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DocuSign Envelope ID: 1OF446D4-3BEC433E-8DD6-00OB04B3103E <br />DIVISION OF EMPLOYMENT SERVICES <br />PLACE OF PERFORMANCE <br />FOR CERTIFICATION REGARDING DRUG -FREE <br />WORKPLACE REQUIREMENTS <br />Name: <br />Name of Contractor: UCLA Extension <br />Contractor Number: <br />Date: 8/31 /2023 <br />The Contractor shall insert in the space provided below the site(s) expected to be used <br />for the performance of work under the contract covered by the certification: <br />Place of Performance (include street address, city, county, state, zip code for each site): <br />1145 Gayley Avenue, <br />Los Angeles, CA 90024 <br />Address <br />EXHIBIT E <br />