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<br />DIVISION OF EMPLOYMENT SERVICES <br /> <br />PLACE OF PERFORMANCE <br /> <br />FOR CERTIFICATION REGARDING DRUG-FREE <br />WORKPLACE REQUIREMENTS <br /> <br />Name: Lee De leon <br />Name of Contractor: <br />Contractor Number: <br /> <br />Templo Clavario CDC <br /> <br />Date: <br /> <br />A-2004-166 <br />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 D <br />