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DIVISION OF EMPLOYMENT SERVICES <br /> <br /> PLACE OF PERFORMANCE <br /> <br /> FOR CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS <br /> <br />Name: Silver Rose <br /> <br />Name of Contractor: <br />Contractor Number: <br /> <br />Date: August 4, <br /> <br />Silver Rose Enterprises, LLC <br /> <br />2003 <br /> <br />The Contractor shall insert in the space provided below the site(s) expected <br />to be used for the performance of work under the contract convered by the <br />certification: <br /> <br />Place of Performance (include street address, city, county, state, zip code <br />for each site): <br /> <br />Santa Aha WORK Center <br />1000 E. Santa Ama Blvd. <br />Santa Aha, CA 92701 <br /> <br /> <br />