Attachment_I_504_Compliance.pdf

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Attached to
Hosptial and Professional Coding Audits
Solicitation number
66000-2526-219
Issued by
San Mateo County, San Francisco City, California

About this file

This document is an Assurance of Compliance form issued by the County of San Mateo Contract Compliance Committee on August 5, 2013, related to Section 504 of the Rehabilitation Act of 1973. The form requires contractors to affirm their commitment to complying with the act's regulations, specifically regarding accessibility for individuals with disabilities. Contractors must indicate whether they employ fewer than or 15 or more persons, and if the latter, they must designate a coordinator to ensure compliance with DHHS regulations.

The document provides an exception for recipients with fewer than 15 employees, allowing them to refer individuals with disabilities to alternative service providers if making significant alterations to existing facilities is not feasible. The form includes fields for the contractor to provide their name, address, and contact information for the designated compliance coordinator, along with a signature from an authorized official certifying the accuracy of the information. This document serves as a standard compliance mechanism to ensure equal access and non-discrimination in service provision.

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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 .