Orange County NC Website
• Contract #68-2001 <br />Northen Blue, L.L.P. <br />II. The site(s) for the performance of work done in connection with the specific agreement are <br />listed below: <br />1. <br />(Street address) <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 1`or 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 />• c~~~ ~~ <br />Signature Title <br />~ o~~ <br />Agency/Organization Date <br />(Certification signature should be same as Contract signature.) <br />• <br />Federal Certification -Drug-Free Workplace (06/04) <br />Page 2 of 2 <br />