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DocuSign Envelope ID:044AD186-BAD7-4A1 B-B44F-162B7511 D3DF <br /> H. 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 /> Cha-pel Hill Oranlize,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 /> Docu Sig ned by: <br /> �,1� VU Uf President <br /> Signatu7Z,4�3aB7EBEAF1443 Title <br /> communication Access Partners Inc 8/8/2019 <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 />