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Attachment D <br />Assurances & Certifications <br />Selected providers will be required to sign and submit "actual" assurances and certificates as <br />required by the City of Santa Ana and the Workforce Investment Board on all contracts. <br />I recognize that I must give assurances for each item below. If I cannot, this proposal will be <br />automatically rejected. Please initial each box. <br />?x I am authorized by my Board of Directors, Trustees, other legally qualified officer, or as the owner of this <br />agency or business to submit this proposal. <br />O We are not currently on any Federal, State of California, or local Debarment list. <br />0 We will provide records to show that we are fiscally solvent, if needed. <br />0 We have, or will have, all of the fiscal control and accounting procedures needed to ensure that WIA funds will <br />be used as required by law and contract. <br />O We have additional funding sources and will not be dependent on WIA funds alone. <br />We do or will meet the applicable Federal, State, and local compliance requirements. <br />These include, but are not limited to: <br />? Records accurately reflect actual performance. <br />O Maintain record confidentiality, as required. <br />O Reporting financial, participant, and performance data, as required. <br />O Comply with State and Federal fiscal and program activity audits. <br />O Complying with Federal and State non-discrimination provisions. <br />O Meeting requirements of Section 504 of the Rehabilitation Act of 1973. <br />O Meeting requirements of the American's with Disabilities Act of 1990. (submit attachment F) <br />• Meeting all applicable labor law, including Child Labor Law standards. <br />O Agree to provide a drug free workplace. <br />? Agree to insure the City of Santa Ana through General Liability Insurance and Automobile Liability <br />Coverage in the amount of $1,000,000.00 policy. <br />O Agree to provide all participants with Grievance Procedures. <br />O Agree to insure proposer's employees through Workers Compensation Insurance <br />(including part-time employees) <br />0 Procurement policies and procedures are in place and meet federal guidelines. <br />We will not: <br />x? Place a youth in a position that will displace a current employee. <br />O Use WIA money to assist, promote, or deter union organizing. <br />O Use funds to employ or train of persons in sectarian activities. <br />O Use funds for youth in the construction, operation, or maintenance of any part of a facility to be used for <br />sectarian instruction or religious worship. <br />O Use WIA funds for activities that would interfere with or replace regular academic requirements for eligible <br />youth who are not dropouts. <br />O Use WIA funds to carry out programs funded under the School-to-Work Opportunities Act of 1994 unless <br />the program(s) are only for youth eligible to participate under WIA. <br />O Use WIA money under this contract to purchase any equipment. <br />all of the above are true. <br />Name <br />Title <br />0 <br />Date <br />Z) <br />EXHIBIT G