Common use of Assurance of Civil Rights Compliance Clause in Contracts

Assurance of Civil Rights Compliance. The State Agency hereby agrees that it will comply with Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.), Title IX of the Education Amendments of 1972 (20 U.S.C. 1681 et seq.), Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), Age Discrimination Act of 1975 (42 U.S.C. Sections 6101-6107); all provisions required by the implementing regulations of the Department of Agriculture; Department of Justice Enforcement Guidelines, and FNS directives and guidelines to the effect that no person shall, on the ground of race, color, national origin, age, sex, or handicap, be excluded from participation in, be denied the benefits of, or otherwise be subjected to discrimination under any program or activity for which the State Agency receives Federal financial assistance from FNS; and hereby gives assurance that it will immediately take measures necessary to effectuate this agreement. By providing this assurance, the State Agency agrees to compile data, maintain records and submit reports as required to permit effective enforcement of the nondiscrimination laws, and to permit Department personnel during normal working hours to review such records, books and accounts as needed to ascertain compliance with the non-discrimination laws. If there are any violations of this assurance, the Department of Agriculture shall have the right to seek judicial enforcement of this assurance. This assurance is given in consideration of and for the purpose of obtaining all Federal financial assistance. grants and loans of Federal funds, reimbursable expenditures, grant or donation of Federal property and interest in property, the detail of Federal personnel, reimbursable expenditures, grant or donation of Federal property and interest in such property or the furnishing of services without consideration or at a nominal consideration, or at a consideration which is reduced for the purpose of assisting the recipient, or in recognition of the public interest to be served by such sale, lease, or furnishing of services to the recipient, or any improvements made with Federal financial assistance extended to the State Agency by the Department of Health. This includes any Federal agreement, arrangement, contract, or other agreement which has as one of its purposes the provision of assistance such as food or cash assistance extended in reliance on the representations and agreements made in this assurance. This assurance is binding on the State Agency, its successors, transferees, and assignees if it receives assistance or retains possession of any assistance from the Department. The person or persons whose signatures appear below are authorized to sign this assurance on the behalf of the State Agency. USDA Nondiscrimination Statement In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA. Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or WIC local agency) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (000) 000-0000. Additionally, program information may be made available in languages other than English. To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: xxxx://xxx.xxxx.xxxx.xxx/complaint_filing_cust.html, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (000) 000-0000. Submit your completed form or letter to USDA by:

Assurance of Civil Rights Compliance. The State Agency hereby agrees that it will comply with Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.), Title IX of the Education Amendments of 1972 (20 U.S.C. 1681 et seq.), Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), Age Discrimination Act of 1975 (42 U.S.C. Sections 6101-6107); all 610 et seq.);all provisions required by the implementing regulations of the Department of Agriculture; Department of Justice Enforcement Guidelines, and FNS directives and guidelines to the effect that no person shall, on the ground of race, color, national origin, age, sex, or handicap, be excluded from participation in, be denied the benefits of, or otherwise be subjected to discrimination under any program or activity for which the State Agency receives Federal financial assistance from FNS; and hereby gives assurance that it will immediately take measures necessary to effectuate this agreement. By providing this assurance, the State Agency agrees to compile data, maintain records and submit reports as required to permit effective enforcement of the nondiscrimination laws, and to permit Department personnel during normal working hours to review such records, books and accounts as needed to ascertain compliance with the non-discrimination non¬-discrimination laws. If there are any violations of this assurance, the Department of Agriculture shall have the right to seek judicial enforcement of this assurance. This assurance is given in consideration of and for the purpose of obtaining any and all Federal financial assistance. grants and loans of Federal funds, reimbursable expenditures, grant or donation of Federal property and interest in property, property the detail of Federal personnel, reimbursable expenditures, grant or donation of Federal property and interest in such property or the furnishing of services without consideration or at a nominal consideration, or at a consideration which is reduced for the purpose of assisting the recipient, or in recognition of the public interest to be served by such sale, lease, or furnishing of services to the recipient, or any improvements made with Federal financial assistance extended to the State Agency by the Department of HealthDepartment. This includes any Federal agreement, arrangement, contract, or other agreement contract which has as one of its purposes the provision of assistance such as food or food, cash assistance extended in reliance on the representations and agreements made in this assurance. This assurance is binding on the State Agency, its successors, transferees, and assignees if as long as it receives assistance or retains possession of any assistance from the Department. The person or persons whose signatures appear below are authorized to sign this assurance on the behalf of the State Agency. USDA Nondiscrimination Statement In accordance with Federal civil rights law Acknowledgement Section Part I. This Agreement is pursuant to 42 U.S.C. Section 1786 and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA7 CFR Part 246. Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or WIC local agency) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (000) 000-0000. Additionally, program information may be made available in languages other than English. To file As a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: xxxx://xxx.xxxx.xxxx.xxx/complaint_filing_cust.html, and at any USDA office, or write a letter addressed retailer I acknowledge my responsibility to USDA and provide in the letter communicate to all of the information requested individual stores covered by this Agreement the provisions and performance requirements outlined in this Agreement. The authorized agent signature below represents the formlegal authority to obligate the retailer. Furthermore, my signature represents that I have read, understand and agree to all provisions outlined in this Agreement. If the authorized agent has any questions about the requirements stated in this Agreement seek legal counsel before signing this Agreement. Store/Corporate Account Trade Name Authorized Agent Name (legibly print) Authorized Agent’s Mailing Address Authorized Agent’s Signature City State Zip Contact Person Name (legibly print) ( ) ( ) Contact Person’s Daytime Telephone Number Cell phone or Emergency Contact Number ( ) Federal Employer Tax I.D. Number Facsimile Number Date Submitted: Contact Person’s Email Address: Part II. – To request Be Completed by the Applicant/Retailer Store Name: Store's County/City: WIC ID No. (If applicable): SNAP No.: Check here if a copy listing of additional retail store locations is attached to this Agreement To Be Completed by State agency Part III. This Retailer Agreement will expire or by September 30, 2020. The undersigned has authority to sign this Agreement on behalf of the complaint form, call (000) 000-0000State agency. Submit your completed form Signature of Division Director or letter to USDA by:Vendor Compliance Manager

Assurance of Civil Rights Compliance. The State Agency hereby agrees that it will comply with Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.), Title IX of the Education Amendments of 1972 (20 U.S.C. 1681 et seq.), Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), Age Discrimination Act of 1975 (42 U.S.C. Sections 6101-6107610 et seq.); all provisions required by the implementing regulations of the Department of Agriculture; Department of Justice Enforcement Guidelines, ; and FNS directives and guidelines to the effect that that, no person shall, on the ground of race, color, national origin, age, sex, or handicap, be excluded from participation in, be denied the benefits of, or otherwise be subjected to discrimination under any program or activity for which the State Agency receives Federal financial assistance from FNS; and hereby gives give assurance that it will immediately take measures necessary to effectuate this agreement. By providing this assurance, the State Agency agrees to compile data, maintain main- tain records and submit reports as required required, to permit effective enforcement en- forcement of the nondiscrimination laws, laws and to permit Department personnel during normal working hours to review such records, books and accounts as needed to ascertain compliance with the non-non- discrimination laws. If there are any violations of this assurance, the Department of Agriculture shall have the right to seek judicial enforcement enforce- ment of this assurance. This assurance is given in consideration consider- ation of and for the purpose of obtaining any and all Federal financial assistance. , grants and loans of Federal funds, reimbursable expenditures, grant or donation of Federal property and interest in property, the detail of Federal personnel, reimbursable expenditures, grant or donation of Federal property and interest in such property or the furnishing of services without consideration or at a nominal consideration, or at a consideration which is reduced for the purpose of assisting the recipient, or in recognition of the public interest to be served by such sale, lease, or furnishing of services to the recipient, or any improvements made with Federal financial assistance extended to the State Agency by the Department of HealthDepartment. This includes any Federal agreement, arrangement, contract, or other agreement contract which has as one of its purposes the provision of assistance such as food or food, cash assistance extended in reliance on the representations repre- sentations and agreements made in this assurance. This assurance is binding on the State Agency, its successors, transferees, and assignees if as long as it receives assistance or retains possession of any assistance from the Department. The person or persons whose signatures appear below are authorized to sign this assurance on the behalf of the State Agency. USDA Nondiscrimination Statement In accordance with Federal civil rights law and U.S. Department Equal Employment Opportunity Clause During the performance of Agriculture (USDA) civil rights regulations and policiesthis Agreement insofar as it relates to State administrative expenses, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA. Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.), should contact the State Agency (State or WIC local agency) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (000) 000-0000. Additionally, program information may be made available in languages other than English. To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: xxxx://xxx.xxxx.xxxx.xxx/complaint_filing_cust.html, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (000) 000-0000. Submit your completed form or letter to USDA byagrees that:

Assurance of Civil Rights Compliance. The State Agency hereby agrees that it will comply with Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.), Title IX of the Education Amendments of 1972 (20 U.S.C. 1681 et seq.), Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), Age Discrimination Act of 1975 (42 U.S.C. Sections 6101-6107); all provisions required by the implementing regulations of the Department of Agriculture; Department of Justice Enforcement Guidelines, and FNS directives and guidelines to the effect that no person shall, on the ground of race, color, national origin, age, sexsex (including gender identity and sexual orientation), or handicap, be excluded from participation in, be denied the benefits of, or otherwise be subjected to discrimination under any program or activity for which the State Agency receives Federal financial assistance from FNS; and hereby gives assurance that it will immediately take measures necessary to effectuate this agreement. By providing this assurance, the State Agency agrees to compile data, maintain records and submit reports as required to permit effective enforcement of the nondiscrimination laws, and to permit Department personnel during normal working hours to review such records, books and accounts as needed to ascertain compliance with the non-non- discrimination laws. If there are any violations of this assurance, the Department of Agriculture shall have the right to seek judicial enforcement of this assurance. This assurance is given in consideration of and for the purpose of obtaining all Federal financial assistance. grants and loans of Federal funds, reimbursable expenditures, grant or donation of Federal property and interest in property, the detail of Federal personnel, reimbursable expenditures, grant or donation of Federal property and interest in such property or the furnishing of services without consideration or at a nominal consideration, or at a consideration which is reduced for the purpose of assisting the recipient, or in recognition of the public interest to be served by such sale, lease, or furnishing of services to the recipient, or any improvements made with Federal financial assistance extended to the State Agency by the Department of Health. This includes any Federal agreement, arrangement, contract, or other agreement which has as one of its purposes the provision of assistance such as food or cash assistance extended in reliance on the representations and agreements made in this assurance. This assurance is binding on the State Agency, its successors, transferees, and assignees if it receives assistance or retains possession of any assistance from the Department. The person or persons whose signatures appear below are authorized to sign this assurance on the behalf of the State Agency. USDA Nondiscrimination Statement In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA. Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or WIC local agency) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (000) 000-0000. Additionally, program information may be made available in languages other than English. To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: xxxx://xxx.xxxx.xxxx.xxx/complaint_filing_cust.html, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (000) 000-0000. Submit your completed form or letter to USDA by:

Assurance of Civil Rights Compliance. The State Agency Applicant hereby agrees that it will comply with Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.), Title IX of the Education Amendments of 1972 (20 U.S.C. 1681 et seq.), Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), Age Discrimination Act of 1975 (42 U.S.C. Sections 6101-6107610 et seq.); all provisions required by the implementing regulations of the U.S. Department of Agriculture; Department of Justice Enforcement Guidelines, ; and FNS PDA directives and guidelines to the effect that no person shall, on the ground of race, color, national origin, age, sex, or handicap, be excluded from participation in, be denied the benefits of, or otherwise be subjected to discrimination under any program or activity for which the State Agency Applicant receives Federal financial assistance from FNSthe U.S. Department of Agriculture through this agreement; and hereby gives assurance that it will immediately take measures necessary to effectuate this agreement. By providing this assurance, the State Agency Applicant agrees to compile data, maintain records and submit reports as required to permit effective enforcement of the nondiscrimination laws, and to permit Department PDA personnel during normal working hours to review such records, books and accounts as needed to ascertain compliance with the non-discrimination non­discrimination laws. If there are any violations of this assurance, the U.S. Department of Agriculture shall have the right to seek judicial enforcement of this assurance. This assurance is given in consideration of and for the purpose of obtaining any and all Federal financial assistance. , grants and loans of Federal funds, reimbursable expenditures, grant or donation of Federal property and interest in property, the detail of Federal personnel, reimbursable expenditures, grant or donation of Federal property and interest in such property or the furnishing of services without consideration or at a nominal consideration, or at a consideration which is reduced for the purpose of assisting the recipientrecipients, or in recognition of the public interest to be served by such sale, lease, or furnishing of services to the recipient, or any improvements made with Federal financial assistance extended to the State Agency Applicant by the Department of HealthPDA. This includes any Federal agreement, arrangement, contract, or other agreement contract which has as one of its purposes the provision of assistance such as food or food, o r cash assistance extended in reliance on the representations and agreements made in this assurance. This assurance is binding on the State AgencyApplicant, its successors, transferees, and assignees if as long as it receives assistance or retains possession of any assistance from the DepartmentPDA. The person or persons whose signatures appear below are authorized to sign this assurance on the behalf of the State Agency. USDA Nondiscrimination Statement In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA. Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etcApplicant.), should contact the Agency (State or WIC local agency) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (000) 000-0000. Additionally, program information may be made available in languages other than English. To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: xxxx://xxx.xxxx.xxxx.xxx/complaint_filing_cust.html, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (000) 000-0000. Submit your completed form or letter to USDA by:

Assurance of Civil Rights Compliance. The State Agency hereby agrees that it will comply with Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.), Title IX of the Education Amendments of 1972 (20 U.S.C. 1681 et seq.), Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), Age Discrimination Act of 1975 (42 U.S.C. Sections 6101-6107); all 610 et seq.);all provisions required by the implementing regulations of the Department of Agriculture; Department of Justice Enforcement Guidelines, and FNS directives and guidelines to the effect that no person shall, on the ground of race, color, national origin, age, sex, or handicap, be excluded from participation in, be denied the benefits of, or otherwise be subjected to discrimination under any program or activity for which the State Agency receives Federal financial assistance from FNS; and hereby gives assurance that it will immediately take measures necessary to effectuate this agreement. By providing this assurance, the State Agency agrees to compile data, maintain records and submit reports as required to permit effective enforcement of the nondiscrimination laws, and to permit Department personnel during normal working hours to review such records, books and accounts as needed to ascertain compliance with the non-non- discrimination laws. If there are any violations of this assurance, the Department of Agriculture shall have the right to seek judicial enforcement of this assurance. This assurance is given in consideration of and for the purpose of obtaining any and all Federal financial assistance. grants and loans of Federal funds, reimbursable expenditures, grant or donation of Federal property and interest in property, property the detail of Federal personnel, reimbursable expenditures, grant or donation of Federal property and interest in such property or the furnishing of services without consideration or at a nominal consideration, or at a consideration which is reduced for the purpose of assisting the recipient, or in recognition of the public interest to be served by such sale, lease, or furnishing of services to the recipient, or any improvements made with Federal financial assistance extended to the State Agency by the Department of HealthDepartment. This includes any Federal agreement, arrangement, contract, or other agreement contract which has as one of its purposes the provision of assistance such as food or food, cash assistance extended in reliance on the representations and agreements made in this assurance. This assurance is binding on the State Agency, its successors, transferees, and assignees if as long as it receives assistance or retains possession of any assistance from the Department. The person or persons whose signatures appear below are authorized to sign this assurance on the behalf of the State Agency. USDA Nondiscrimination Statement In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA. Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or WIC local agency) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (000) 000-0000. Additionally, program information may be made available in languages other than English. To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: xxxx://xxx.xxxx.xxxx.xxx/complaint_filing_cust.html, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (000) 000-0000. Submit your completed form or letter to USDA by:

Assurance of Civil Rights Compliance. The State Agency Contractor hereby agrees that it will comply with Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.), Title IX of the Education Amendments of 1972 (20 U.S.C. 1681 et seq.), Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), Age Discrimination Act of 1975 (42 U.S.C. Sections 6101-6107610 et seq.); all provisions required by the implementing regulations of the Department of Agriculture; Department of Justice Enforcement Guidelines, ; and FNS directives and guidelines to the effect that no person shall, on the ground of race, color, national origin, age, sex, or handicap, be excluded from participation in, be denied the benefits of, or otherwise be subjected to discrimination under any program or activity for which the State Agency receives Federal financial assistance from FNS; and hereby gives assurance that it will immediately take measures necessary to effectuate this agreement. By providing this assurance, the State Agency Contractor agrees to compile data, maintain records and submit reports as required to permit effective enforcement of the nondiscrimination laws, and to permit Department NYSDOH and USDA personnel during normal working hours to review such records, books and accounts as needed to ascertain compliance with the non-non- discrimination laws. If there are any violations of this assurance, the NYSDOH and US Department of Agriculture shall have the right to seek judicial enforcement of this assurance. This assurance is given in consideration of and for the purpose of obtaining any and all Federal financial assistance. , grants and loans of Federal funds, reimbursable expenditures, grant or donation of Federal property and interest in such property, the detail of Federal personnel, reimbursable expenditures, grant or donation of Federal property and interest in such property or the furnishing of services without consideration or at a nominal consideration, or at a consideration which is reduced for the purpose of assisting the recipient, or in recognition of the public interest to be served by such sale, lease, or furnishing of services to the recipient, or any improvements made with Federal financial assistance extended to the State Agency Contractor by the Department of HealthDepartment. This includes any Federal agreement, arrangement, contract, or other agreement contract which has as one of its purposes the provision of assistance such as food or food, cash assistance extended in reliance on the representations and agreements made in this assurance. This assurance is binding on the State AgencyContractor, its successors, transferees, and assignees if as long as it receives assistance or retains possession of any assistance from the Department. The person or persons whose signatures appear below are authorized to sign this assurance on the behalf of the State Agency. USDA Nondiscrimination Statement In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA. Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etcContractor.), should contact the Agency (State or WIC local agency) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (000) 000-0000. Additionally, program information may be made available in languages other than English. To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: xxxx://xxx.xxxx.xxxx.xxx/complaint_filing_cust.html, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (000) 000-0000. Submit your completed form or letter to USDA by:

Assurance of Civil Rights Compliance. The State Agency hereby agrees that it will comply with Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.), Title IX of the Education Amendments of 1972 (20 U.S.C. 1681 et seq.), Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), Age Discrimination Act of 1975 (42 U.S.C. Sections 6101-6107); all 610 et seq.);all provisions required by the implementing regulations of the Department of Agriculture; Department of Justice Enforcement Guidelines, and FNS directives and guidelines to the effect that no person shall, on the ground of race, color, national origin, age, sex, or handicap, be excluded from participation in, be denied the benefits of, or otherwise be subjected to discrimination under any program or activity for which the State Agency receives Federal financial assistance from FNS; and hereby gives assurance that it will immediately take measures necessary to effectuate this agreement. By providing this assurance, the State Agency agrees to compile data, maintain records and submit reports as required to permit effective enforcement of the nondiscrimination laws, and to permit Department personnel during normal working hours to review such records, books and accounts as needed to ascertain compliance with the non-discrimination non¬-discrimination laws. If there are any violations of this assurance, the Department of Agriculture shall have the right to seek judicial enforcement of this assurance. This assurance is given in consideration of and for the purpose of obtaining any and all Federal financial assistance. grants and loans of Federal funds, reimbursable expenditures, grant or donation of Federal property and interest in property, property the detail of Federal personnel, reimbursable expenditures, grant or donation of Federal property and interest in such property or the furnishing of services without consideration or at a nominal consideration, or at a consideration which is reduced for the purpose of assisting the recipient, or in recognition of the public interest to be served by such sale, lease, or furnishing of services to the recipient, or any improvements made with Federal financial assistance extended to the State Agency by the Department of HealthDepartment. This includes any Federal agreement, arrangement, contract, or other agreement contract which has as one of its purposes the provision of assistance such as food or food, cash assistance extended in reliance on the representations and agreements made in this assurance. This assurance is binding on the State Agency, its successors, transferees, and assignees if as long as it receives assistance or retains possession of any assistance from the Department. The person or persons whose signatures appear below are authorized to sign this assurance on the behalf of the State Agency. USDA Nondiscrimination Statement In accordance with Federal civil rights law Acknowledgement Section Part I. This Agreement is pursuant to 42 U.S.C. Section 1786 and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA7 CFR Part 246. Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or WIC local agency) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (000) 000-0000. Additionally, program information may be made available in languages other than English. To file As a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: xxxx://xxx.xxxx.xxxx.xxx/complaint_filing_cust.html, and at any USDA office, or write a letter addressed retailer I acknowledge my responsibility to USDA and provide in the letter communicate to all of the information requested individual stores covered by this Agreement the provisions and performance requirements outlined in this Agreement. The authorized agent signature below represents the formlegal authority to obligate the retailer. To request Furthermore, my signature represents that I have read, understand and agree to all provisions outlined in this Agreement. If the authorized agent has any questions about the requirements stated in this Agreement seek legal counsel before signing this Agreement. Store/Corporate Legal Name Authorized Agent Name (legibly print) Authorized Agent’s Mailing Address Authorized Agent’s Signature City State Zip Contact Person Name (legibly print) ( ) Contact Person’s Daytime Telephone Number Contact Person’s Email Address Federal Employer Tax I.D. Number Date Signed Check here if a copy listing of the complaint form, call (000) 000-0000. Submit your completed form or letter additional retail store locations is attached to USDA by:this Agreement