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Exhibit G Assurances & Certifications Selected providers will be required to sign and submit "acmal" assurances and certificates as required by the City of Santa Ana and the Workforce Investment Board on all contracts. I recognize that I must give assurances for each item below. IfI cannot, this proposal will be automatically rejected. Please initial each box. ~ ~ ~ ~ ~ I am authorized by my Board of Directors, Trustees, other legally qualified officer, or as the owner of this agency or business to submit this proposal. We are not currently on any Federal, State of California, or local Debarment list. We will provide records to show that we are fiscally solvent, if needed. We have, or will have, all of the fiscal control and accounting procedures needed to ensure that "VIA funds will be used as required by law and contract. We have additional funding sources and will not be dependent on WIA funds alone. ~ meet the applicable Federal, State, and local compliance requirements. These include, but are not limited to: ~Records accurately reflect actual performance. ~Maintain record confidentiality, as required. ~Reporting financial, participant, and performance data, as required. ~Comply with State and Federal fiscal and program activity audits. ~Complying with Federal and State non-discrimination provisions. ~Meeting requirements of Section 504 of the Rehabilitation Act of 1973. ~Meeting requirements of the American's with Disabilities Act of 1990. (submit completed survey) ~Meeting all applicable labor law, including Child Labor Law standards. ~Agree to provide a drug free workplace. ~Agree to insure the City of Santa Ana through General Liability Insurance and Automobile Liability ~ Coverage in the amount of$I,OOO,OOO.OO policy. ~Agree to provide all participants with Grievance Procedures. ~Agree to insure proposer's employees through Workers Compensation Insurance (including part-time employees) We will not: ~Place a youth in a position that will displace a current employee. ~Use WIA money to assist, promote, or deter union organizing. [2JUse funds to employ or train of persons in sectarian activities. ~Use funds for youth in the construction, operation, or maintenance of any part of a facility to be used for sectarian instruction or religious worship. ~Use WIA funds for activities that would interfere with or replace regular academic requirements for eligible youth who are not dropouts. ~Use WIA funds to carry out programs funded under the School-to-Work Opportunities Act of 1994 unless the program(s) are only for youth eligible to participate under WIA. J hereby assure that all of the above are true. , I " '_L J.,",: L?;,.J/cC ., ('J' , i Program Director 7/25/2005 ., i \"r~j) !.-.((,tJ:::.~ Name Title Date