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Van Fleet Water Production Facility Improvements BVP 13-196 <br /> EXHIBIT 4 <br /> EQUAL EMPLOYMENT OPPORTUNITY <br /> Polk County is an Equal Opportunity/Affirmative Action Employer. <br /> Pursuant to Executive Order 11246 as amended, you are advised that under the provisions of government contracting, <br /> contractors and subcontractors are obliged to take affirmative action to provide equal employment opportunity without regard <br /> to race,creed,color, national origin,age or sex. <br /> We are committed to equal opportunity employment effort and expect firms that do business with the County to have a <br /> vigorous affirmative action program. <br /> CERTIFICATION BY PROPOSED PRIME OR SUBCONTRACTOR <br /> REGARDING EQUAL EMPLOYMENT OPPORTUNITY <br /> This certification is authorized pursuant to Executive Order 11246, Part 11, Section 203(b), (30 F.R. 12319-15). Any <br /> Contractor or prospective contractor, or any of the proposed subcontractors, shall state as an initial part of the BVP or <br /> negotiations of the Contract whether it has participated in any previous Contract or subcontract to the equal opportunity <br /> clause;and, if so, whether it has filed all compliance reports due under applicable instructions. <br /> Where the certification indicated that the prime or subcontractor has not filed a compliance report due under applicable <br /> instruction,such Contractor shall be required to submit a compliance report. <br /> Contractor's Name: <br /> Address: <br /> 1. Contractor has participated in a previous contract or subcontract,subject to the Equal Opportunity Clause: <br /> YES NO <br /> 2. Compliance Reports were required to be filed in connection with such Contract or subcontract: <br /> YES NO <br /> 3. Contractor has filed all compliance reports due under applicable instructions: <br /> YES NO <br /> 4. If answer to Item 3 is No,please explain in detail on reverse side of this certification. <br /> 42 <br /> 162 <br />