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<br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> DIVISION OF EMPLOYMENT SERVICES <br /> <br /> PLACE OF PERFORMANCE <br /> FOR CERTIFICATION REGARDING DRUG-FREE <br /> <br /> WORKPLACE REQUIREMENTS <br /> <br /> <br /> Name: 40e Name of Contractor: no4 d L. "4e!: d7C&&'V0% Q, <br /> <br /> <br /> Contractor Number: <br /> Date:L~~l <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 /> <br /> Place of Performance (include street address, city, county, state, zip code for each site): <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> r-,g 04 C. EXHIBIT C <br />