Orange County NC Website
Browse       Search
.i <br />18 <br />CERTIFICATION REGARDING DRUG -FREE WORKPLACE REQUIREMENTS Page 2 - I <br />ll. The sites) for the performance of work done in connection with the specific agreement are listed below: <br />1. <br />(Street address) <br />(City, county, state, zip code) <br />2. <br />(Street address) <br />(City, county, state, zip code) <br />Contractor will inform the Department 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, suspension <br />or termination of grants, or government -wide Federal suspension or debarment (Section 4 CFR Part 85, <br />Section 85.615 and 86.620). <br />EXECUTED BY <br />CONTRACTOR AUTHORIZED OFFICER <br />ADDRESS <br />(Certification signature should be same as Contract signature.) <br />DATE <br />