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OMB Number: 4040-0007 

Expiration Date: 02/28/2022

ASSURANCES - NON-CONSTRUCTION PROGRAMS

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IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.

NOTE: Certain of these assurances may not be applicable to your project or program. If you have questions, please contact the 

awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances. 

If such is the case, you will be notified.

As the duly authorized representative of the applicant, I certify that the applicant:

Has the legal authority to apply for Federal assistance 

and the institutional, managerial and financial capability 

(including funds sufficient to pay the non-Federal share 

of project cost) to ensure proper planning, management 

and completion of the project described in this 

application.

Act of 1973, as amended (29 U.S.C. §794), which 

prohibits discrimination on the basis of handicaps; (d) 

the Age Discrimination Act of 1975, as amended (42 U.

S.C. §§6101-6107), which prohibits discrimination on 

the basis of age; (e) the Drug Abuse Office and 

Treatment Act of 1972 (P.L. 92-255), as amended, 

relating to nondiscrimination on the basis of drug 

abuse; (f) the Comprehensive Alcohol Abuse and 

Alcoholism Prevention, Treatment and Rehabilitation 

Act of 1970 (P.L. 91-616), as amended, relating to 

nondiscrimination on the basis of alcohol abuse or 

alcoholism; (g) §§523 and 527 of the Public Health 

Service Act of 1912 (42 U.S.C. §§290 dd-3 and 290 

ee- 3), as amended, relating to confidentiality of alcohol 

and drug abuse patient records; (h) Title VIII of the Civil 

Rights Act of 1968 (42 U.S.C. §§3601 et seq.), as 

amended, relating to nondiscrimination in the sale, 

rental or financing of housing; (i) any other 

nondiscrimination provisions in the specific statute(s) 

under which application for Federal assistance is being 

made; and, (j) the requirements of any other 

nondiscrimination statute(s) which may apply to the 

application.

2. Will give the awarding agency, the Comptroller General 

of the United States and, if appropriate, the State, 

through any authorized representative, access to and 

the right to examine all records, books, papers, or 

documents related to the award; and will establish a 

proper accounting system in accordance with generally 

accepted accounting standards or agency directives.

3. Will establish safeguards to prohibit employees from 

using their positions for a purpose that constitutes or 

presents the appearance of personal or organizational 

conflict of interest, or personal gain.

4. Will initiate and complete the work within the applicable 

time frame after receipt of approval of the awarding 

agency.

5. Will comply with the Intergovernmental Personnel Act of 

1970 (42 U.S.C. §§4728-4763) relating to prescribed 

standards for merit systems for programs funded under 

one of the 19 statutes or regulations specified in 

Appendix A of OPM's Standards for a Merit System of 

Personnel Administration (5 C.F.R. 900, Subpart F).

6. Will comply with all Federal statutes relating to 

nondiscrimination. These include but are not limited to: 

(a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) 

which prohibits discrimination on the basis of race, color 

or national origin; (b) Title IX of the Education 

Amendments of 1972, as amended (20 U.S.C.§§1681- 

1683, and 1685-1686), which prohibits discrimination on 

the basis of sex; (c) Section 504 of the Rehabilitation

Previous Edition Usable Standard Form 424B (Rev. 7-97)

Authorized for Local Reproduction Prescribed by OMB Circular A-102

7. Will comply, or has already complied, with the 

requirements of Titles II and III of the Uniform 

Relocation Assistance and Real Property Acquisition 

Policies Act of 1970 (P.L. 91-646) which provide for 

fair and equitable treatment of persons displaced or 

whose property is acquired as a result of Federal or 

federally-assisted programs. These requirements 

apply to all interests in real property acquired for 

project purposes regardless of Federal participation in 

purchases.

8. Will comply, as applicable, with provisions of the 

Hatch Act (5 U.S.C. §§1501-1508 and 7324-7328) 

which limit the political activities of employees whose 

principal employment activities are funded in whole 

or in part with Federal funds.
Standard Form 424B (Rev. 7-97) Back

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Will comply, as applicable, with the provisions of the DavisBacon Act (40 U.S.C. §§276a to 276a-7), the Copeland Act 

(40 U.S.C. §276c and 18 U.S.C. §874), and the Contract 

Work Hours and Safety Standards Act (40 U.S.C. §§327- 

333), regarding labor standards for federally-assisted 

construction subagreements.

Will comply with the Wild and Scenic Rivers Act of 

1968 (16 U.S.C. §§1271 et seq.) related to protecting 

components or potential components of the national 

wild and scenic rivers system.

10. Will comply, if applicable, with flood insurance purchase 

requirements of Section 102(a) of the Flood Disaster 

Protection Act of 1973 (P.L. 93-234) which requires 

recipients in a special flood hazard area to participate in the 

program and to purchase flood insurance if the total cost of 

insurable construction and acquisition is $10,000 or more.

11. Will comply with environmental standards which may be 

prescribed pursuant to the following: (a) institution of 

environmental quality control measures under the National 

Environmental Policy Act of 1969 (P.L. 91-190) and 

Executive Order (EO) 11514; (b) notification of violating 

facilities pursuant to EO 11738; (c) protection of wetlands 

pursuant to EO 11990; (d) evaluation of flood hazards in 

floodplains in accordance with EO 11988; (e) assurance of 

project consistency with the approved State management 

program developed under the Coastal Zone Management 

Act of 1972 (16 U.S.C. §§1451 et seq.); (f) conformity of 

Federal actions to State (Clean Air) Implementation Plans 

under Section 176(c) of the Clean Air Act of 1955, as 

amended (42 U.S.C. §§7401 et seq.); (g) protection of 

underground sources of drinking water under the Safe 

Drinking Water Act of 1974, as amended (P.L. 93-523); 

and, (h) protection of endangered species under the 

Endangered Species Act of 1973, as amended (P.L. 93- 

205).

13. Will assist the awarding agency in assuring compliance 

with Section 106 of the National Historic Preservation 

Act of 1966, as amended (16 U.S.C. §470), EO 11593

(identification and protection of historic properties), and 

the Archaeological and Historic Preservation Act of 

1974 (16 U.S.C. §§469a-1 et seq.).

14. Will comply with P.L. 93-348 regarding the protection of 

human subjects involved in research, development, and 

related activities supported by this award of assistance.

15. Will comply with the Laboratory Animal Welfare Act of 

1966 (P.L. 89-544, as amended, 7 U.S.C. §§2131 et 

seq.) pertaining to the care, handling, and treatment of 

warm blooded animals held for research, teaching, or 

other activities supported by this award of assistance.

16. Will comply with the Lead-Based Paint Poisoning 

Prevention Act (42 U.S.C. §§4801 et seq.) which 

prohibits the use of lead-based paint in construction or 

rehabilitation of residence structures.

17. Will cause to be performed the required financial and 

compliance audits in accordance with the Single Audit 

Act Amendments of 1996 and OMB Circular No. A-133, 

"Audits of States, Local Governments, and Non-Profit 

Organizations."

18. Will comply with all applicable requirements of all other 

Federal laws, executive orders, regulations, and policies 

governing this program.

SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE

APPLICANT ORGANIZATION DATE SUBMITTED

PERSON AUTHORIZED TO SIGN ON BEHALF OF YOUR COMPANY (CEO, PRESIDENT, FOUNDER, ETC.)

COMPANY NAME

Will comply with the requirements of Section 106(g) of 

the Trafficking Victims Protection Act (TVPA) of 2000, as 

amended (22 U.S.C. 7104) which prohibits grant award 

recipients or a sub-recipient from (1) Engaging in severe 

forms of trafficking in persons during the period of time 

that the award is in effect (2) Procuring a commercial 

sex act during the period of time that the award is in 

effect or (3) Using forced labor in the performance of the 

award or subawards under the award.

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