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STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION CERTIFICATION OF NON SEGREGATION & NON DISCRIMINATION 275-030-13 EQUAL OPPORTUNITY OFFICE 07109 SECTION 1: PROJECT IDENTIFICATION 1. Financial Project No. Z. F.A P. No. 3. FDOT LAP Contract No. 4. Count5. District or Name of Local Agency 6.Prime Contractor's Name _ 7.Com an Name of Confractor Su tier, Rental Com an or A en. L;bmitting this certifi tion 18. FEID No of Co, in Box 7 I kfo nktrk.eLk e_ �. Ire ;A- ;A %A C'. % S- �?Lf SECTION 2: CE -R IFICATION STATEMENTS —) CERTIFICATION OF CERTIFICATION OF NONSEGREGATED FACILITIES NON DISCRIMINATION As a federally assisted construction contractor, I As a 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;recruitment or recruitment advertising; layoff or restrooms and washrooms, restaurants and termination rates of pay and other forms of fountains, recreation or entertainment area, compensation; and selection for training, including transportation, and housing facilities provided for apprenticeship, pre apprenticeship, and/or on-the-job employees which are segregated by explicit training. directives or are in fact segregated on the basis of 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 FHWA-1273. Compliance with Title VI of the Civil Rights Act and the provisions of the American Disabilities Act of 1990 are incor orated in this certification. 9. Name first/last of corporate Official signing Certification 10. Job Title of person named in Box 9 It o L 1 -��Lk -e vAJ 11. Signature of SgArify 12. Date of Signature �cjiall 00490-1