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<br />. <br /> <br />. <br /> <br />DIVISION OF EMPLOYMENT SERVICES <br /> <br />PLACE OF PERFORMANCE <br /> <br />FOR CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS <br /> <br />I,; <br /> <br />,--, <br />,-/ j <br />:!/~ v'vv~t,.' 1 <br /> <br />'(:;r; ,; <br /> <br />Name: <br /> <br />,0'1/,// <br /> <br />Name of Contractor: <br /> <br />~~_Li;A <br /> <br />Contractor 'Number: <br /> <br />Date: <br /> <br />j)dtf <br />, f <br /> <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 /> <br />Place of Performance (include street address, city, county, state, zip code <br />for each site): <br /> <br />,)tJ (;' .1 . - <br />4. C..:: It:t:U,- { LL t-<-J .:.t.<./ <br /> <br />,J .,11. ,I", <br /> <br />u-J ~:J'!e/ <br />{ <br />