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CERTIFICATION FORM
<br />Recipient Name and Address: Indian River County Board of County Commissioners
<br />Grant Title: Indian River County Planning Grant Number: 2009-JAGC-917Award Amount: $3,900
<br />Contact Person Name and Title: Sandra L. Bowden, Chairperson Phone Number: (772) 567-8000 x1447
<br />Federal regulations require recipients of financial assistance from the Office of Justice Programs (OJP), its component agencies, and the
<br />Office of Community Oriented Policing Services (COPS) to prepare, maintain on file, submit to OJP for review, and implement an Equal
<br />Employment Opportunity Plan (EEOP) in accordance with 28 C.F.R §§ 42.301-.308. The regulations exempt some recipients from all of
<br />the EEOP requirements. Other recipients, according to the regulations, must prepare, maintain on file and implement an EEO P, but they
<br />do not need to submit the EEOP to OJP for review. Recipients that claim a complete exemption from the EEOP requirement must
<br />complete Section A below. Recipients that claim the limited exemption from the submission requirement, must complete Section B
<br />below. A recipient should complete either Section A or Section B, not both. If a recipient receives multiple OJP or COPS grants,
<br />please complete a form for each grant, ensuring that any EEOP recipient certifies as completed and on file (if applicable) has been
<br />prepared within two years of the latest grant. Please send the completed form(s) to the Office for Civil Rights, Office of Justice Programs,
<br />U.S. Department of Justice, 810 Vh Street, N.W., Washington, D.C. 20531. For assistance in completing this form, please call (202)307-
<br />0690 or TTY (202) 307-2027.
<br />Section A- Declaration Claiming Complete Exemption from the EEOP Requirement. Please check all the boxes that
<br />app ly.
<br />❑ Recipient has less than 50 employees, ❑ Recipient is an Indian tribe,
<br />El Recipient is a non-profit organization, ❑ Recipient is an educational institution, or
<br />❑ Recipient is a medical institution, 0 Recipient is receiving an award less than $25,000
<br />1, Sandra L. Bowden [responsible official], certify that
<br />Indian River County Board of County Commissioners [recipient] is not required to
<br />prepare an EEOP for the reason(s) checked above, pursuant to 28 C.F.R §42.302. I further certify that Indian River
<br />Board of County Commissioners [recipient] will comp with applicable Federal civil rights
<br />I aws that prohibit discrimination in employment and in the deliver);. ervice .
<br />Sandra L. Bowden, Chairperson July 15,
<br />Print or type Name and Title
<br />Sil&a7ture Date
<br />Section B- Declaration Claiming Exemption from the EEOP Submission Requirement and Certifying That an
<br />EEOP Is on File for Review.
<br />If a recipient agency has 50 or more employees and is receiving a single award or subaward for $25,000 or more, but less than $500,000,
<br />then the recipient agency does not have to submit an EEOP to OJP for review as long as it certifies the following (42 C.F.R, § 42.305):
<br />19 [responsible official], certify that
<br />the [recipient],which has 50 or more
<br />employees and is receiving a single award or subaward for $25,000 or more, but less than $500,000, has formulated an
<br />EEOP in accordance with 28 CFR §42.301, et seq., subpart E. I further certify that the EEOP has been formulated and
<br />signed into effect within the past two years by the proper authority and that it is available for review. The EEOP is on file in
<br />the office of. [organization],
<br />at [address],for review by the public and
<br />employees or for review or audit by officials of the relevant state planning agency or the Office for Civil Rights, Office of
<br />Justice Programs, U. S. Department of Justice, as required by relevant laws and regulations.
<br />Print or type Name and Title
<br />OMB Approval No. 1121-0140 Expiration Date: 01/31/06
<br />Signature
<br />Date
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