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r Applicant Assurances U .S . Department of Housing OMB Approval No . 2501 -0017 and Certifications and Urban Development (expires 01 /31 /2008) Instructions for the HUD-424-B Assurances and Certifications As part of your application for HUD funding , you , as the official authorized to sign on behalf of your organization or as an Individual must provide the following assurances and certifications . By submitting this form , you are stating that to the best of your knowledge and belief, all assertions are true and correct. As the duly authorized representative of the applicant, I certify that the 5 . Will comply with the acquisition and relocation app a t [Insert b low the Name a d title of the Authorized Representative , requirements of the Uniform Relocation Assistance na a of O gan" I�rrand e d of signature) : and Real Property Acquisition Policies Act of 1970 , Name . J ` Title : CHAIR as amended (42 U .S . C . 4601 ) and implementing Or COUNTY COMMISSION Date : 05/19/ZOOS . regulations at 49 CFR Part 24 and 24 CFR 420 1 . Has the legal authority to apply for Federal assistance, has the Subpart A. institutional, managerial and financial capability (including funds to pay 6 . Will comply with the environmental the non-Federal share of program costs) to plan , manage and complete requirements of the National Environmental the program as described in the application and the governing body Policy Act (42 U .S .C .4321 et seq . ) and related has duly authorized the submission of the application , including these Federal authorities prior to the commitment or assurances and certifications , and authorized me as the official expenditure of funds for property acquisition and representative of the applicant to act in connection with the application physical development activities subject to and to provide any additional information as may be required . implementing regulations at 24 CFR parts 50 or 58 . 2. Will administer the grant in compliance with Title VI of the Civil Rights 7. That no Federal appropriated funds have been Act of 1964 (42 U .S .C . 2000 (d )) and implementing regulations (24 CFR paid , or will be paid , by or on behalf of the applicant, Part 1 ), which provide that no person in the United States shall , on the to any person for influencing or attempting to grounds of race , color or national origin, be excluded from participation influence an officer or employee of any agency, a in , be denied the benefits of, or otherwise be subjected to discrimination Member of Congress, and officer or employee of under any program or activity that receives Federal financial assistance Congress, or an employee of a Member of Congress, OR if the applicant is a Federally recognized Indian tribe or its tribally in connection with the awarding of this Federal grant designated housing entity, is subject to the Indian Civil Rights Act or its extension , renewal , amendment or modification . (25 U .S . C . 1301 -1303). if funds other than Federal appropriated funds have 3 . Will administer the grant in compliance with Section 504 of the or will be paid for influencing or attempting to Rehabilitation Act of 1973 (29 U .S . C . 794) , as amended , and implement- influence the persons listed above , I shall complete ing regulations at 24 CFR Part 8 , and the Age Discrimination Act of 1975 and submit Standard Form-LLL, Disclosure Forth to (42 U .S . C . 6101 -07 ), as amended , and implementing regulations at 24 Report Lobbying . I certify that I shall require all sub CFR Part 146 which together provide that no person in the United States awards at all tiers ( including sub-grants and contracts ) shall , on the grounds of disability or age, be excluded from participation to similarly certify and disclose accordingly . in , be denied the benefits of, or otherwise be subjected to discrimination Federally recognized Indian Tribes and tribally under any program or activity that receives Federal financial assistance ; designated housing entities (TDHEs) established by except if the grant program authorizes or limits participation to designat- Federally-recognized Indian tribes as a result of the ed populations , then the applicant will comply with the nondiscrimination exercise of the tribe's sovereign power are excluded requirements within the designated population . from coverage by the Byrd Amendment, but State- r . Will comply with the Fair Housing Act (42 U .S .C . 3601 -19 ), as recognized Indian tribes and TDHEs established amended , and the implementing regulations at 24 CFR Part 100 , which under State law are not excluded from the statute's prohibit discrimination in housing on the basis of race , color, religion, coverage . sex , disability, familial status , or national origin ; except an applicant These certifications and assurances are material which is an Indian tribe or its instrumentality which is excluded by representations of the fact upon which HUD can rely statute from coverage does not make this certification ; and further when awarding a grant. If it is later determined that, except If the grant program authorizes or limits participation I the applicant, knowingly made an erroneous to designated populations, then the applicant will comply with the certification or assurance, I may be subject to nondiscrimination requirements within the designated population . criminal prosecution. HUD may also terminate the grant and take other available remedies. form HUD-424-B (0212004)