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STATE OF WASHINGTON JUSTICE ASSISTANCE GRANT <br />DEPARTMENT OF COMMERCE FORM 10 <br />EQUAL EMPLOYMENT OPPORTUNITY PLAN (EEOP) CERTIFICATION <br />Recipient Name and Address: <br />Grant Title: FFY'19 Justice Assistance Grant — Washington State Grant Number: 2019-DJ-BX-0035 <br />Subaward No.: <br />Federal regulations require recipients of financial assistance from the Office of Justice Programs (OJP), its compone... <br />agencies, and the Office of Community Oriented Policing Services (COPS) to prepare, maintain on file, submit to OJP for <br />review, and implement an Equal Employment Opportunity Plan (EEOP) in accordance with 28 CFR Sections 42.301-.308. <br />The regulations exempt some recipients from all of the EEOP requirements. Other recipients, according to the regulations, <br />must prepare, maintain on file, and implement an EEOP, but they do not need to submit the EEOP to OJP for review. <br />Recipients that claim a complete exemption from the EEOP requirement must complete Section B below. Recipients that <br />claim the limited exemption from the submission requirement must complete Section C below. <br />Recipients should complete Section A, B or Section C, not multiple sections. If a recipient receives multiple federal grants, <br />please complete a form for each grant, Do Not Use Another Grant's Certificate when completing this application package. <br />Section A — Declaration of Compliance with the EEOP Requirement <br />I, [individual with primary functional responsibility for equal opportunity/civil rights <br />compliance for the jurisdiction], certify that <br />[recipient] has prepared an EEOP and if appropriate submitted to the Office of Civil Rights, US Department of Justice a copy, pursuant to 28 <br />CFR. <br />Print Name of Individual with <br />Primary Functional Responsibility <br />Signature Date <br />Sect B - Declaration of Claimin omplete Exemption from the EEOP Requirement. Please check all boxes that apply. <br />❑ Recip - t has less than 50 ployees ❑ Recipient is an Indian Tribe 0 Recipient is a non-profit organization <br />❑ Recipien 's an educati• al institution 0 Recipient is a medical institution 0 Recipient's award is less than $25.000 <br />I, [individual with primary functional responsibility for equal opportunity/civil rights <br />compliance for th- : sdiction], certify that <br />[recipient] is i .t requi -d to prepare an EEOP for the reason(s) checked above, pursuant to 28 CFR Sections 42.302. I further certify that <br />[recipient jurisdiction] will comply with the applicable Federal civil rights laws <br />that pro . . it discrimination ' employment and in the delivery of services. <br />Print Name of Individual <br />Date <br />Signature <br />ction C - Declaration Claiming <br />Re iew. <br />emstion from the EEOP Submission Requirement and Certifying that an EEOP Is on File for <br />If a re ipient agency has 50 or ore employees and is receiving a single award or subaward for $25,000 or more, but less than <br />$500,0, then the recipient . gency does not have to submit an EEOP for review to the Department of Justice as long as it certifies <br />the follo ' g (42 CFR Se ion 42.305): <br />opportunity/civ <br />which has 50 or <br />an EEOP in acco <br />into effect with. <br />the <br />[org <br />r for review <br />U.S. Department <br />employees <br />Program <br />[individual with primary functional responsibility for equal <br />compliance for the jurisdiction], certify that [recipient jurisdiction], <br />employees and is receiving a single award or subaward for $25,000 or more, but less than $500,000, has formulated <br />e with 28 CFR Section 42.301, et. seq., subpart E. I further certify that the EEOP has been formulated and signed <br />ast two years by the proper authority and that it is available for review. The EEOP is on file in the office of <br />ization], at [address], for review by the public and <br />audit by officials of the relevant state planning agency or the Office for Civil Rights, Office of Justice <br />fJustice, as required by relevant laws and regulations. <br />Prt Name of Individual wit Signature Date <br />unary Functional Responsibi •ty <br />25 <br />