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<br />FE8-1a-2(30.~ 1<:1:0,j L:::"Jf'!;
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<br />FEB-14-2005 09:15
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<br />I Assurances & Certifications
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<br />S.I led providers will be required to sign anu submit "..tlllal" assur-doce. and ccrtifiC$t",.
<br />.quired by the Cit)' or Stinllo AJlu and the Workforce In,,.ument Boara on ll1I ool11Ol'lict&<
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<br />J CllgnUt tj",j I must give as!UraDctJ; fl)r c.ch item below, If 1 ClllllltJl, tWo proposal will
<br />be l1roIDllUCIlll)' J...jected Please initial eacL box.
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<br />] alll 8uthori:z.ed by my 'BObla /)fDirc:c~or.r., Trustet~, otht:~ iegtllly qU3.1ifi<<l (\ffi;er, or a-s th.e OWTJer Dr llm;
<br />IIgt:ncy ~r baslm:s~ tu ~ubmjt [."/1:; plOP:lSaJ
<br />WI:. e.l't nol cl"trrr..l1tl) on wy Federal, Stl:Itc of QJlifomi.ll , Dr IOC1l1 DcblU"lnent list
<br />We will JlTOVldt: recon.i~ to ,how that1lJ!.' are fisr;lllly $olvcm, if11l~oded.
<br />We JIll/t, (.IT wiJl1avt, al) of the fr!J;td cClIltrol and accoUDting prooouurct; n.:edcil 10 ens~e that WlA. funds.
<br />",jI) be IUd as reQ\.!\fed by lzw ~aLllXl~Ct.
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<br />e !iDVnottm<.m&lfu.ntling-nlU~O-wjlLnDl..ht....dl'p.e.l).ci_onl Oll WJ A funds alone.
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<br />will m..,' the applicable Federal, Stat<, and IDcul comvIianc.e requirements. These
<br />",elude, but are not 11lIliled to:
<br />RccCJrd:; 3CCUf,jtcly rld}e;r bCl1.l~l pertonu:mcc.
<br />Mainmm TocorO c:.onfidenhali::y. as required.
<br />Reportmg "fina.llCiOll, pD.rtu~i'Part~, and pe...forntan~ QaDi, a.) Jequirtd,
<br />Campl)' 'WIth State aM. Fe~l fis=1 and prog.ram 8.Cl:iVltY1i.1diu
<br />Cump1yjng with FedC3'aJ Jlnd SUllO ilcm-discrimmation prOV~S}Qm;.
<br />Met:un, ToquireIO~ ofSecuo1J 5V4 oftbe Rt:hu."iiitRtior. Act of 1973,
<br />lvIeetlDg. requlfc.tlll:;lIb of the Ame.rlc&rl's with !nSabiiitie> Act cf 199(;-. (s'Ubmit completed SIU....cy}
<br />Me=Z t\lapplieable IabOI l.w, i.cluQjn~ Chik Wor Lltw .,."donls
<br />Agrt~ W I'TC\lWe ~ QrUi fret 'Norkpl,-oc
<br />Agree 10 illStlt'e ~h~ City of ~w Am through GCIICI-:sl lJabiHt)' Ins\lrjIDct iUld AUUJmobiic 1..l~ility
<br />Coverage ir, tlJ, ...,,,,,, of Sl.OOO.OODUD poUey
<br />All''' to provIlle .11 ~,,"icjpantt with Cir;"....co l'roco<lures
<br />^grcc to in,U1c prClp~"s empkryOC"s thr0\1g.1 Workco Coml'cr.:mLi01l1nl:W:IJlce (inl;ludmg: part-time
<br />cll~ploycgs)
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<br />-,ewillllQl:
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<br />?la:c ~ )'OUUI in Z' positioo :!her will tli~l~c ll.cWTent emplor=.
<br />Use W1A 1'DtlJ1C}'to IUSl.st. promote, or dtHtl' U1lion ot.8J.U1Lt.m~
<br />U~ fulds K: employ \)T mrin Qfpersons m 5ecmnAIllIctj\.jtie~
<br />lhe funds for youth in thl ..;onstructioll, I;;'peratian, or m~intQ1Mcc of~)' pan Ofl flicility to ~ ~Cld fm
<br />~~ian in5-trllCrion or reilg.,ou5 wOl'$hip.
<br />USt WlA tunds 10r l\~tivitic:. that would iml:rfere wirh OJ repl.,oc regul2J ac8l.'ltIr.1C r-:oquireml!nt: for
<br />t.hglble youth wllu;2Te not dropout!;
<br />Use WlA funds1c C.ll1TY oUt pl"OgraIll'.i fund~ wuiu the School-to,WDJt, Opponun;bc~ Act of 1994
<br />.uJ.lcss ~ht prosra.'1ll~) iltt only for Y\luth dj~ib1e UI 08.J1icil'ate under WlA.
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<br />th'l~ above are tnle.
<br />-'
<br />Exec;u1.ive Director
<br />Titl.
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<br />Jul 25. 2005
<br />Dot<:
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<br />37
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<br />F~X:714 835 7330
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