Attachment_I_504_Compliance.pdf
PDF 176 KB Posted
- Attached to
- Purchase of a Furnished Mobile Dental Van
- Solicitation number
- 66000-2425-206
- Issued by
- San Mateo County, San Francisco City, California
About this file
Attachment I is a Section 504 Rehabilitation Act Compliance form issued by the County of San Mateo Contract Compliance Committee on August 5, 2013. The document is an assurance of compliance form that requires contractors to agree to adhere to Section 504 of the Rehabilitation Act of 1973, as amended, and all associated DHHS regulations and guidelines. The form provides two options for contractors based on their employee count: those with fewer than 15 employees and those with 15 or more employees, with the latter required to designate a specific person to coordinate compliance efforts.
The form includes blank fields for contractors to provide their name, address, and contact information for the designated 504 compliance coordinator. An exception note indicates that for organizations with fewer than 15 employees who cannot make facility accessibility accommodations, an alternative is to refer disabled persons seeking services to other accessible providers. The document requires an authorized official's signature, title, and date to certify the completeness and accuracy of the information provided.
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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 .