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<br /> CERTIFICATION FORM
<br /> Recipient Name and Address . Indian River County Board of County Commissioners, 1801276' Street, Vero Beach, FL 32960
<br /> Grant Title : Indian River County Drug Testing Program Grant Number: 20144AGG2114 Award Amount: $ 103575 . 00
<br /> Contact Person Name and Title : Colleen Peterson, Human Resources Mgr. phone Number: _ (72) 226- 1377
<br /> Federal regulations require recipients of financial assistance from the Office of Justice Programs (OJP ) , its component agencies, and the
<br /> Office of Community Oriented Policing Services (COPS ) to prepare , maintain on file , submit to OJP for review., and implement an Equal
<br /> Employment Opportunity Plan (EEOP ) in accordance with 28 C .F .R § § 42 .301 -308 . The regulations exempt som, e.frr4pients from all
<br /> of
<br /> the EEOP requirements . Other recipients , according to the regulations , must prepare , maintain on file and impl *it
<br /> afi EEOP , but they
<br /> do not need to submit the EEOP to OJP for review . Recipients that claim a complete exemption from the EEOP requirement must
<br /> complete Section A below . Recipients that claim the limited exemption from the submission requirement, must complete Section B
<br /> below . A recipient should complete either Section A or Section B , not both . If a recipient receives multiple OJP or COPS
<br /> grants,
<br /> please complete a form for each grant, ensuring that any EEOP recipient certifies as completed and on file (if applicable) has
<br />been � < 0ya >
<br /> prepared within two years of the latest grant. Please send the completed form(s) to the Office for Civil Rights , Office of Justice
<br /> Pro a Tis z '�
<br /> U . S . Department of Justice 810 7'h, Street N .W . Washington, D . C . 20531 . For assistance in completing this form lease
<br /> call 202 07 ° A ;
<br /> p � �
<br /> P g , P ( � �, � �
<br /> 0690 or TTY (202) 307-2027 . m $ � 0a
<br /> Section A- Declaration Claiming Complete Exemption from the EEOP Requirement. please check all the boxes t 16 � � € >
<br /> apply a
<br /> NTg
<br /> ❑ Recipient has less than 50 employees , ❑ Recipient is an Indian tribe , _ >
<br /> ❑ Recipient is a non -profit organization, ❑ Recipient is an educational institution, or ;I
<br /> ❑ Recipient is a medical institution, ❑ Recipient is receiving an award less than $ 25 ,000
<br /> I, [responsible official] , certify that a
<br /> [recipient] is not required to M
<br /> prepare an EEOP for the reason(s) checked above , pursuant to 28 C .F .R §42 . 302 . I further certify that
<br /> [recipient] will comply with applicable Federal civil rights
<br /> laws that prohibit discrimination in employment and in the delivery of services .
<br /> Print or type Name and Title Signature Date
<br /> Section B- Declaration Claiming Exemption from the EEOP Submission Requirement and Certifying That an
<br /> EEOP Is on File for Review .
<br /> If a recipient agency has 50 or more employees and is receiving a single award or subaward for $ 25 ,000 or more , but less
<br /> than $ 500 ,000 ,
<br /> then the recipient agency does not have to submit an EEOP to OJP for review as long as it certifies the following (42 C
<br />. F .R. § 42 . 305 ) :
<br /> I Colleen Peterson [responsible official] , certify that
<br /> the Indian River County BCC [recipient] ,which has 50 or more
<br /> employees and is receiving a single award or subaward for $25 , 000 or more , but less than $500,000, has formulated an
<br /> EEOP in accordance with 28 CFR §42 . 301 , et seq. , subpart E. I further certify that the EEOP has been formulated and
<br /> signed into effect within the past two years by the proper authority and that it is available for review. The EEOP is on
<br /> file in
<br /> the office of: Indian River County Board of County Commissioners [organization] ,
<br /> at 1801 27 Street, Vero Beach, FL 32960 [address] ,for review by the public and
<br /> employees or for review or audit by officials of the relevant state planning agency or the Office for Civil Rights , Office of
<br /> Justice Programs, U . S . Department of Justice, as required by elevant laws and regulations .
<br /> Colleen Peterson, Human Resources Manager ltd d
<br /> Print or type Name and Title Signature Date
<br /> OMB Approval No. 11214140 Expiration Date: 12/31 /12
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