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Contract#68-5000 <br /> Inter-Faith Council for Social Service,Inc. <br /> H. The site(s)for the performance of work done in connection with the specific agreement are <br /> listed below: <br /> 1.100 W. Rosemary Street <br /> (Street address) <br /> _Chanel Hill NC 27514 <br /> (City, county, state, zip code) <br /> 2. 110 W. Main Street <br /> (Street address) <br /> Carrboro NC 27510 <br /> (City,county, state,zip code) <br /> 3. 2505 Homestead Road <br /> (Street address) <br /> Chapel Hill NC 27514 <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 /> Signature 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 />