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as
<br />ASSURANCE OF COMPLIANCE
<br />ASSURANCE OF COMPLIANCE WITH TITLE VI OF THE CIVIL RIGHTS ACT OF 1964, SECTION 504 OF THE REHABILITATION ACT OF
<br />1973, TITLE IX OF THE EDUCATION AMENDMENTS OF 1972, AND THE AGE DISCRIMINATION ACT OF 1975
<br />The Applicant provides this assurance in consideration of and for the purpose of obtaining Federal grants, loans, contracts, property, discounts
<br />or other Federal financial assistance from the Department of Health and Human Services.
<br />THE APPLICANT HEREBY AGREES THAT IT WILL COMPLY WITH:
<br />1. Title VI of the Civil Rights Act of 1964 (Pub. L. 88-352), as amended, and all requirements imposed by or pursuant to the Regulation
<br />of the Department of Health and Human Services (45 C.F.R. Part 80), to the end that, in accordance with Title Vl of that Act and the
<br />Regulation, no person in the United States shall, on the ground of race, color, or national origin, be excluded from participation in, be`
<br />denied the benefits of, or be otherwise subjected to discrimination under any program or activity for which the Applicant receives
<br />Federal financial assistance from the Department.
<br />2. Section 504 of the Rehabilitation Act of 1973 (Pub. L. 93-112), as amended, and all requirements imposed by or pursuant to the
<br />Regulation of the Department of Health and Human Services (45 C.F.R. Part 84), to the end that, in accordance with Section 504 of
<br />that Act and the Regulation, no otherwise qualified handicapped individual in the United States shall, solely by reason of his handicap,
<br />be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity
<br />for which the Applicant receives Federal financial assistance from the Department.
<br />3. Title IX of the Educational Amendments of 1972 (Pub. L. 92-318), as amended, and all requirements imposed by' or pursuant to the
<br />Regulation of the Department of Health and Human Services (45 C.F.R. Part 86), to the end that, in accordance with Title IX and the
<br />Regulation, no person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or
<br />be otherwise subjected to discrimination under any education program or activity for which the Applicant receives Federal financial
<br />assistance from the Department.
<br />4. The Age Discrimination Act of 1975 (Pub. L. 94-135), as amended, and all requirements imposed by or pursuant to the Regulation of
<br />the Department of Health and Human Services (45 C.F.R. Part 91), to the end that, in accordance with the Act and the Regulation, no
<br />person in the United States shall, on the basis of age, be denied the benefits of, be excluded from participation in, or be subjected to
<br />discrimination under any program or activity for which the Applicant receives Federal financial assistance from the Department.
<br />The Applicant agrees that compliance with this assurance constitutes a condition of continued receipt of Federal financial assistance, and that it
<br />is binding upon the Applicant, its successors, transferees and assignees for the period during which such assistance is provided. if any real
<br />property or structure thereon is provided or improved with the aid of Federal financial assistance extended to the Applicant by the Department,
<br />this assurance shall obligate the Applicant, or in the case of any transfer of such property, any transferee, for the period during which the real
<br />property or structure is used for a purpose for which the Federal financial assistance is extended or for another purpose involving the provision
<br />of similar services or benefits. If any personal property is so provided, this assurance shall obligate the Applicant for the period during which it
<br />retains ownership or possession of the property. The Applicant further recognizes and agrees that the United States shall have the right to seek
<br />judicial enforcement of this assurance.
<br />The person or persons whose signature(s) appear(s) below is/are authorized to sign this assurance, and commit the Applicant to the above
<br />provisions.
<br />Date
<br />Signature and Title of Authorized Official
<br />Name of Applicant or Recipient
<br />Street
<br />Mail Form to:
<br />DHHS/Office for Civil Rights
<br />Office of Program Operations
<br />Humphrey Building, Room 509E
<br />200 Independence Ave., S.W.
<br />Washington, D.C. 20201
<br />City, State, Zip Code
<br />Form HHS~90
<br />5197
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