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Contract#68-2012 <br /> CNC Access,Inc.dba ResCare HomeCare <br /> II. The site(s) for the performance of work done in connection with the specific agreement are <br /> listed below: <br /> 1._ 4011 owlmR5rr� -DR Su ITS 0,111C ( <br /> (Street address) <br /> 7D�M4-411 iDAHMAC01 Nc a�`�ol <br /> (City, c unty, state, zip 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).z�_ <br /> IMA LDIf,'ECr_R <br /> St e Title <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 />