75B - PH - CDBG PROGRAM 13-14 - Laserfiche WebLink

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i Vill. CERTIFICATIONS A. Applicant certifies that it will not discriminate against any employee or applicant for employment because of race, religious creed, color, national origin, ancestry, physical disability, mental disability, medical condition, marital status, sex or age, in compliance with Government Code 12900, of seq. Applicant agrees to take affirmative action to insure that applicants are employed, and that employees are treated during employment, without regard to their race, religious creed, color, national origin, ancestry, physical disability, mental disability, medical condition, marital status, sex or age. B. Applicant certifies that it does not discriminate against any person wishing to benefit from their services/program on the basis of race, religious creed, color, national origin, ancestry, physical disability, mental disability, medical condition, marital status, sex or age. IX. SIGNATURE I hereby certify that, to the best of my knowledge, all statements made in this application are true and correct. If funds are granted to our organization, they will be used for a CDBG-eligible purpose, I understand that liability and workers compensation insurance will be required for our group, and that our formal agreement with the City will specify other reporting and programmatic provisions. Name Title Signature Date 4 75B-89