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• <br /> NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES <br /> DIVISION OF PUBLIC HEALTH <br /> CERTIFICATION REGARDING ENVIRONMENTAL TOBACCO SMOKE <br /> Certification for Contracts,Grants,Loans and Cooperative Agreements <br /> Public Law 103-227,Part C-Enviromnental Tobacco Smoke,also known as the Pro-Children Act <br /> of 1994 (Act),requires that smoking not be permitted in any portion of any indoor facility owned <br /> or leased or contracted for by an entity and used routinely or regularly for the provision of health, <br /> day care,education,or library services to children under the age of 18, if the services are funded <br /> by Federal programs either directly or through State or local governments,by Federal grant, <br /> contract,loan,or loan guarantee. The law does not apply to children's services provided in <br /> private residences,facilities funded solely by Medicare or Medicaid funds,and portions of <br /> facilities used for inpatient np drug or alcohol treatment. Failure to comply with the provisions of <br /> the law may result in the imposition of a civil monetary penalty of up to$1,000 per day and/or <br /> the imposition of an administrative compliance order on the responsible entity. <br /> By signing and submitting this application,the Contractor certifies that it will comply with the <br /> requirements of the Act.The Contractor further agrees that it will require the language of this <br /> certification be included in any subawards that contain provisions for children's services and that <br /> all subgrantees shall certify accordingly. <br /> X&AIL•ritAta' 6_,°01A.n4-1 44ea.-#11 Diredbr-- <br /> Authorized ncy Official Signature Title I <br /> I • as. • ' , At, • 3/rcioi • <br /> Official gency Na Date <br /> (Signature should be same as Contract signature) <br /> Smoke 3/00 <br />