424B Form – Fill Out and Use This PDF

1. Has the legal authority to apply for Federal assistance

Act of 1973, as amended (29 U.S.C. §794), which

and the institutional, managerial and financial capability

prohibits discrimination on the basis of handicaps; (d)

(including funds sufficient to pay the non-Federal share

the Age Discrimination Act of 1975, as amended (42

of project cost) to ensure proper planning, management

U.S.C. §§6101-6107), which prohibits discrimination

and completion of the project described in this

on the basis of age; (e) the Drug Abuse Office and

application.

Treatment Act of 1972 (P.L. 92-255), as amended,

relating to nondiscrimination on the basis of drug

2.

Will give the awarding agency, the Comptroller General

abuse; (f) the Comprehensive Alcohol Abuse and

of the United States and, if appropriate, the State,

Alcoholism Prevention, Treatment and Rehabilitation

through any authorized representative, access to and

Act of 1970 (P.L. 91-616), as amended, relating to

the right to examine all records, books, papers, or

nondiscrimination on the basis of alcohol abuse or

documents related to the award; and will establish a

alcoholism; (g) §§523 and 527 of the Public Health

proper accounting system in accordance with generally

Service Act of 1912 (42 U.S.C. §§290 dd-3 and 290 ee-

accepted accounting standards or agency directives.

3), as amended, relating to confidentiality of alcohol

and drug abuse patient records; (h) Title VIII of the

3.

Will establish safeguards to prohibit employees from

Civil Rights Act of 1968 (42 U.S.C. §§3601 et seq.), as

using their positions for a purpose that constitutes or

amended, relating to nondiscrimination in the sale,

presents the appearance of personal or organizational

rental or financing of housing; (i) any other

conflict of interest, or personal gain.

nondiscrimination provisions in the specific statute(s)

under which application for Federal assistance is being

4.

Will initiate and complete the work within the applicable

made; and, (j) the requirements of any other

time frame after receipt of approval of the awarding

nondiscrimination statute(s) which may apply to the

agency.

application.

5.

Will comply with the Intergovernmental Personnel Act of

7.

Will

comply,

or has already complied, with the

1970 (42 U.S.C. §§4728-4763) relating to prescribed

requirements of Titles II and III of the Uniform

standards for merit systems for programs funded under

Relocation Assistance and Real Property Acquisition

one of the 19 statutes or regulations specified in

Policies Act of 1970 (P.L. 91-646) which provide for

Appendix A of OPM's Standards for a Merit System of

fair and equitable treatment of persons displaced or

Personnel Administration (5 C.F.R. 900, Subpart F).

whose property is acquired as a result of Federal or

federally-assisted programs. These requirements apply

6.

Will comply with all Federal statutes relating to

to all interests in real property acquired for project

nondiscrimination. These include but are not limited to:

purposes regardless of Federal participation in

(a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352)

purchases.

which prohibits discrimination on the basis of race, color

or national origin; (b) Title IX of the Education

8.

Will

comply,

as applicable, with provisions of the

Amendments of 1972, as amended (20 U.S.C. §§1681-

Hatch Act (5 U.S.C. §§1501-1508 and 7324-7328)

1683, and 1685-1686), which prohibits discrimination on

which limit the political activities of employees whose

the basis of sex; (c) Section 504 of the Rehabilitation

principal employment activities are funded in whole or

in part with Federal funds.

Previous Edition Usable

Standard Form 424B (Rev. 7-97)

Authorized for Local Reproduction

Prescribed by OMB Circular A-102