HomeMy Public PortalAbout030_010_TI_FFY 2015 Survey & Planning Application-initial_signature page for Mayor 12.ASSURANCES:
The Applicant hereby assures and certifies by placing his/her initials beside each item below that the Applicant will
comply with all applicable regulations,policies, guidelines and requirements including OMB Circular No's A-87,A-95,
A-110 and A-102, as they relate to the application, acceptance, and use of Federal funds for this Federally-assisted
project. Also the Applicant assures and certifies with respect to the grant that: (initial blank beside each number to
signify willingness and ability to comply)
PLEASE INITIAL EACH.
1. Legal Authority-Applicant possesses legal authority to apply for the grant; that a resolution,motion or similar
action has been or will be duly adopted as an official act of the applicant's governing body, authorizing the submission of
the application, including all understandings and assurances contained therein, and directing and authorizing the person
identified as the official representative of the applicant to act in connection with the application and to provide such
additional information as may be required.
2. Civil Rights-Applicant will comply with Title VI of the Civil Rights Act of 1964(P.L. 88-352), as amended,
and in accordance with Title VI of that Act,no person in the United States shall, on the ground of race, color, or national
origin,be excluded from participation in,be denied the benefits of, or be otherwise subjected to discrimination under any
program or activity for which the applicant receives Federal assistance and will immediately take any measures necessary
to effectuate this agreement.
3. Nondiscrimination-Applicant will comply with Title VI of the Civil Rights Act of 1964 (42 USC 2000d) as
amended,prohibiting employment discrimination where(a)the primary purpose of the grant is to provide employment or
(b) discriminatory employment practices will result in unequal treatment of persons who are or should be benefiting from
the grant-aided activity. It will comply with Section 504 of the Rehabilitation Act of 1973 as amended,Age
Discrimination Act of 1975, and Drug Abuse Office and Treatment Act of 1972.
4. Conflict of Interest-Applicant will establish safeguards to prohibit employees from using their positions for
purposes that are or give the appearance of being motivated by a desire for private gain for themselves or others,
particularly those with whom they have family,business or other ties.
5. Access to Records-Applicant will give the grantor agency or the Comptroller General (through any authorized
representative)the access to and the right to examine all records,books,papers, or documents related to the grant.
6. Programmatic and Financial Compliance-Applicant will comply with all requirements imposed by the
Federal grantor agency concerning special requirements of law,program requirements and other administrative
requirements approved in accordance with appropriate Office of Management and Budget Circular. (For units of
governments): It will maintain adequate financial management systems which will be(a)in accordance with the
standards specified in OMB Circular A-102,Attachment G, "Standards for Grantee Financial Management Systems", and
(b) auditory in accordance with the General Accounting Office's Standards for Audit of Governmental Organizations,
Programs,Activities,and Functions.
7. Audit-Applicant will have an organization-wide, independent audit performed for each year in which federal
funds are received, if required. This audit will be preformed by using the required financial and compliance audits in
accordance with Single Audit Act of 1984 and will be submitted to HPD following the end of the contract period.
8. Flood Insurance-Applicant will comply with the flood insurance purchases requirements of Section 102(a)of
the Flood Disaster Protection Act of 1973 (P.L. 93-234)which requires recipients in a special flood hazard area to
participate in the program and to purchase flood insurance if the total cost of insurable construction and acquisition is
$10,000 or more.
13. CERTIFICATION:
I certify that I have read the accompanying Instruction Sheet and Assurances and accept all terms and conditions set forth
therein. I also certify that all information contained in this application is correct,that the matching share will be provided
as indicated, and that the project will be undertaken in conformance with the Secretary of the Interior's Standards for
Archaeology and Historic Preservation and all applicable state and federal guidelines and regulations.
APPLICANT SIGNATURE:
January 22,2015
Authorized signature Date
Jason Buelterman Mayor, City of Tybee Island
Typed or printed name TITLE
APPLICATIONS MUST BE POSTMARKED BY FEBRUARY 2,2015.
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