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• <br /> • <br /> • <br /> • <br /> ATTACHMENT C <br /> CER1 if'LCATTON FORM <br /> Compliance with the Equal Employment Opportuniiy Plan(EEOP)Requirements <br /> Please read carefully the Instructions(see below)and then complete Section A orSection.8 or Section C,not all three. <br /> Recipient's Name:Everett Police Department <br /> Address:3002 WETMORE,EVERETT,WA 98201. • <br /> Is agency a Direct 0 or Sub recipient Q of OJP,OVW or COPS funding? _Law Enforcement Agency?Yes Q No D <br /> DUNS Number.608909156 Vendor Number(only if direct recipient):N/A <br /> Name and Title of Contact Person:Tracey Versteeg, <br /> Telephone Number:(425)257-8447 E-Mail Address:tversteea vn-everettwa.gov <br /> Section A'—..Declaration;.Claiiiung'ColonpleteEteiilption•:from�alie•EEOP•Re'quiremeiit�f::=:�:,;:;-;';:;?::;; '..:'.:;:: ;:, : : <br /> it P <br /> l e if�i .[ i 4ii:�l`'eas cherh all the dllowiit boxes XFidt. l>sPPY' - <br /> I :1. <br /> 1. <br /> -thea' <br /> .a: <br /> Less em I <br /> �Ziidiea'ti <br /> Metlii�l <br /> 1: ill <br /> i ins6i�ori: <br /> �Y P Y� ��----••�� <br /> tom <br /> Q Noapmfitotganization •��- diziatiat>ai tiarr-:' -.`Q'Receii$igsna�vardIes • <br /> sttian <br /> I, :I !:• 3 it 's 1.:!! •. . :(respo>rsiMe afficidl];; <br /> certify that[recipient]is not requiredtoprepare atiF O' for the reason(s)checked•above;.pursuit-tb'2'$'C:FR' <br /> I further certify that . <br /> . i =! �' : - <br /> 1 •t. r ,[YPCipiErtt]i- <br /> wi l comply with all applicable fedeial civil rights laws fliatprohibit discrimination in'employment:end intae deIivery'of <br /> services: ;'°; E I' <br /> Prim or Type Name and Title ' :1 i . . ilSigrAatta a <br /> Section B--Declaration Claiming Exemption from EEOP Submission Requirement and Certifying <br /> That an EEOP Is on File for Review <br /> ea recipient has fob)or more employees and is receiving a single afv/trd or,subaword of 525,000 or more,but less than 5500,000,then the recipient <br /> agency does not have to submit an EEOP to the OCR for review as long as it certifies the folkwing(42 CFR§42305): <br /> I, Michael Duerr [responsible official], <br /> certify that City of Everett Washington [recipient] <br /> Which has fifty or more employees and is receiving a single award for $25,000 or more, but less than$500,000,has <br /> formulated an EEOP in accordance with 28 CFR pt.42,subpt E.I further certify that within the last twenty-four months,the <br /> proper authority has formulated and signed into effect the EEOP and,as required by applicable federal law,it is available <br /> for review by the public,employees,the appropriate state planning agency,and the Office for Civil Rights,Office of Justice <br /> Programs,U.S.Department of Justice.The EEO?is on file at the following office: <br /> City of Everett, Human Resources <br /> [organization], • <br /> 2930 Wetmore Ave. Everett, WA 98201 : . • <br /> [address]. <br /> Michael Duerr. HR Manager l�� �cf <br /> Print or Type Name and Title Sngierboo a Date <br /> Section Deelarstion.Statiioigitliatu`:EEOBISlibrtToimlfa's';B6etSiabxnifted;tbr 69fdiWforpiT: <br /> , <br /> ;; a <br /> or•Rirvi l <br /> i lits i <br /> b - <br /> I <br /> I: <br /> i �r•' <br /> nl.. <br /> :ri <br /> tl•o��..baiv„'r7'o�a5'b`D'0�0`or mire�Yh�ii.i�k`>':e`cf 3'eif''r.�--->,iitist.,.:•:. <br /> ;Tfd recrpie>ii agencyYids,�i,fty`or'iii'or'e t.-1bye23°eriid is i''ictiviiig��rrtglif�iVur r 3R ar f p agenlj+• <br /> i endan1FoP ShorlF6rn <br /> ° ! i <br /> i::�d.i <br /> i • <br /> 0 <br /> .ee <br /> pp.! <br /> :9 <br /> - •I I••1 <br /> rtify that <br /> which has fifty ormore employees-and•is receivingalsingle;sward of�500;000`oz nioze;lia5'£dizonlatedia rEEOP a':: ; <br /> accordance•with 28`C R pt.42,.su'ti .it:sii tty6fit it fdr�' <br /> Office'for Civil Rights;Office•o';Ju ceProgicaiiit2. 1S10ep ¢ieiit'df ustice: <br /> 1• <br /> , <br /> I <br /> Print or Type Name and Title i ;E• lSigriature <br />