Federal Requirements For Construction Contracts (Page 15 of 35) in pdf

CERTIFICATION OF NONSEGREGATED FACILITIES

General Contractor submits this form when the Contract is signed. Subcontractors must submit

this form before beginning work on the project.

Company Name:

Company Address:

Company Telephone Number:

Date:

Company Tax Identification Number:

Name of Project:

Is Company (check one)

General Contractor or

Subcontractor on this project?

As used in this certification, the term “segregated facilities” means any waiting room, work area, rest

rooms and washrooms, 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 that are segregated by explicit directive or are in fact

segregated on the basis of race, color, religion, or national origin because of habit, local custom or

otherwise.

The Contractor certifies that no segregated facilities are or will be maintained or provided for the

Contractor’s employees at any of the Contractor’s establishments, and that the Contractor’s employees do

not and will not be permitted to perform their services at any location under the Contractor’s control

where segregated facilities are maintained.

The Contractor further agrees (except if the Contractor has obtained identical certifications from proposed

Subcontractors for specific time periods) that, prior to entering into subcontracts which exceed $10,000

and are not exempt from the Equal Opportunity Clause, the Contractor will

(1)

obtain identical certifications from proposed Subcontractors;

(2)

retain the certification in its files; and

(3)

forward the following notice to proposed Subcontractors (except if the proposed

Subcontractors have submitted identical certifications for specific time periods):

“Notice to Prospective Subcontractors of Requirement for Certifications of

Nonsegregated Facilities: A Certification of Nonsegregated facilities must be submitted

before the award of a subcontract exceeding $10,000 which is not exempt from the

provisions of the Equal Opportunity clause of the prime contract. The certification may

be submitted either for each subcontract or for all subcontracts during a period (i.e.

quarterly, semiannually, or annually).”

The Contractor agrees that a breach of this certification or a breach of a Subcontractor’s identical

certification is a violation of the Equal Opportunity Clause in the Contract. The penalty for making false

statements in these certifications is prescribed in 18 U.S.C. 1001.

Signature of Officer or Owner of Company:

Printed Name and Title of Signatory Above:

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Federal Requirements For Construction Contracts Page 15