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ATTACHMENT III <br />INDIAN RIVER COUNTY HEALTH DEPARTMENT <br />CIVIL RIGHTS CERTIFICATE <br />The applicant provides this assurance in consideration of and for the purpose of obtaining federal grants, loans, <br />contracts (except contracts of insurance or guaranty), property, discounts, or other federal financial assistance to <br />programs or activities receiving or benefiting from federal financial assistance The provider agrees to complete <br />the Civil Rights Compliance Questionnaire, DH Forms 946 A and B (or the subsequent replacement if adopted <br />during the contract period), if so requested by the department. <br />The applicant assures that it will comply with. <br />1 Title VI of the Civil Rights Act of 1964, as amended, 42 U S C., 2000 Et seq , which prohibits <br />discrimination on the basis of race, color or national origin in programs and activities receiving or <br />benefiting from federal financial assistance <br />2 Section 504 of the Rehabilitation Act of 1973, as amended, 29 U S C 794, which prohibits discrimination <br />on the basis of handicap in programs and activities receiving or benefiting from federal financial <br />assistance. <br />3. Title IX of the Education Amendments of 1972, as amended, 20 U S.C. 1681 et seq , which prohibits <br />discrimination on the basis of sex in education programs and activities receiving or benefiting from <br />federal financial assistance <br />4 The Age Discrimination Act of 1975, as amended, 42 U S C 6101 et seq., which prohibits discrimination <br />on the basis of age in programs or activities receiving or benefiting from federal financial assistance <br />5 The Omnibus Budget Reconciliation Act of 1981, P L 97-35, which prohibits discrimination on the basis <br />of sex and religion in programs and activities receiving or benefiting from federal financial assistance <br />6 All regulations, guidelines and standards lawfully adopted under the above statutes The applicant agrees <br />that compliance with this assurance constitutes a condition of continued receipt of or benefit from federal <br />financial assistance, and that it is binding upon the applicant, its successors, transferees, and assignees <br />for the period during which such assistance is provided The applicant further assures that all contracts, <br />subcontractors, subgrantees or others with whom it arranges to provide services or benefits to <br />participants or employees in connection with any of its programs and activities are not discriminating <br />against those participants or employees in violation of the above statutes, regulations, guidelines, and <br />standards In the event of failure to comply, the applicant understands that the grantor may, at its <br />discretion, seek a court order requiring compliance with the terms of this assurance or seek other <br />appropriate judicial or administrative relief, to include assistance being terminated and further assistance <br />being denied <br />