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☐ ☒ d) Paid providers of goods or services to the program or having other financial interest in the <br />program? <br />If you have answered YES to any question, please provide a full explanation below. <br /> <br />NON-DISCRIMINATION <br />Provider agrees as part of consideration of the granting of funds by funding agencies to the <br />parties hereto for themselves, their agents, officials, employees and servants agree not to <br />discriminate in any manner of these basis of race, color, gender, national origin, age, <br />handicap, religion, sexual orientation, gender identity/expression, familial status or veterans <br />status with reference to any activities carried out by the grantee, no matter how remote. The <br />parties hereto further agree in all respects to conform to the provision and intent of Orange <br />County Civil Rights Ordinance, as amended and the Orange County Anti-discrimination <br />Policy. This provision is enforced by action for specific performance, injunctive relief, or <br />other remedy as by law provided; this provision shall be binding on the grantees, the <br />successors and assigns of the parties hereto with reference to the above subject manner. <br />To the best of my knowledge and belief all of the above information is true and <br />current. I acknowledge and understand that the existence of a potential conflict of <br />interest does not necessarily make the program ineligible for funding, but the existence <br />of an undisclosed conflict may result in the termination of any grant awarded. <br /> <br /> <br /> <br />Signature: 1/14/2021 <br /> Executive Director Date <br /> <br /> <br /> <br />Signature: 1/14/2021 <br /> <br /> Board Chairperson Date <br /> <br /> <br />DocuSign Envelope ID: DA5CF954-7FB4-49AB-99CC-0C1ABAA1F102