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<br /> Everett Forward Grant Program | Agreement | Page 11 <br />Exhibit 4: CIVIL RIGHTS CERTIFICATION FORM <br />The funds provided to the grant beneficiary named below (hereinafter referred to as the “Grantee”) are available <br />under section 603 of the Social Security Act, as added by section 9901 of the American Rescue Plan Act. <br />Grantee understands and acknowledges that: <br />As a condition of receipt of federal financial assistance from the Department of the Treasury, with monies <br />distributed through City of Everett, Grantee provides the assurances stated herein. The federal financial <br />assistance may include federal grants, loans and contracts to provide assistance to Grantee, the use or rent of <br />Federal land or property at below market value, Federal training, a loan of Federal personnel, subsidies, and <br />other arrangements with the intention of providing assistance. Federal financial assistance does not <br />encompass contracts of guarantee or insurance, regulated programs, licenses, procurement contracts by the <br />Federal government at market value, or programs that provide direct benefits. <br /> <br />The Civil Rights Restoration Act of 1987 provides that the provisions of the assurances apply to all of the <br />operations of Grantee’s program(s) and activity(ies), so long as any portion of Grantee’s program(s) or <br />activity(ies) is federally assisted in the manner prescribed above <br /> <br />Grantee certifies the following: <br />1. Grantee ensures its current and future compliance with Title VI of the Civil Rights Act of 1964, as <br />amended, which prohibits exclusion from participation, denial of the benefits of, or subjection to <br />discrimination under programs and activities receiving federal financial assistance, of any person in the <br />United States on the ground of race, color, or national origin (42 U.S.C. § 2000d et seq.), as implemented <br />by the Department of the Treasury Title VI regulations at 31 CFR Part 22 and other pertinent executive <br />orders such as Executive Order 13166, directives, circulars, policies, memoranda, and/or guidance <br />documents. <br />2. Grantee acknowledges that Executive Order 13166, “Improving Access to Services for Persons with <br />Limited English Proficiency,” seeks to improve access to federally assisted programs and activities for <br />individuals who, because of national origin, have Limited English proficiency (LEP). Grantee understands <br />that denying a person access to its programs, services, and activities because of LEP is a form of national <br />origin discrimination prohibited under Title VI of the Civil Rights Act of 1964 and the Department of the <br />Treasury’s implementing regulations. Accordingly, Grantee shall initiate reasonable steps, or comply with <br />the Department of the Treasury’s directives, to ensure that LEP persons have meaningful access to its <br />programs, services, and activities. Grantee understands and agrees that meaningful access may entail <br />providing language assistance services, including oral interpretation and written translation where <br />necessary, to ensure effective communication in Grantee’s programs, services, and activities. <br />3. Grantee agrees to consider the need for language services for LEP persons when Grantee develops <br />applicable budgets and conducts programs, services, and activities. As a resource, the Department of the <br />Treasury has published its LEP guidance at 70 FR 6067. For more information on taking reasonable steps <br />to provide meaningful access for LEP persons, please visit http://www.lep.gov. <br />4. Grantee acknowledges and agrees that compliance with the assurances constitutes a condition of <br />continued receipt of federal financial assistance and is binding upon Grantee and its successors, <br />transferees, and assignees for the period in which such assistance is provided. <br />5. Grantee shall comply with Title VI of the Civil Rights Act of 1964, which prohibits Grantees of federal <br />financial assistance from excluding from a program or activity, denying benefits of, or otherwise <br />discriminating against a person on the basis of race, color, or national origin (42 U.S.C. § 2000d et seq.), as <br />implemented by the Department of the Treasury’s Title VI regulations, 31 CFR Part 22, which are herein <br />incorporated by reference and made a part of this contract (or agreement). Title VI also includes