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<br />DIVISION OF EMPLOYMENT SERVICES <br />PLACE OF PERFORMANCE <br />FOR CERTIFICATION REGARDING DRUG-FREE <br />WORKPLACE REQUIREMENTS <br /> <br />Name: <br /> <br />Lee De leon <br /> <br />Name of Contractor: Templo Clavario CDC <br />Contractor Number: A-2004-166 <br />Date: June 22, 2005 <br /> <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 /> <br />Place of Performance (include street address, city, county, state, zip code for each site): <br /> <br />2511 W 5TH Street Santa Ana Ca 92703 <br /> <br />EXHIBIT F <br />