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Contract#68-2010 <br /> TAMM,LLC dba Right at Home—Durham/Chapel Hill <br /> II. The site(s) for the performance of work done in connection with the specific agreement are <br /> listed below: <br /> 1. vg. c:Dc b i(N SAre� Ste Z� <br /> (Street address) <br /> I�AI56oro .5f ®,xnf-,Nc- �_'�;lj <br /> (City, -county, code) <br /> 2. <br /> (Street address) <br /> (City, county, state, zip code) <br /> Contractor will inform the County of any additional sites for performance of work under this <br /> agreement. <br /> False certification or violation of the certification shall be grounds for suspension of payment, <br /> suspension or termination of grants, or government-wide Federal suspension or debarment <br /> (Section 4 CFR Part 85, Section 85.615 and 86.620). <br /> /V_C,_ V 0 Ouvoa- <br /> Signature Title <br /> A(I kl�A f_.Hwm?_ Otk� &I Lz_-Lib <br /> Agency/Organization Date <br /> (Certification signature should be same as Contract signature.) <br /> Federal Certification-Drug-Free Workplace(06/04) Page 2 of 2 <br />