The undersigned shall require that the language of this certification be included in the award documents for all covered sub-awards exceeding $100,000 in Federal funds at all appropriate tiers and that all subrecipients shall certify and disclose accordingly. Does Supplier agree? YES ________ Initials of Authorized Representative of Supplier RECORD RETENTION REQUIREMENTS FOR CONTRACTS INVOLVING FEDERAL FUNDS When federal funds are expended by HISD for any contract resulting from this procurement process, Supplier certifies that it will comply with the record retention requirements detailed in 2 CFR § 200.333. Supplier further certifies that it will retain all records as required by 2 CFR § 200.333 for a period of three years after grantees or subgrantees submit final expenditure reports or quarterly or annual financial reports, as applicable, and all other pending matters are closed. Does Supplier agree? YES ________ Initials of Authorized Representative of Supplier CERTIFICATION OF COMPLIANCE WITH THE ENERGY AND CONSERVATION ACT When HISD expends federal funds for any contract resulting from this procurement process, Supplier certifies that it will comply with the mandatory standards and policies relating to energy efficiency which are contained in the state energy conservation plan issued in compliance with the Energy Policy and Conservation Act (42 U.S.C. 6321 et seq.; 49 C.F.R. Part 18). Does Supplier agree? YES ________ Initials of Authorized Representative of Supplier CERTIFICATION OF EMPLOYMENT STATEMENT It is the policy of HISD not to discriminate on the basis of race, color, national origin, gender, limited English proficiency or handicapping conditions in its programs. Supplier agrees not to discriminate against any employee or applicant for employment to be employed in the performance of this Contract, with respect to hire, tenure, terms, conditions and privileges of employment, or a matter directly or indirectly related to employment, because of age (except where based on a bona fide occupational
Does Supplier agree? YES ________ Initials of Authorized Representative of Supplier SUPPLIER AGREES TO COMPLY WITH ALL APPLICABLE FEDERAL, STATE, AND LOCAL LAWS, RULES, REGULATIONS, AND ORDINANCES. IT IS FURTHER ACKNOWLEDGED THAT SUPPLIER CERTIFIES COMPLIANCE WITH ALL PROVISIONS, LAWS, ACTS, REGULATIONS, ETC. AS SPECIFICALLY NOTED ABOVE. Supplier’s Name: _______________________________________________________________________________________ Address, City, State, and Zip Code: ________________________________________________________________________ Number: ____________________________________ Fax Number: ____________________________________ Printed Name and Title of Authorized Representative: __________________________________________________________ Email Address: Signature of Authorized Representative: _____________________________________________________________________ Date: ___________________________ FORM H: EXCEPTION FORM
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