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Supporting Documents Form 1.3 Equal Employment Opportunity Plan (EEOP) Certification A. Definitions Ivoe LEntitv - Educationallmedicallnon-profit institution/Native American Tribe - certification required (select appropriate choice below). EEOP NOT REQUIRED. Tvoe II Entitv - All other recipients receiving more than $25,000, but not more than $500,000 - certification required (select the appropriate choice below); organizations must maintain EEOP on file for possible audit if the organization has more than 50 employees. Tvoe III Entitv - For profit entities and state and local governments receiving $500,000 or more - certifications required (select the appropriate choice below); the organization must submit an EEOP to the Office for Civil Rights (OCR) for approval. B. Oraanization TvDe ~ SELECT One: ¡¡option 1: I certify this organization is a Type I Entity. This entity will comply with the prohibitions I~j~~;ri.r~. ~~~i~IS~~=~~~~~~;o~:n~O~~; ~~ a~I~:~~~ ~~ ~~~O;~~fo~~e~~~~;~~~n~:~~~nraa~ guidelines of the Department of Health and Human Services (28 CFR §42.302). Option 2: I certify this organization Is a Type II Entity that employs less than 50 people. This entity will comply with the prohibitions against discrimination in any program or activity (28 CFR §42.302), but is not required to maintain an Equal Employment Opportunity Plan (28 CFR §42.301 et seq). Option 3: I certify this organization is a Type II Entity that employs 50 or more people. This entity will comply with prohibitions against discrimination in any program or activity (28 CFR §42.302), and has formulated an Equal Employment Opportunity Plan (28 CFR §42.302 et seq), that is on file in the office of: - . . ' , - " Option 4: I certify this organization Is a Type III Entity. This entity will comply with the prohibitions against discrimination in any program or activity (28 CFR §42.302), and has formulated an Equal Employment Opportunity Plan (28 CFR §42.301 et seq), that will be submitted to the Office for Civil Rights, Office of Justice Programs, Department of Justice, for approval upon award of a grant. 1.4 Debarment Certification A. The applicant certifies that it and its principals: 1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, sentenced to a denial of Federal benefits by a State or Federal Court, or voluntarily excluded from participation in this transaction by any federal department or agency; 2. Have not within a three-year period preceding this application been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 3. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (federal, state, or local) with commission of any of the offenses unumerated in section 1.2(a) of this form; and have not within a three-year period preceding this application had one or more public transactions (federal, state, or local) terminated for cause or default; or B. If the applicant is unable to certify to the above statements, SELECT 'Unable to Certify' and provide an explanation below: D Unable to Certify Page 20'5 Supporting Documents Form