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EXHIBIT D <br /> ADA Form <br /> The undersigned CONT RACTOR swears that the information herein contained is true and correct <br /> and that none of the information supplied was for the purpose of defrauding the County <br /> The CONTRACTOR shall not discriminate against any employee or applicant for employment <br /> because of physical or mental handicap in regard to any position for which the employee or <br /> applicant for employment is qualified The CONTRACTOR agrees to comply with the rules, <br /> regulations and relevant orders issued pursuant to the Americans with Disabilities Act (ADA). <br /> USC s 12,101 et seq It is understood that in no event shall the County be held liable for the <br /> actions or omissions of the CONTRACTOR or any other party or partes to the Contract for failure <br /> to comply with the ADA. The CONTRACTOR agrees to hold harmless and indemnify the County, <br /> its agents, officers or employees from any and all claims, demands, debts, liabilities or causes of <br /> action of every kind or character, whether in law or equity, resulting from the CONTRACTOR's <br /> acts or omissions in connection with the ADA. <br /> CONTRACTOR: I i ,�r <br /> Signature- <br /> Printed <br /> ignature Printed Name- it l �_ J i <br /> Title- <br /> Date- <br /> Affix <br /> itle'Date'Affix Corporate Seal <br /> STATE OF Florida i <br /> COUNT)' OF Pasco <br /> The foregoina instrument was acknowledged before me this <br /> day of 20 by /L!.>hlci .%/ l/�.� of <br /> ;6-1 firm.,_ �i J firm. on behalf 66f the firm He/She is <br /> personally known _J0 —rtte or has produced <br /> � -enti+cation:—`-" r <br /> Print Name 1�ili.�c.r 1= %c.- <br /> VELVET D.BURRS `' <br /> '- MYCAMMISSIaY�FF9QSt75 Notary Public In and for the County and <br /> "YD1RES:September 12,2019 State Aforementioned <br /> Wary Pubk Unduwrtem <br /> r My commission expires. <br /> i <br /> ;-3 <br />