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CERTIFICATION FORM
<br />Compliance with the Equal Employment Opportunity Plan (EEOP) Requirements
<br />Please read carefully the Instructions (see below) and then complete Section A or Section B or Section C, not all three. If recipient
<br />completes Section A or C and sub-Qr'ants a sin -ale award over 5500.000. in addition. nleave emmnlete ,4ectinn n
<br />Recipient's Name: Indian River County Sheriff's Office
<br />Address: 4055 41 st Avenue, Vero Beach, FL 32960
<br />Is agency a; ❑ Direct or Ix Sub recipient of OJP, OVW or COPS funding? I Law Enforcement Agency? a Yes ❑ No
<br />DUNS Number: 039894332Vendor Number (onlyif direct recipient)
<br />Name and Title of Contact Person: Annette M. Russell
<br />Telephone Number: 772-978-6214 E -Mail Address: arussell@iresheriff.org
<br />Section',A' ofiecii►"raidoit laimmgC emtbEF P tjnremen.
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<br />{recipier t] snot:r uir t8 pie i_a ati IGEOP fbr•the i+easoiii(s);c ticked move, pursuant to'28*C.F.R 642.302.
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<br />will comply"viii applir6le federal civil:rights lawsthat rohibit'tiiseixiiunakion.ii► eiriployment anti is the delivery_of
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<br />Section B—Declaration Claiming Exemption from the EEOP Submission Requirement and Certifying
<br />That an EEOP Is on File for Review
<br />If a recipient agency has fifty or more employees and is receiving a single award or, subaward, of $25, 000 or more, but less than $500, 000, then
<br />the recipient agency does not have to submit an EEOP to the OCR for review as long as it certifies the following (42 C.F.R. § 42.305)'
<br />I, Deryl Loar, Sheriff of Indian River County [responsible
<br />official], certify that Indian River County Sheriffs Office
<br />[recipient], which has fifty or more employees and is receiving a single award or subaward for $25,000 or more, but less
<br />than $500,000, has formulated an EEOP in accordance with 28 CFR pt. 42, subpt. E. I further certify that within the last
<br />twenty-four months, the proper authority has formulated and signed into effect the EEOP and, as required by applicable
<br />federal law, it is available for review by the public, employees, the appropriate state planning agency, and the Office for
<br />Civil Rights, Office of Justice Programs, U.S. Department of Justice. The EEOP is on file at the following office:
<br />Indian River County Shedfrs Office
<br />[organization],
<br />4055 41 st Avenue, Vero Beach, FL 32960
<br />[address].
<br />De[yl Loar Sheriff of Indian River Counf)L- 02/14/2017
<br />Print or Type Name and Title Signature Date
<br />Sectioe4 �= pe la ation 5#a leig`t a# ` P 196(. V —: ffis eeniSnbm tted fib tl e;O�ee fo"r Citvil
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<br />If a recipfeirt •agentiy has;iore eln{ploji�es'aiid is recxiving a i;ingli aivArc'ar strbuward •af. X5500 000 or,tione, then tfu recipient agency
<br />mw0sen aiiE.OP_.Siin tK,f'o
<br />riiiata.�"OGRfor.rieview. `.h`` ;"
<br />,. = ::: ,.. `•, .-, .. � ; .. [responsible
<br />OCIClCer�tf�,ftll8t-<
<br />{recipierit],twliicri'hasfiiy iii tuore`employees:and is reeeivarig':a si_gle -awaid of $500,000.or more .has t`otmulated an
<br />ESOP. in • iicco di iii a ,w r ,. x. p ;, 6 ,i.-. , .., -, = , ,1
<br />cez�vitti•28�CFR•:p2:�,;42;�subpt.;E;+�and'seiit,it for:rei►iew,*ori . ' ` ,"�.1-' ,•.. '. �'�' '
<br />date 'ta.t}it~ s"
<br />{ ice for.ivtl'2igtts; 0ick'bf Jristice Ptogrtns; U.S. Departfnent of Justice:
<br />i,,;,%`' f.lrecipienlsilrgrcriits°asr»gletrvardoverS50b,011f),"rnvdditio
<br />!t, please.conrplele`Sectiori D
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<br />Print orT lVaine;dAdTtteis -r' ,,. -:R: `r :,...::..Si �: Dime
<br />P193
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