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DIVISION OF EMPLOYMENT SERVICES <br />PLACE OF PERFORMANCE <br />FOR CERTIFICATION REGARDING DRUG -FREE WORKPLACE REQUIREMENTS <br />Name: <br />Wesley A. Bosch, M.A. <br />Name of Contractor: Wesley A. Bosch, M.A. <br />Contractor'Number: <br />Date: August 2, 2004 <br />The Contractor shall insert in the space provided below the site(s) expected <br />to be used for the performance of work under the contract convered by the <br />certification: <br />Place of Performance (include street address, city, county, state, zip code <br />for each site): <br />1000 E. Santa Ana Blvd. #200 <br />Santa Ana, CA 92701 <br />