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DocuSign Envelope ID:BD69DF46-15CD-49E6-8588-93617FCCFB94 <br /> D. The site(s) for the performance of work done in connection with the specific agreement are listed <br /> below: <br /> ]. <br /> (Street address) <br /> (City, county, state, zip code) <br /> 2. <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 agreement. <br /> False codifioakionor violation of the certification shall bc grounds for suspension o[payment, suspension <br /> or termination of grants, or government-wide Federal suspension or debarment <br /> 45 C.F.R. Section 02'510. Section 4 CFR Part 85, Section 85'615 and 86.020. <br /> CERTIFICATION REGARDING NONDISCRIMINATION <br /> The Vendor certifies that it will comply with all Federal statutes relating to nondiscrimination. These <br /> include but are not limited to: (a) Title VI of the Civil Rights Act o[ l964 (PI- 88-352) which prohibits <br /> discrimination on the basis of race, color or national origin: (b) Title IX of the Education Amendments of <br /> 1972, as amended (20 U.S.C. §81681'l603, and 1685-1686), which prohibits discrimination on the basis <br /> of sex; (c) Section 504ofdbeRobuhi|itadoo /\otofl973, aooz000dcd (29U.S.C. 8794), vvbicbpcohibi& <br /> discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. <br /> §86l01'6l07), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and <br /> Treatment Act of 1972 (P.[. 92-255), as amended, relating to nondiscrimination on the basis of drug <br /> abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation <br /> Act of 1970 (p.I... 91-610), as amended, relating to nondiscrimination on the basis of alcohol abuse or <br /> alcoholism; (g) Title VIII of the Civil Rights Act of 1068 (42 U.S.C. 883601 et seq.), as amended, <br /> relating to nondiscrimination in the sale, rental or financing of housing; (h) the Food Stamp Act and <br /> USDA policy, which prohibit discrimination on the basis of religion and political beliefs; and (h the <br /> requirements of any other nondiscrImination statutes which may apply to this Agreement. <br /> f—DocuSigned by: <br /> atAAAA, ti-SkriklatA, Executive Di rector <br /> Signutmro ^^~~~~~'~^`~^ Title ---- -- <br /> Chatham Transit Network 8/22/2016 <br /> Agency/Organization Date <br /> (Certification signature should be same as Contract signature.) <br /> Federal Certification Drug-Free Workplace& Nondiscrimination rev. 86'2015 <br /> Page 2of2 <br />