**USDA** Form Approved

Form RD 400-6 OMB No. 0575-0018

(Rev. 4-00)

**COMPLIANCE STATEMENT**

This statement relates to a proposed contract with

[,]{.underline}

*(Name of borrower or grantee)*

who expects to finance the contract with assistance from either the
Rural Housing Service (RHS), Rural Business-Cooperative Service (RBS),
or the Rural Utilities Service (RUS) or their successor agencies, United
States Department of Agriculture (whether by a loan, grant, loan
insurance, guarantee, or other form of financial assistance).I am the
undersigned bidder or prospective contractor, I represent that:

1\. I have, have not, participated in a previous contract or subcontract
subject to Executive

11246 (regarding equal employment opportunity) or a preceding similar
Executive Order.

2\. If I have participated in such a contract or subcontract, I have,
have not, filed all

compliance reports that have been required to file in connection with
the contract or subcontract.

If the proposed contract is for \$50,000 or more and I have 50 or more
employees, I also represent that:

3\. I have, have not previously had contracts subject to the written
affirmative action

programs requirements of the Secretary of Labor.

4\. If I have participated in such a contract or subcontract, I have,
have not developed and

placed on file at each establishment affirmative action programs as
required by the rules and

regulations of the Secretary of Labor.

I understand that if I have failed to file any compliance reports that
have been required of me, I am not

eligible and will not be eligible to have my bid considered or to enter
into the proposed contract unless

and until I make an arrangement regarding such reports that is
satisfactory to either the RHS, RBS or RUS,

or to the office where the reports are required to be filed.

I also certify that I do not maintain or provide for my employees any
segregated facilities at any of my

establishments, and that I do not permit my employees to perform their
services at any location, under my

control, where segregated facilities are maintained. I certify further
that I will not maintain or provide for

my employees any segregated facilities at any of my establishments, and
that I will not permit my employees to perform their services at any
location, under my control, where segregated facilities are maintained.
I agree that a breach of this certification is a violation of the Equal
Opportunity clause in my contract. As used in this certification, the
term "segregated facilities" means any waiting rooms, work areas,
restrooms and wash rooms, restaurants and other eating areas time
clocks, locker rooms and other storage or dressing areas, parking lots,
drinking fountains, recreation or entertainment areas, transportation,
and housing facilities provided for employees which are segregated by
explicit directive or are in fact segregated on the basis of race,
creed, color, or national origin, because of habit, local custom, or
otherwise. I further agree that (except where I have obtained identical
certifications for proposed subcontractors for specific time periods) I
will obtain identical certifications from proposed subcontractors prior
to the award of subcontracts exceeding \$10,000 which are not exempt
from the provisions of the Equal Opportunity clause; that I will retain
such certifications in my files; and that I will forward the following
notice to such proposed subcontractors (except where the proposed
subcontractors have submitted identical certifications for specific time
periods):

(See Reverse).

*According to the Paperwork Reduction Act of 1995, an agency may not
conduct or sponsor, and a person is not required to respond to a
collection of information unless it displays a valid OMB control number.
The valid OMB control number for this information collection is
0575-0018. The time required to complete this information collection is
estimated to average 10 minutes per response, including the time for
reviewing instructions, searching existing data sources, gathering and
maintaining the data needed, and [completing and reviewing the
collection of information]{.underline}***[.]{.underline}**

*Position 6* RD 400-6 (Rev. 4-00)

**NOTICE TO PROSPECTIVE SUBCONTRACTORS OF REQUIREMENTS FOR**

**CERTIFICATIONS OF NON-SEGREGATED FACILITIES**

A certification of Nonsegregated Facilities, as required by the May 9,
1967, order (32F.R. 7439, May 19, 1967) on

Elimination of Segregated Facilities, by the Secretary of Labor, must be
submitted prior to the award of a subcontract

exceeding \$10,000 which is not exempt from the provisions of the Equal
Opportunity clause. The certification may be

submitted either for each subcontract or for all subcontracts during a
period (i.e. quarterly, semiannually, or annually).

NOTE: The penalty for making false statements in offers is prescribed in
18 U.S.C. 1001.

DATE

*(Signature of Bidder or Prospective Contractor)*

*Address (including Zip Code)*