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DocuSign Envelope ID:2D2D4024-9587-4AD4-BF9B-91 E3244EA302 <br /> II. The site(s) for the performance of work done in connection with the specific agreement are <br /> listed below: <br /> 113 Mayo Street <br /> (Street address) <br /> Hillsborough, Oran e NC 27278 <br /> (City, County, state, zip code) <br /> 2.--- 2501 Homestead Road <br /> (Street address) <br /> _ Chapel Hill, Oran e NC, 27516 _ <br /> (City, county, state, zip code) <br /> Contractor will inform the County of any additional sites for peifbimance of work under this <br /> agreement. <br /> False certification or violation of the certification shall be grounds fbi suspension of'payment, <br /> suspension or termination of giants, or government-wide Federal suspension or debarment <br /> (Section 4 CFR Part 85, Section 85 615 and 86.620) <br /> DocuSigned by: <br /> Karen and Burmese interpreter <br /> �a9]�E]FlSFJ_'14(14 <br /> Signature Title <br /> 9/1/2015 <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 />