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Contrail #68-2002 <br />OPC Liaison <br />II. T'he site(s) for the performance of work done in connection with the specific agreement are <br />listed below: <br />1. ~ oo ~~ ro Pa,l> rl~/~ S yi-~~ X10 <br />(Street address) <br />c~-ap~~ 1-1-i ~ ~ , N G Z'1 S~ ~ <br />(City, county, state, zip code) <br />2. <br />(Street address) <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 />• Signature <br />pp G f~r'.~o~ Proof rare <br />Agency/Organization Date <br />~-r-.~a~T~ i recrbr ~ c~'o <br />Title <br />Cv•S•o8 <br />(Certification signature should be same as Contract signature.) <br />. Federal Certification -Drug-Free Workplace (06/04) <br />Page 2 of 2 <br />