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DIVISION OF EMPLOYMENT SERVICES <br />PLACE OF PERFORMANCE <br />FOR CERTIFICATION REGARDING DRUG-FREE <br />WORKPLACE REQUIREMENTS <br />Name: ?e. Ie?-1 A• C?SC.1n <br />Name of Contractor: \?e?•t,C.1n <br />Contractor Number: <br />Date: :1111 ? c no <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 />Place of Performance (include street address, city, county, state, zip code for each site): <br />1 oo C ar%tt,, Pnd 22)'6_ 200 <br />bC&O±c, kV-i,? , C .C, aZan\ <br />EXHIBIT C