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Part IV qtj <br />DEPARTMEP T O AW N STr' SCI ;N <br />D VISI N OI' oTAI'F P' N -11N, :.t)rtphenr.OiAlhr l niitrdllvo . <br />BUREAU OF CRIMINAL JJSTlr... PLANNING1Ext _ <br />r• <br />•,'� AND ASSISTANCE equalrtutEmpiuymant Opportunity Certification" t <br />SUBGRANT APPLICATION <br />SUPT RSED_E S: F. UoCtive onto Approved HY: L. Kenneth troland, Jr, Sceretao, <br />Section N/A Poeo N/A ApProvel Deu: Pprll, 1974 <br />1 <br />I <br />Please indicate by a check mark (4 which of tho following applies To your implementing agency: <br />A. This agency has 50 or more employees and has received or applied for total LEAA funds in <br />excess cf $25,000. <br />8. This agency employs fewer than 50 peoplo. <br />X C. This agency has received or applied for less than $25,000 from LEAH. <br />X D. This state agency has formulated an Affirmative Action Plan, pursuant to LEAA Guidelines. <br />E. This agency is an educational institution. <br />_ F. This agency is a hospital or medical facility. <br />G. This agency is a non-profit organization. <br />Signed <br />I <br />If Item A is the only item checked, please fill out the certification form below. <br />Y <br />This agency employs 50 or more employees and has received or applied to the Bureau of Criminal justice <br />Planning and Assistance in Tallahasce, Florida, for total funds in excess of $25,000. <br />1, , certify that the has iormui- <br />Person Filing the Application Criminal Justice Agenry <br />aced an Equa! Employment Opportunity Program in accordance with 23 C.F.R., 42.301, et, seq„ Subpart <br />E, and'that it is on file in the Office of <br />;Name) (Title) <br />(Address) , <br />for review or audit by officials of tiro cognizant State Planning Agency or the Law Enforcement Assistance <br />Administration, as required by relevant laws and regulations. <br />Signed <br />s <br />• Sac Instruction Manual, Section IV, Page 1, for instructions on completing this tone. <br />.. Y t <br />