Attachment_I_504_Compliance.pdf
PDF 176 KB Posted
- Attached to
- Pharmacy Consulting Services
- Solicitation number
- 66000-2526-234
- 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 engaging with the county. The document requires all contractors to certify their compliance with Section 504 of the Rehabilitation Act of 1973, as amended, and applicable Department of Health and Human Services (DHHS) regulations. Contractors must complete the form by identifying their entity name, principal address, and designating a Section 504 compliance coordinator if the organization employs 15 or more persons. Organizations with fewer than 15 employees are exempt from designating a specific coordinator but may be required to refer individuals seeking services to accessible alternative providers if facility modifications would constitute a significant alteration to existing structures. An authorized official must sign and date the completed assurance form, certifying the accuracy of all provided information.
The assurance form serves as a binding commitment applicable to the contractor, its successors, transferees, and assignees, and the County extends contracts in reliance upon the representations and agreements contained therein. This compliance requirement applies to the Pharmacy Consulting Services contract opportunity for San Mateo Medical Center, where the selected contractor must maintain compliance with Section 504 throughout the three-and-one-half-year contract term with no renewal options. The form does not specify separate pricing or funding requirements, as it functions as a prerequisite compliance document rather than a pricing or budgetary instrument.
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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."
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