Orange County NC Website
Browse       Search
ATTACHMENT C <br />FEDERAL CERTIFICATIONS <br /> <br />The undersigned states that: <br /> <br />1. He or she is the duly authorized representative of the Contractor named below; <br /> <br />2. He or she is authorized to make, and does hereby make, the following certifications on behalf of the Contractor, as set <br />out herein: <br /> <br />a. The Certification Regarding Nondiscrimination; <br />b. The Certification Regarding Drug-Free Workplace Requirements; <br />c. The Certification Regarding Environmental Tobacco Smoke; <br />d. The Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered <br />Transactions; and <br />e. The Certification Regarding Lobbying; <br /> <br />3. He or she has completed the Certification Regarding Drug-Free Workplace Requirements by providing the addresses at <br />which the contract work will be performed; <br /> <br />4. [Check the applicable statement] <br /> <br />[ ] He or she has completed the attached Disclosure Of Lobbying Activities because the Contractor has made, or <br />has an agreement to make, a payment to a lobbying entity for influencing or attempting to influence an officer or <br />employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member <br />of Congress in connection with a covered Federal action; <br /> <br />OR <br /> <br />[X] He or she has not completed the attached Disclosure Of Lobbying Activities because the Contractor has not <br />made, and has no agreement to make, any payment to any lobbying entity for influencing or attempting to <br />influence any officer or employee of any agency, any Member of Congress, any officer or employee of Congress, <br />or any employee of a Member of Congress in connection with a covered Federal action. <br /> <br />5. The Contractor shall require its subcontractors, if any, to make the same certifications and disclosure. <br /> <br /> <br />________________________________________________________________________________________________ <br />Signature Title <br /> <br /> <br />________________________________________________________________________________________________ <br />Contractor Name Date <br /> <br /> <br />[This Certification Must be Signed by the Same Individual Who Signed the Proposal Execution Page] <br /> <br />I. Certification Regarding Nondiscrimination <br /> <br />The Contractor certifies that it will comply with all Federal statutes relating to nondiscrimination. These include but are <br />not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, <br />color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §§1681-1683, and <br />1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as <br />amended (29 U.S.C. §794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of <br />1975, as amended (42 U.S.C. §§6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office <br />and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the <br />DocuSign Envelope ID: 04F36197-9976-45D7-BDCC-F429CFE8B0F9 <br />Beautiful Remissions LLC <br />Angency Director <br />1/16/2024