Compliance with the Equalemployment Opportunityplan(EEOP)Requirements

CERTIFICATIONFORM

Compliance with the EqualEmployment OpportunityPlan(EEOP)Requirements

PleasereadcarefullytheInstructions(seebelow)andthencompleteSectionAorSectionBorSectionC,notallthree.

Recipient’s Name: / DUNS Number:
Address:
GrantTitle:VOCA Services to Victims of SV Violence / GrantNumber:1395-219CRCC / AwardAmount:
Name and TitleofContactPerson:
TelephoneNumber: / E-MailAddress
SectionA—DeclarationClaimingComplete Exemption fromthe EEOPRequirement
Please check all the followingboxes thatapply:
□Recipienthas less thanfiftyemployees.□Recipient is anIndian tribe.□Recipient is a medicalinstitution.
□Recipient is anonprofitorganization.□Recipient is aneducationalinstitution.□Recipientis receiving anawardless than $25,000.
I,[responsible official],certifythat [recipient]isnotrequired toprepare anEEOP forthereason(s)checkedabove,pursuantto28C.F.R § 42.302.
Ifurthercertifythat the Illinois Coalition Against Sexual Assault [recipient]willcomplywithapplicablefederalcivilrightslawsthatprohibitdiscriminationinemploymentandinthedeliveryofservices.
Printor Type Name andTitle:Signature Date:
SectionB—DeclarationClaimingExemption from the EEOPSubmissionRequirement and CertifyingThatan EEOPIs on File for Review
If arecipientagency has fiftyormore employees andis receiving asingle award or subawardof$25,000 or more,butlessthan $500,000,then therecipientagency does nothave tosubmitan EEOPtothe OCRforreview as longas itcertifies the following (42C.F.R.§ 42.305):
I,[responsible official],certifythat [recipient],whichhasfiftyormoreemployeesandisreceivingasingleawardorsubawardfor$25,000ormore,butlessthan
$500,000,hasformulatedanEEOPinaccordancewith28CFRpt.42,subpt.E.Ifurthercertifythatwithinthelasttwenty-fourmonths,theproperauthorityhasformulatedandsignedintoeffecttheEEOPand,asrequiredbyapplicablefederallaw,itisavailableforreviewbythepublic,employees,theappropriatestateplanningagency,andtheOfficeforCivilRights,OfficeofJusticePrograms,U.S.Departmentof Justice.The EEOPis on fileatthefollowingoffice:
[organization],
[address].
Printor Type Name andTitle Signature Date
SectionC—DeclarationStatingthat an EEOPUtilizationReport HasBeenSubmittedtotheOffice forCivilRights for Review
If arecipientagency has fiftyormore employees andis receiving asingle award or subaward of$500,000ormore,thenthe recipientagency mustsendanEEOPUtilizationReporttothe OCR for review.
I,[responsible official],certifythat [recipient],whichhasfiftyormoreemployeesandisreceivingasingleawardof$500,000ormore,hasformulatedanEEOPinaccordancewith28CFRpt.42,subpt.E,andsentitforreviewon [date]totheOfficeforCivilRights,Officeof JusticePrograms,U.S.DepartmentofJustice.
Printor Type Name andTitle Signature Date

INSTRUCTIONS

Completingthe CertificationForm

Compliance with the EqualEmployment OpportunityPlan(EEOP)Requirements

ThefederalregulationsimplementingtheOmnibusCrimeControlandSafeStreetsAct(SafeStreetsAct)of1968,asamended,requiresomerecipientsoffinancialassistancefromtheU.S.DepartmentofJusticesubjecttothestatute’sadministrativeprovisionstocreate,keeponfile,submittotheOfficeforCivilRights(OCR)attheOfficeofJusticePrograms(OJP)forreview,andimplementanEqualEmploymentOpportunityPlan(EEOP). See28C.F.R.pt.42,subpt.

E.AllawardsfromtheOfficeofCommunityOrientedPolicingServices(COPS)aresubjecttotheEEOPrequirements;manyawardsfromOJP,includingawardsfromtheBureauofJusticeAssistance(BJA),theOfficeofJuvenileJusticeandDelinquencyPrevention(OJJDP),andtheOfficeforVictimsofCrime(OVC)aresubjecttotheEEOPrequirements;andmanyawardsfromtheOfficeonViolenceAgainstWomen(OVW)arealsosubjecttotheEEOPrequirements.IfyouhaveanyquestionsastowhetheryourawardfromtheU.S.DepartmentofJusticeissubjecttotheSafeStreetsAct’sEEOP requirements,pleaseconsultyourgrantaward document,yourprogrammanager, orthe OCR.

Recipientsshould completeeitherSection Aor SectionBor Section C,notallthree.

Section A

TheregulationsexemptsomerecipientsfromalloftheEEOPrequirements.YourorganizationmayclaimanexemptionfromalloftheEEOPrequirementsifitmeetsanyofthefollowingcriteria:itisanonprofitorganization,aneducationalinstitution,amedicalinstitution,oranIndiantribe;oritreceivedanawardunder$25,000;orithaslessthanfiftyemployees. Toclaimthe completeexemptionfromthe EEOP requirements,completeSectionA.

Section B

Althoughtheregulationsrequiresomerecipientstocreate,maintainonfile,andimplementanEEOP,theregulationsallowsomerecipientstoforegosubmittingtheEEOPtotheOCRforreview.Recipientsthat(1)areaunitofstateorlocalgovernment,anagencyofstateorlocalgovernment,oraprivatebusiness;and(2)havefiftyormoreemployees;and(3)havereceivedasinglegrantawardof$25,000ormore,butlessthan$500,000,mayclaimthelimitedexemptionfromthesubmissionrequirementbycompletingSectionB.IncompletingSectionB,therecipientshouldnotethattheEEOP on filehasbeenpreparedwithintwenty-fourmonthsof the dateofthe mostrecentgrantaward.

Section C

Recipientsthat(1)areaunitofstateorlocalgovernment,anagencyofstateorlocalgovernment,oraprivatebusiness,and(2)havefiftyormoreemployees,and(3)havereceivedasinglegrantawardof$500,000ormore,mustprepare,maintainonfile,submittotheOCRforreview,andimplementanEEOP.RecipientsthathavesubmittedanEEOPUtilization Report(orintheprocessofsubmittingone)to theOCR,shouldcompleteSectionC.

SubmissionProcess

IfarecipientreceivesmultipleawardssubjecttotheSafeStreetsAct,therecipientshouldcompleteaCertificationFormforeachgrant.RecipientsshoulddownloadtheonlineCertificationForm,havetheappropriateofficialsignit,electronicallyscanthesigneddocument,andthensendthesigneddocumenttothefollowinge-mailaddress: .Thedocumentmusthavethefollowingtitle:EEOPCertification.IfyouhavequestionsaboutcompletingorsubmittingtheCertificationForm,pleasecontacttheOfficeforCivilRights,OfficeofJusticePrograms,810 7thStreet,NW,Washington, DC 20531 (Telephone: (202)307-0690 andTTY: (202)307-2027).

Public ReportingBurdenStatement

PaperworkReductionAct Notice. UnderthePaperworkReductionAct, a personis notrequiredtorespondto a collectionofinformationunlessitdisplays a currentvalidOMB controlnumber.Wetrytocreateforms andinstructionsthatareaccurate,can beeasilyunderstood,and whichimpose theleastpossibleburdenonyou to provideus withinformation.

Theestimatedminimumaveragetime to complete andfilethisapplicationis 20minutesperform.Ifyou have anycommentsregardingthe accuracyofthisestimate, orsuggestionsformakingthisformsimpler,you canwriteto theOfficeof JusticePrograms, 810 7thStreet,N.W.,Washington,D.C.20531.