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1 STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION 275-030-13 CERTIFICATION OF NON SEGREGATION & EQUAL OPPORTUNITY OFFICE NON DISCRIMINATION 07M SECTION 1 : PROJECT IDENTIFICATION 1 , Financial Project No. 2. F.A P. No . 3. FDOT LAP Contract No. 4. Coun 5. District or Name of Local Agency 6. Prime Contractor `s Name 7. Com an Name of Con ctor. Supplier, Rental Com an or A e ubmittin this rtification 8. FEID No of Co. in Box 7 SECTION : CERTIFICATION STATEMEN S CERTIFICATION OF CERTIFICATION OF NONSEGREGATED FACILITIES NON DISCRIMINATION As a federally assisted construction contractor, I As contractor, sub recipient or subcontractor on a hereby certify: the following for t his company : Federally funded contract, this company certifies that it A . This company does not maintain or provide shall not discriminate on the basis of race , color, national any segregated facilities for employees at origin , or sex in the performance of such contracts , any of our establishments and we do not The contractor shall carry out applicable requirements of permit our employees to perform their 49 CFR Part 26 in the award and administration of DOT services at any location , under our control, assisted contracts . The company agrees that a failure to where segregated facilities are maintained . carry out these requirements is a material breach of B. Agreement that a breach of this certification contract, which may result in the contract's termination or is a violation of the equal opportunity clause such other- remedy as the recipient deems appropriate, in this contract Each subcontract, rental agreement and or material C. We will obtain and retain identical supplier agreement this company subsequently enters certifications from proposed subcontractors into for this contact will require this same Certification , prior to the award of subcontracts exceeding It is the policy of this company to assure that applicants $ 10 ,000 which are not exempt from the are employed , and that employees are treated during provisions of the equal opportunity clause. employment, without regard to their race, religion , sex, As used in this certification , the terms "segregated color, national origin, age or disability. Actions include : facilities" means any waiting rooms, work areas, employment, upgrading , demotion , or transfer; restrooms and washrooms , restaurants and recruitment or recruitment advertising ; layoff or fountains , recreation or entertainment area, termination ; rates of pay and other forms of transportation , and housing facilities provided for compensation ; and selection for training, including employees which are segregated by explicit apprenticeship , ra r nticeship , pre apprenticeship, and/or onAhe-job directives or are in fact segregated on the basis of g. race, color, religion or national origin because of This certification extends to the project identified .above habit, local custom , or any other reason , and affirms our commitment to insure nondiscrimination and to take affirmative action to assure equal opportunity as set forth under laws, executive orders , rules, regulations ( 28 CFR 35, 29 CFR 1630 and 41 CFR 60) and orders of the Secretary of Labor as modified by the provisions of FHWAA273 . Compliance with Title VI of the Civil Rights Act and the provisions of the American Disabilities Act of 1990 are incorporated in this certification . 9. Name first/last of corporate. Official signing Certification 10. Job Title of person named in Box 9 11 . Signature of Certi .in ' 1 12. Date of Signature 400� woe 00490 - 1