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XIII. Does toilet stall for the disabled have bars on each side of wall? <br />Per Dept. of Rehab. Sect. 504 YESP NO❑ <br />XIV. Is there a telephone reasonably accessible to handicap individuals? <br />Per Dept, of Rehab. Sect. 504 YES® NO❑ <br />XV. Is there a water fountain reasonably accessible to disabled '- dividuals? <br />Per Dept. of Rehab. Sect. 504 YESIM NOF -1 <br />XVI. Are auxiliary (supplementary) aides available when requested by the individual? <br />Per CFR Title 20,29,41 YE NOF -1 <br />XVII. Do all contracts and agreements signed by the individual contain Employer Equal <br />opportunity employer language? <br />CFR Title 20,29,41 YES[ NOF <br />I certify that I have validated all <br />Service Provider Information: <br />WV i <br />First Na e <br />Service P ovrder Signature <br />Business Address <br />Business Phone Number <br />responses: <br />O/ K r S1 Date <br />�kw6U <br />Last Name <br />1t -x- I4 <br />Date <br />