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1 <br /> • II.The site(s)for the performance of work done in connection with the specific agreement are listed below: <br /> 1. 300 W Tryon St <br /> (Street address) <br /> Hillsborough NC 27278 <br /> (City,county,state,zip code) <br /> 2. 2501 Homestead Rd. <br /> (Street address) <br /> Chapel Hill NC 27516 <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 .620). <br /> EXECUTED BY /V Health Director <br /> CONTRACT AUTHORIZED OFFICER <br /> 300 W. Tryon St. Zi <br /> ADDRESS DATE <br /> Hillsborough NC 27278 <br /> (Certification signature should be same as Contract signature.) <br />