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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: K.'/'/<\a. H,~scJ~ <br />Name of Contractor: Th..~. CQIl-t hf'l j'~1/L Pawtl' ~J <br />Contractor Number: Fed..€'AI' a;, I 1:. {} #: <=r s- ~ ?> '? S ~ 8' '3 I <br />Date: ..J'vV\e.,;2., ~, ).. 00 7 <br />, <br /> <br />-; <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 />Ii 'i e., Wa k:e.,?..a h-1 Ave, S/-e-. E <br />,/ <br /> <br />SQ.-\ 4 /hAa GA <br />. <br /> <br />9;Z 70S""" (orc.lA<;e, (;) <br />v <br /> <br />f,.XHf8r, P <br />