Laserfiche WebLink
<br />DIVISION OF EMPLOYMENT SERVICES <br />PLACE OF PERFORMANCE <br />FOR CERTIFICATION REGARDING DRUG-FREE WORKPLACE <br />REQUIREMENTS <br /> <br />Name of Contractor: <br /> <br />U~lf/P t~9c,AJJvJ.1 I0J"Z{ f-. U L CLA1114) <br />0)__.ffi'v\.ft / Prey C\ 1211YV1 0 <br /> <br />Name: (2j\'IS~~ <br /> <br />Contractor Number: <br /> <br />Date: <br /> <br />$- -(~ - 0/0 <br /> <br />The Contractor shall insert in the space provided below the site(s) expected to be <br />used for the performance of work under the contract covered by the certification: <br /> <br />Place of Performance (include street address, city, county, state, zip code for each <br />site): <br /> <br />IDol P: N{,rft! sf <br />~~l~ C). '12 'it S- <br />