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10 <br /> Page 9of12 <br /> summary, statistical, or other form which does not directly or indirectly identify particular , <br /> individuals. <br /> F. CIVIL RIGHTS <br /> 1. The Department shall assure that no person, on the grounds of race, color, age, <br /> religion, sex, marital status, immigration status, or national origin (unless <br /> otherwise medically indicated) or otherwise qualified handicapped individual <br /> solely by reason of his/her handicap be excluded from participation in, be denied <br /> the benefits of, or be subjected to discrimination under any program or activity <br /> covered by this Contract. <br /> 2. The Department shall complete HHS Form 441, Assurance of Compliance with <br /> the Department of Health and Welfare regulations, under Title VI of the Civil <br /> Rights Act of 1964; for the Women, Infants and Children Program, FNS-64, <br /> Assurance of Compliance with the Department of Agriculture Food and Nutrition <br /> Service, under Title VI of the civil Rights Act of 1964; and HHS Form 641, <br /> Assurance of Compliance with Section 504 of the Rehabilitation Act of 1973. <br /> 3. The American with Disabilities Act 1990 (ADA) makes it unlawful to discriminate <br /> in employment against a qualified individual with a disability and outlaws <br /> discrimination against individuals with disabilities in State and local government <br /> services and public accommodations. The Department certifies that it and its <br /> principals and subcontractors will comply with regulations in A.D.A. Tibe I <br /> (Employment), Title II (Public Services), and True III (Public Accommodations) in <br /> fulfilling the obligations under this agreement. <br /> G. RESPONSIBILITIES OF THE STATE <br /> 1. The State shall provide to the Department upon request technical assistance in <br /> the preparation of the Consolidated Contract, Activity Budgets and Contract <br /> Addenda. <br /> 2. The State shall specify those administrative forms/reports and their respective <br /> revision dates that are required by particular activities pertaining to the <br /> Department's budget with the State in Listing of Required Fiscal and Statistical <br /> Reports (Addendum 1)for the contract period. New forms/reports not listed in <br /> Required Fiscal and Statistical Reports shall be implemented during a contract <br /> period only with the approval of the State Health Director. <br /> 3. The State shall provide to the Department within thirty (30) days after receiving <br /> an acceptable activity budget from the Department an approved signed copy of <br /> the budget. - <br /> 4. The State shall provide funds to the Department upon approval of the Contract <br /> Addenda, activity budgets, and signing of this contract. <br /> 5. The State shall assist the Department to comply with all applicable laws, <br /> regulations, and standards relating to the activities covered in this contract. <br /> 6. The State reserves the right to conduct reviews to determine compliance with the <br /> terms of this contract. <br />