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<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 requremenls Imposed by or pursuant to the Regulation
<br />of the Department of Health and Human Services (45 C F.R Part BO), to the end That, In accordance with Title VI of that Act and the
<br />Regulallon, no person in the United States shall, on the ground of race, color, or naflonai odgin, be excluded from participation in, be
<br />denied the benefits of, or be otherwise subjected to discdmination under any program or activity for which the Applicant receives
<br />Federal financial assistance from the Department
<br />2. Section 504 of the Rehabliitellon Act of 1973 (Pub. L. 93-112), as amended, and all requlremenls 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 Thal, In accordance with Section 504 of
<br />that Acl and the Regulation, no otherwise qualified handicapped individual In the United Slates shall, solely by reason of his handicap.
<br />be excluded from participation In, be denied the benefits of, or be subjected to discdmination under any program or activity
<br />for which the Applicant receives Federal financial assistance from the Department
<br />3 Title IX of (he Educational Amendments of 1972 (Pub. L. 92-318), as amended, and ail requlremenls Imposed by or pursuant to the
<br />Regulation of the Depadment of Health and Human Services (45 C F R. Part 86), to the end that, in accordance with Title IX and the
<br />Regulallon, no person in the Unlted Stales 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 far 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 Regulallon 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 Unlted Stales shall, on the basis of age, be denied the benefits of, be excluded from participation in, or be subjected to
<br />discdmination under any program or activity for which the Applicant receves Federal financial assistance from the Department
<br />The Applicant agrees that compliance with this assurance constitutes a condlt(on of continued receipt of Federal nnanclal assistance, and Thal it
<br />is binding upon the Appllcanl, its successors, Transferees and assignees for the pedod dudng 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 fo the Applicant by the Aepartment,
<br />this assurance shall obligate the Applicant, or in the case of any lrensfer of such property, any transferee, for the period dudng which the real
<br />property or structure (s used for a purpose for which the Fedeml financial assistance is extended or for ano(her purpose involving the provision
<br />of similar services or benefits. if any personal property Is so provided, this assurance shall obligate the Appllcanl for iha pedod during which it
<br />retains ownership or possession of the property. The Applicant further recognizes and agrees that the United Stales shall have the right to seek
<br />judicial enforcement of this assurance.
<br />The person or persons whose signa(ure(s) appear(s) below Is/are authorized to sign this assurance, and commit the Appllcanl to the above
<br />provisions.
<br />Date Signature and Tifie of Aulhodzed Official
<br />Name of Applicant or Recipient
<br />Street
<br />Mall Form lo:
<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.O. 20201
<br />City, State, Zip Code
<br />Form HHS-690
<br />5/97
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