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DocuSign Envelope ID:246A3B97-8291-4A09-9B7C-80AF9135F8B9 <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 /> 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 851 Section 85.615 and 86.620). <br /> Douu5igned by: <br /> �{s6w Ra�L,5 7 Executive Director <br /> Signat_ V 5Fa3F096DB884BC 'Title <br /> Refugee community Partnership 8/9/2019 <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 />