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DocuSign Envelope ID: 88034C6E- 715D- 41C8- A5B0- 814CA90145FF <br />11. The site(s) for the performance of work done in connection with the specific agreement are <br />listed below: <br />1. 113 Mao Street <br />(Street address) <br />Hillsborough, Orange, NC, 27278 <br />(City, county, state, zip code) <br />2. 2501 Homestead Road <br />(Street address) <br />ChM el 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, or government -wide Federal suspension or debarment <br />(Section 4 CFR Part 85, Section 85.615 and 86.620). <br />DocuSigned by, <br />�'a 1�7V'bb�3 <br />Si€ 85BC7D01D910446... <br />Title <br />Agency /Organization late <br />interpreter <br />7/3/2018 <br />(Certification signature should be same as Contract signature.) <br />Federal Certification - Drug -Free Workplace (06144) Page 2 of 2 <br />