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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 />e CO1r'ty Health Dt~partimect (hereinafter called the "Applicant ") <br />Name of Applicant (type or print) <br />HEREBY AGREES THAT it will comply with Title VI of the Civil Rights Act of 1964 (P.L. <br />88 -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 the 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 flnan- <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 behalf of the Applicant. <br />Date <br />By <br />P. 0. Box 8181 <br />Hillsborough, NC 27278 <br />APpticmt's maiWq address <br />HHS441 (Rev. 121 <br />County Health Departnmt <br />Applicant (type or print) <br />Sitnature and Tide of Audxdted Official <br />Moses Carey, Chair <br />Board of County Coamissioners <br />14 <br />