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Local Assistance Procedures Manual EXHIBIT 9-C Local Agency ADA Annual Certification Form Exhibit 9-C: Local Agency Americans with Disabilities Act (ADA) Annual Certification Form Local Agency ADA Annual Certification Form 49 CFR 27: Nondiscrimination on the Basis of Disability in Programs or Activities Receiving Federal Financial Assistance City of Santa Ana Local Agency: State Fiscal Year (July 1-June 30): I. Michael Ortiz Name of ADA / 504 Lls� g4fi4_ Telephone Number: l E-mail Address: mortiz@santa-ana.org NOTE: Section 504 applies to federally funded programs and ADA applies to state and local government funded programs (Title II). An ADA Officer is only required if the agency has 50 or more employees.* II. ADA Grievance / Complaint Procedure Adopted? Yes: 'F No: Ifyes, date of completion/last updated: 10/17/1994 If no, planned date of adoption: NOTE: An ADA Officer is only required ifthe agency has 50 or more employees.* III. Self -evaluation completed? Yes: ✓ No: Ifyes, date of completion/last updated: Ifno, planned date of completion: 05/30/2017 NOTE: Allpublic entities receiving federal funds are required to complete a self -evaluation. Agencies are required to review and make modifications as needed to the self -evaluation to ensure there is non-discrimination on the basis of disability. Local agencies shall implement a system for periodically reviewing and updating self -evaluations and, if applicable, transition plans. As a best practice, it is recommended to review the self -evaluation every three years prior to submitting or adopting the four-year Transportation Improvement Program. * The Section 8.1000 in Title II, Technical Assistance Manual states, "How does a public entity determine whether it has 50 or more employees? Determining the number of employees willbe based on a governmentwide total of employees, rather than by counting the number of employees of a subunit, department, or division of the local government. Part-time employees are included in the determination." City Council 20 — 74 7/18/2Q ge 1 oft ary 2021