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Convact# <br />Good I-lealtli Services Inc. <br />II. The site(s) for the performance of work done in connection with the specific agreement are <br />listed below: <br />1. 1303 S. Cannon Blvd <br />(Street address) <br />(City, county, state, zip <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 shal] be grounds for suspension of payment, <br />suspension or termination of grants, or government-wide Federal suspension or dcbarment <br />(Section 4 CFR Part 85, Section 85.615 and 86.620). <br />/ ~ ..~g-J'~. Ys~ <br />Tony M Curdy <br />President <br />Title <br />Good Health Services. Inc. <br />Agency/Organization <br />~/~ /~~ <br />Date <br />Federal Certification - Drug-Free Workplace (06/04) ~- ~ Page 2 of 2 <br />