Attachment_I_504_Compliance.pdf
PDF 176 KB Posted
- Attached to
- Medicare DDE acces
- Solicitation number
- 66600-2526-256
- Issued by
- San Mateo County, San Francisco City, California
About this file
This is a Section 504 Compliance Assurance form issued by the County of San Mateo Contract Compliance Committee on August 5, 2013, establishing compliance requirements for contractors entering into agreements with the county. The document requires all contractors to comply with Section 504 of the Rehabilitation Act of 1973, as amended, and applicable Department of Health and Human Services (DHHS) regulations. The assurance applies to all contracts executed after the date of the document and is binding on the contractor, its successors, transferees, and assignees. Contractors must certify their commitment to compliance through an authorized official's signature and provide required information including contractor name, address, and contact details.
The form includes a two-tier classification based on contractor size. Contractors employing fewer than 15 persons need only acknowledge the assurance requirements. Contractors employing 15 or more persons must designate a Section 504 coordinator responsible for coordinating compliance efforts with DHHS regulations. The document includes an exception clause allowing contractors with fewer than 15 employees to refer disabled persons seeking services to other accessible providers if facility modifications would constitute a significant alteration to existing facilities. The contractor must certify the accuracy of submitted information and authorize an official representative to execute the assurance on the organization's behalf.
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Text version
Issued by County of San Mateo Contract Compliance Committee August 5, 2013
ATTACHMENT I
Assurance of Compliance with Section 504 of the Rehabilitation Act of 1973, as Amended
The undersigned (hereinafter called "Contractor(s)") hereby agrees that it will comply with Section 504 of the Rehabilitation Act of 1973, as amended, all requirements imposed by the applicable DHHS regulation, and all guidelines and interpretations issued pursuant thereto.
The Contractor(s) gives/give this assurance in consideration of for the purpose of obtaining contracts after the date of this assurance. The Contractor(s) recognizes/recognize and agrees/agree that contracts will be extended in reliance on the representations and agreements made in this assurance. This assurance is binding on the Contractor(s), its successors, transferees, and assignees, and the person or persons whose signatures appear below are authorized to sign this assurance on behalf of the Contractor(s).
The Contractor(s): (Check a or b)
☐ a. Employs fewer than 15 persons.
☐ b. Employs 15 or more persons and, pursuant to section 84.7 (a) of the regulation (45 C.F.R.
84.7 (a), has designated the following person(s) to coordinate its efforts to comply with the DHHS regulation.
Name of 504 Person:
Name of Contractor(s):
Street Address or P.O. Box:
City, State, Zip Code:
I certify that the above information is complete and correct to the best of my knowledge
Signature:
Title of Authorized Official:
Date:
*Exception: DHHS regulations state that: "If a recipient with fewer than 15 employees finds that, after consultation with a disabled person seeking its services, there is no method of complying with (the facility accessibility regulations) other than making a
Issued by County of San Mateo Contract Compliance Committee August 5, 2013 significant alteration in its existing facilities, the recipient may, as an alternative, refer the handicapped person to other providers of those services that are accessible."
File details come from the government source that posted it. Updated .