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<br />DIVISION OF EMPLOYMENT SERVICES <br />PLACE OF PERFORMANCE <br />FOR CERTIFICATION REGARDING DRUG-FREE WORKPLACE <br />REQUIREMENTS <br /> <br />Name: 4 A-/ CAR TliR <br />Name of Contractor: OrGl~e e,,,ltt t1A.5eifllC< fl,,,, (J;rps; <br />Contractor Number: <br />Date: 62..1-01;. <br /> <br />The Contractor shall insert in the space provided below the site(s) expected to be <br />used 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 <br />site): <br /> <br />I g '> 3 dr-n.. R..<<[/fAQflJ Ave <br />kM kl'lVI. CPr qi'i{()f <br />. <br /> <br />El:HIHIT F <br />