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DocuSign Envelope ID:5B6FF7D8-5B74-4BD3-BC2C-DDBAEB3C9E82 <br /> II. the site(s)for the petformance of work done in connection with the specific agreement are <br /> listed below: <br /> 1 113 Mayo Street <br /> (Street address) <br /> Hillsborough, Orange,NC, 27278 <br /> (City, county, state, zip code) <br /> 2 _ 2501 Homestead Road _ <br /> (Street address) <br /> Chapel Hill, Orange,NC, 27516 <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, of government-wide Federal suspension oz debarment <br /> (Section 4 CFR Part 85, Section 85 615 and 86.620) <br /> F DocuSigned by' <br /> brbks interpreter <br /> DO 10446... <br /> �;rgnature Title <br /> 8/20/2015 <br /> Agency/Organization Date <br /> (Certification signature should be same as Contract signature} <br /> Federal Certification-Drug-Free Workplace(06104) Page 2 of 2 <br />