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11 <br /> ASSURANCE OF COMPLIANCE WITH THE DEPARTMENT OF <br /> HEALTH AND HUMAN SERVICES REGULATION UNDER <br /> TITLE VI OF THE CIVIL RIGHTS ACT OF 1964 <br /> Orange County Health Department (hereinafter called tl:e "Applicant") <br /> Name of Applicaw (type or print) <br /> HEREBY AGREES THAT it will comply with Title VI of the Civil Rights Act of 1964 (P.L. <br /> S8-352) and all requirements imposed by or pursuant to the Regulation of the Department <br /> of Health and Human Services (45 C.F.R. Part 80) issued pursuant to that title, to the end <br /> that, in accordance with Title VI of that Act and the Regulation, no person in the United <br /> States shall, on the ground of race, color, or national origin, be excluded from participation <br /> in, be denied the benefits of, or be otherwise subjected to discrimination under any program <br /> or activity for which the Applicant receives Federal financial assistance from :he Depart- <br /> ment; and HEREBY GIVES ASSURANCE THAT it will immediately take any measures <br /> necessary to effectuate this agreement. <br /> If any real property or structure thereon is provided or improved with the aid of Federal <br /> financial assistance extended to the Applicant by the Department,this Assurance shall obligate <br /> the Applicant, or in the case of any transfer of such property, any transferee, for the period <br /> during which the real property or structure is used for a purpose for which the Federal financial <br /> assistance is extended or for another purpose involving the provision of similar services or <br /> benefits. If any personal property is so provided, this Assurance shall obligate the Applicant <br /> for the period during which it retains ownership or possession of the property. In all other <br /> cases, this Assurance shall obligate the Applicant for the period during which the Federal <br /> financial assistance is extended to it by the Department. <br /> THIS ASSURANCE is given in consideration of and for the purpose of obtaining any and <br /> all Federal grants, loans, contracts, property, discounts or other Federal financial assistance <br /> extended after the date hereof to the Applicant by the Department, including installment <br /> payments after such date on account of applications for Federal financial assistance which <br /> were approved before such date. The Applicant recognizes and agrees that such Federal finan- <br /> cial assistance will be extended in reliance on the representations and agreements made in <br /> this Assurance, and that the United States shall have the right to seek judicial enforcement <br /> of this Assurance. This Assurance is binding on the Applicant, its successors, transferees, <br /> and assignees, and the person or persons whose signatures appear below are authorized to <br /> sign this Assurance on behzlf of the Applicant. <br /> Date Orange County Health Department <br /> ADpluant hype or print) <br /> By <br /> Silnatute and Title of Authorized Official <br /> Moses Carey, Jr., Chair, Board of County Camiissioners <br /> HHS-4+1 (Rev. 12/12) <br />