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dD <br />ATTACHMENT III <br />CIVIL RIGHTS CERTIFICATE <br />The applicant provides this assurance in consideration of <br />and for the purpose of obtaining federal grants, loans, <br />contracts (except contracts of insurance or guaranty), <br />property, discounts, or other federal financial assistance <br />to programs or activities receiving or benefiting from <br />federal financial assistance. The provider agrees to <br />complete the Civil Rights Compliance Questionnaire, HRS <br />Forms 946 A and B (or the subsequent replacement if adopted <br />during the contract period), if so requested by the <br />department. <br />The applicant assures that it will comply with: <br />1. Title VI of the Civil Rights Act of 1964, as <br />amended, 42 U.S.C., 2000 Et seq., which prohibits <br />discrimination on the basis of race, color or national <br />origin in programs and activities receiving or <br />benefiting from federal financial assistance. <br />2. Section 504 of the Rehabilitation Act of 1973, as <br />amended, 29 U.S.C. 794, which prohibits discrimination <br />on the basis of handicap in programs and activities <br />receiving or benefiting from federal financial <br />assistance. <br />3. Title iX of the Education Amendments of 1972, as <br />amended, 20 U.S.C. 1681 et seq., which prohibits <br />discrimination on the basis of sex in education <br />programs and activities receiving or benefiting from <br />federal financial assistance. <br />4. The Age Discrimination Act of 1975, as amended, 42 <br />U.S.C. 6101 et seq., which prohibits discrimination on <br />the basis of age in programs or activities receiving or <br />benefiting from federal financial assistance. <br />