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DIVISION OF EMPLOYMENT SERVICES <br />PLACE OF PERFORMANCE <br />FOR CERTIFICATION REGARDING DRUG -FREE WORKPLACE <br />Name: <br />Name of Contractor: <br />Contractor Number: <br />Date: <br />REQUIREMENTS <br />OC Children's Therapeutic Arts Center <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 />Place of Performance (include street address, city, county, state, zip code for each <br />site): <br />cc <br />22 i �_ t\� . Br uo d wGy <br />L(-u rn l n C) ' \ c 41._ Lc I <br />SG n �-a P r)0 , C) C-(j ) oe ('c)U n L--i <br />