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DocuSign Envelope ID:03945128-5AF0-4274-B12E-9229E2258D5B
<br /> DPSNorth Carolina Department fPubli � f ty
<br /> Emergency Management
<br /> Pat McCrory, Governor Michael A. Spravberry,Director
<br /> Frank L„pent°, Secretary
<br /> A. The [Sub-Recipient, licensee, lessee, permittee, etc., as appropriate] for
<br /> herself/himself, his/her personal representatives, successors in interest, and assigns, as
<br /> a part of the consideration hereof, does hereby covenant and agree [in case of deeds,
<br /> and leases add "as a covenant running with the land"] that (1) no person on the
<br /> grounds of race, color, sex, or national origin shall be excluded from participation in,
<br /> be denied the benefits of, or be otherwise subjected to discrimination in the use of
<br /> said facilities, (2) that in the construction of any improvements on, over or under such
<br /> land and the furnishing services thereon, no person on the grounds of race, color, sex,
<br /> or national origin shall be excluded from the participation in, be denied the benefits
<br /> of, or be otherwise subjected to discrimination, and (3) that the [Sub-Recipient,
<br /> licensee, lessee, permittee, etc.] shall use the premises in compliance with all other
<br /> requirements imposed by or pursuant 2 CFR Sub Part F Effectuation of Title VI of
<br /> the Civil Rights Act of 1964, and as said Regulations may be amended.
<br /> B. That in the event of breach of any of the above nondiscrimination covenants, Sub-
<br /> Recipient shall have the right to terminate the [license, lease, permit, etc.] and to
<br /> re-enter and repossess said land and the facilities thereon, and hold the same as if said
<br /> [license, lease,permit, etc.] had never been made or issued.
<br /> C. That in the event of breach of any of the above nondiscrimination covenants, Sub-
<br /> Recipient shall have the right to re-enter said land and facilities thereon, and the
<br /> above-described lands and facilities shall thereupon revert to and vest in and become
<br /> the absolute property of Sub-Recipient and its assigns.
<br /> * Reverted clause and related language to be used only when it is determined that such
<br /> a clause is necessary in order to effectuate the purpose of Title VI of the Civil Rights
<br /> Act of 1964.
<br /> 29. Assurance of Compliance with Privacy Act
<br /> The Sub-Recipient agrees:
<br /> A. To comply with the provisions of the Privacy Act of 1974, 5 U.S.C. §552A and
<br /> regulations adopted there under, when performance under the program involves the
<br /> design, development, or operation of any system or records on individuals to be
<br /> operated by the Sub-recipient, its third-party contractors, subcontractors, or their
<br /> employees to accomplish a USDHS function.
<br /> B. To notify USDHS when the Sub-Recipient or any of its third-party contractors,
<br /> subcontractors„ sub recipients, or their employees anticipate a system of records on
<br /> behalf of USDHS in order to implement the program, if such system contains
<br /> information about individuals name or other identifier assigned to the individual. A
<br /> system of records subject to the Act may not be used in the performance of this
<br /> Agreement until the necessary and applicable approval and publication requirements
<br /> have been met.
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