Orange County NC Website
Browse       Search
Contract #68-2006 <br />Triangle Home Health Care, Inc. <br />II. The site(s) for the performance of work done in connection with the specific agreement are <br />listed below: <br />1. 'U Q. ~- ~, a ~ s <br />(Street address) <br />(City, county, state, zip code) <br />(Street address) <br />(City, county, state, zip code) <br /> <br />• <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 />!~ ~ ~ ~~~ <br />Signature Title <br />~v~; !j <br />Agency/Org ~ tion , ~ t <br />v~~ 0 <br />Date <br />(Certification signature should be same as Contract signature.) <br />Federal Certification -Drug-Free Workplace (06/04) <br />Page 2 of 2 <br />