Sample Exhibit 5 - Equal Employment Opportunity Certification Statement.pdf
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- Primary Care Patient Experience Surveys
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- RFP-1-2023
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- Oregon
About this file
This document is an Equal Employment Opportunity (EEO) Certification Statement from Multnomah County, designed for contractors executing contracts valued over $75,000. The form requires contractors to certify their commitment to equal employment practices by selecting either Part 1 (no employees) or Part 2 (has employees), with mandatory disclosure and ongoing reporting requirements throughout the contract period.
The certification requires contractors to affirm they will not discriminate based on protected characteristics such as race, color, religion, sex, national origin, age, disability, sexual orientation, and gender identity. Contractors must also pledge to avoid improper employment practices, including soliciting biased recommendations, coercing political activities, obstructing employment competition, or giving improper preferences. Failure to submit updated documentation when employee status changes may result in termination of existing county contracts. The document is dated 1/29/10 and provides a standardized template for contractors to demonstrate their commitment to fair employment practices.
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1/29/10 snt Exhibit 5 – Equal Employment Opportunity Certification Statement
Exhibit 5 – Equal Employment Opportunity Certification Statement
Every Contractor executing a contract for more than $75,000 must complete this Exhibit.
Equal Employment Opportunity (EEO) means eliminating barriers to ensure that all employees are considered for the employment of their choice and have the chance to perform to their maximum potential. EEO practices include, but are not limited to, fairness at work, hiring based on merit and promotion based on talent. It concerns all aspects of employment including recruitment, pay and other rewards, career development and work conditions.
All County Contractors signing new contracts with the County must complete this form. A Contractor who signs Part 1 and later adds employees during the period of performance of any County Contract must immediately notify the County of the change in status and submit an updated form with Part 2 signed. Failure to submit an updated form may result in termination of all existing contracts.
CERTIFICATION
I certify under penalty of perjury that [check Part 1 or Part 2]:
Part 1: Contractor has no employees. Should Contractor hire employees at a later date during the term of the contract, Contractor will immediately notify the Department that issued the contract and submit an updated Certification with Part 2 completed.
—OR—
Part 2: Contractor has employees. Contractor, as an Equal Opportunity Contractor, does not:
1. Discriminate against employees or applicants based on race, color, religion, sex, familial status, national origin, age, mental or physical disability, sexual orientation, gender identity, or source of income;
2. Solicit or consider employment recommendations based on factors other than personal knowledge or records of job-related abilities or characteristics;
3. Coerce the political activity of any person;
4. Deceive or willfully obstruct anyone from competing for employment;
5. Influence anyone to withdraw from competition for any position so as to improve or injure the employment prospects of any other person;
6. Give improper preference or advantage to anyone so as to improve or injure the employment prospects of that person or any other employee or applicant.
Contractors Signature:
Company Name:
Signature:
Title:
Date:
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