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10 ' <br /> Page 9 of 12 <br /> person's written consent except as may be otherwise required by applicable law or regulation. <br /> Such information may be disclosed in summary, statistical, or other form which does not directly or <br /> indirectly identify particular individuals. <br /> F. CIVIL RIGHTS <br /> 1. The Department shall assure that no person, on the grounds of race, color, age, religion, <br /> sex, marital status, immigration status, or national origin (unless otherwise medically <br /> indicated) or otherwise qualified handicapped individual solely by reason of his/her <br /> handicap be excluded from participation in, be denied the benefits of, or be subjected to <br /> discrimination under any program or activity covered by this Contract. <br /> 2. The Department shall complete HHS Form 441, Assurance of Compliance with the <br /> Department of Health and Welfare regulations, under Title VI of the Civil Rights Act of <br /> 1964; for the Women, Infants and Children Program, FNS-64, Assurance of Compliance <br /> with the Department of Agriculture Food and Nutrition Service, under Title VI of the civil <br /> Rights Act of 1964; and HHS Form 641, Assurance of Compliance with Section 504 of the <br /> Rehabilitation Act of 1973. <br /> 3. The American with Disabilities Act 1990 (ADA) makes it unlawful to discriminate in <br /> employment against a qualified individual with a disability and outlaws discrimination <br /> against individuals with disabilities in State and local government services and public <br /> accommodations. The Department certifies that it and its principals and subcontractors will <br /> comply with regulations in A.D.A. Title I (Employment), Title II (Public Services), and Title III <br /> (Public Accommodations) in 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 the <br /> preparation of the Consolidated Contract/Activity Budgets and Contract Addenda. <br /> 2. The State shall specify those administrative forms/reports and their respective revision <br /> dates that are required by particular activities pertaining to the Department's budget with <br /> the State in Listing of Required Fiscal and Statistical Reports (Addendum 1) for the contract <br /> period. New forms/reports not listed in Required Fiscal and Statistical Reports shall be <br /> implemented during a contract 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 an activity <br /> budget from the Department an approved signed copy of the budget. <br /> 4. The State shall provide'funds to the Department upon approval of the Contract Addenda, <br /> activity budgets, and signing of this contract. <br /> 5. The State shall assist the Department to comply with all applicable laws, regulations, and <br /> standards relating to the activities covered in this contract. <br /> 6. The State reserves the right to conduct reviews to determine compliance with the terms of <br /> this contract. <br />