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<br />Federal Certification - Drug-Free Workplace (06/04) Page 2 of 2 <br /> <br />II. The site(s) for the performance of work done in connection with the specific agreement are listed below: <br /> <br /> 1. __________ 113 Mayo Street______________________ (Street address) <br /> ___________Hillsborough, Orange, NC, 27278 ____________ (City, county, state, zip code) <br /> 2. _____________2501 Homestead Road____________________ (Street address) <br /> ___________Chapel Hill, Orange, NC, 27516______________ (City, county, state, zip code) Contractor will inform the County of any additional sites for performance of work under this agreement. False certification or violation of the certification shall be grounds for suspension of payment, suspension or termination of grants, or government-wide Federal suspension or debarment (Section 4 CFR Part 85, Section 85.615 and 86.620). <br /> <br /> <br /> <br />_________________________________ __________________________________ <br />Signature Title <br /> <br /> <br />_________________________________ __________________________________ <br />Agency/Organization Date <br /> <br /> <br />(Certification signature should be same as Contract signature.) <br /> <br /> <br />Docusign Envelope ID: 89E3DD83-36C1-471E-B20E-2066F92010F1 <br />Senior Manager <br />Spanish Without Borders, LLC 11/11/2024