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r <br />DIVISION OF EMPLOYMENT SERVICES <br />PLACE OF PERFORMANCE <br />FOR CERTIFICATION REGARDING DRUG-FREE <br />WORKPLACE REQUIREMENTS <br />Name: ~'~-':.,,,i <br />Name of Contractor: <br />Contractor Number: <br />Date: <br />P_v~„l d~".i ;. <br />,~ .. <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 /> <br />'~~L~i j- Z.G/ `L 2'Y7 <br />,- <br />EXHIBIT D <br />