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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: 6~7-~~~ Lv/2;J--pr <br />Name of Contractor: Ph;.. <br />Contractor Number: <br />Date: ?;( ( II 0 <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 />2-3 f Eo. 6 VZf4.-~ <br />'Jk !i"-u, <br />L~ ~L U4qa~'l- <br />l <br />Lo r ~- j<<b- I' ~~ '1rlJ <br /> <br />EXHIBIT E <br />