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Attachment D <br />Assurances & Certifications <br />Selected providers will be required to sign and submit "actual" assurances and certificates as required by the City <br />of Santa Ana and the Workforce Investment Board on all contracts. <br />I recognize that I must give assurances for each item below. If I cannot, this proposal will be automatically <br />rejected. Please initial each box. <br />1 am authorized by my Board of Directors, Trustees, other legally qualified officer, or as the owner of <br />this agency or business to submit this proposal. <br />We are not currently on any Federal, State of California, or local Debarment list. <br />[,,,g ® We will provide records to show that we are fiscally solvent, if needed. <br />® We have, or will have, all of the fiscal control and accounting procedures needed to ensure that WIA <br />funds will be used as required by law and contract. <br />® We have additional funding sources and will not be dependent on WIA funds alone. <br />We do or will meet the applicable Federal, State, and local compliance requirements. These include, but are <br />not limited to: <br />®Records accurately reflect actual performance. <br />®Maintain record confidentiality, as required. <br />®Reporting financial, participant, and performance data, as required. <br />®Comply with State and Federal fiscal and program activity audits. <br />®Complying with Federal and State non-discrimination provisions. <br />®Meeting requirements of Section 504 of the Rehabilitation Act of 1973. <br />®Meeting requirements of the American's with Disabilities Act of 1990. (submit completed survey) <br />l - ®Meeting all applicable labor law, including Child Labor Law standards. <br />®Agree to provide a drug free workplace. <br />®Agree to insure the City of Santa Ana through General Liability Insurance and Automobile Liability ? <br />Coverage in the amount of $1,000,000.00 policy. <br />®Agree to provide all participants with Grievance Procedures. <br />,p ( ®Agree to insure proposer's employees through Workers Compensation Insurance <br />(including part-time employees) <br />®Procurement policies and procedures are in place and meet federal guidelines. <br />We will not: <br />QG ®Place a youth in a position that will displace a current employee. <br />I ®Use WIA money to assist, promote, or deter union organizing. <br />®Use funds to employ or train of persons in sectarian activities. <br />®Use funds for youth in the construction, operation, or maintenance of any part of a facility to be used <br />for sectarian instruction or religious worship. <br />®Use WIA funds for activities that would interfere with or replace regular academic requirements for <br />eligible youth who are not dropouts. <br />1 ®Use WIA funds to carry out programs funded under the School-to-Work Opportunities Act of 1994 <br />unless the program(s) are only for youth eligible to participate under WIA. <br />q? ®Use WIA money under this contract to purchase any equipment. <br />assure that all of the above are true. <br />Director, Career Dev <br />Name Title <br />ROP <br />Date <br />31 <br />EXHIBIT G