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~• <br />Contract #68-2013 <br />Dr. Betty Rintoul <br />II. The site(s) for the performance of work done in connection with the specific agreement are <br />listed below: <br />1 <br />(Sheet address) <br />C~aP.e f I-~-f II VI/ c 2~~ ~ ~ <br />(City, county, state, zip code) <br />(Street address) <br />CA ,r ~ b o ra ~V ~ ~~ S1 v <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 />r~~~ <br />Signature <br />Agency/Organization <br />~ , <br />Title <br />Date <br />(Certification signature should be same as Contract signature.) <br />Federal Certification -Drug-Free Workplace (06/04) Page 2 of 2 <br />