br />EXHIBIT E <br />Page 3 of 3 <br />