Orange County NC Website
Browse       Search
DocuSign Envelope ID:3104DB10-5BE2-4447-B27F-DB78763E6E88 <br /> II. The site(s) for the performance of work done in connection with the specific agreement are <br /> listed below: <br /> 1. 113 Mayo Street <br /> (Strcct address) <br /> -HillsborougL Orange,NC, 27278 <br /> (City, county, state, zip code) <br /> 2. 2501. Homestead Road <br /> (Sheet 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, or government-wide Federal suspension or debarment <br /> (Section 4 CFR Part 85, Section 85.615 and 86.620). <br /> DocuSigned by: <br /> 1«fL l�ww �III. <br /> Spanish Interpreter <br /> 52176F590C4C4D2... _ <br /> Signature Title <br /> 7/18/2016 <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 />