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Affidavit - Exis'ting,Participant Under penalty of perjury, the undersigned officials certify that they have read and understand their obligations under the Equitable Sharing Agreement and that the information submitted in conjunction with this Document is an accurate accounting of funds received and spent by the Agency under the Justice and/or Treasury Guides during the reporting period and that the recipient Agency is in compliance with the National Code of Professional Conduct for Asset Forfeiture. The undersigned certify that the recipient Agency is in compliance with the nondiscrimination requirements of the following laws and their Department of Justice implementing regulations: Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000d et seq.), Title IX of the Education Amendments of 1972 (20 U.S.C. § 1681 et seq.), Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. § 794), and the Age Discrimination Act of 1975 (42 U.S.C. § 6101 et seq.), which prohibit discrimination on the basis.of race, color, national origin, disability, or age in any federally assisted program or activity, or on the basis of sex in any federally assisted education program or activity. The Agency agrees that it will comply with all federal statutes and regulations permitting federal investigators access to records and any other sources of information as may be necessary to determine compliance with civil rights and other applicable statutes and regulations. During the past fiscal year: (1) has any court or administrative agency issued any finding, judgment, or determination that the Agency discriminated against any person or group in violation of any of the federal civil rights statutes listed above; or (2) has the Agency entered into any settlement agreement with respect to any complaint filed with a court or administrative agency alleging that the Agency discriminated against any person or group in violation of any of the federal civil rights statutes listed above? O Yes O No If you answered yes to the above question, complete Table I Name: Deryl Loar Title: Sheriff Date: E-mail: dloar@ircsheriff.org Subscribe to Equitable Sharing Wire: The Equitable Sharing Wire is an electronic newsletter that gives you important, substantive, information regarding Equitable Sharing policies, practices, and procedures. Final Instructions: Step 1: Click to save for your records Step 2: Click to save in XML format GoverninBody Head Signature: Name: Title: County Administrator Date: E-mail: jbaird@ircgov.com krninix@ircsheriff.org kgoodwin@iresheriff.org Step 3: Email the XML file to aca.submit@usdoj.gov Step 4: Scan & email this Affidavit to aca.affidavit@usdoj.gov (Email subject line must include Agency NCIC/ORI Code) FOR AGENCY USE ONLY Entered by Entered on o FY End: 09/30/2015 NCIC: FLO310000 0 I 1111111111111111111111 11111111111111111 Date Printed: November 18, 2015 14:31 Agency: Indian River County Sheriffs Office Phone: 772978-6409 State: FL Preparer: Kathy Minix E-mail: kminix@ircsheriff.org Page 5 of 5 October 2012 Version 2.1 ' 44