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<br />TEXAS TRt, ,:IC SAFETY PROGRAM r.ONTh .;T
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<br />RE.PRE:)E:t~T A1IONS, CERTIFICATIONS: AND ACKNOWLEDGMENTS
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<br />CONIII-JGlNT FEl (check ~lDprOprlale boxes)
<br />rhe con\lar;tor If:pri)sel1ts (a) that il ['\ 11as,IK has not, employed or retamed any company or pe'son (olher
<br />thal1 a tull.time hona tide employee working solely tor the offeror) to solicit or secure this contract, and (b) (hat It
<br />i' has,:X has 1101. pa"j or agrp.ed to pay any company or person (other \l1an a fulHime bona fide employee
<br />wofl.<lnO solely 1011h~ cOllha(101) ~nv fef!. commISSion. percenlagc. or brokerage fee contingent upon or result-
<br />ing 110m the aWilld 01 1I1Is contract: and i1[jrCflS to fUrlllsh informalron r8latmq to (a) ancJ (b) interpretation oJf the
<br />representalion, mcludmg Ih8tell1l "bona fide employee", see Code 01 Feljeral Regulations, Title 41, Chapter "
<br />Subpart!- 15)
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<br />II. EOUAL OPf'ORlUNITY (check apPlOprtate boxes)
<br />The contractor rP.lHesents that'tl)(.., has, [J has not, participated in a PICVIOUS contract or subcontract subject
<br />elthel to Ih" E'lUdl Opportunity clause herein or the clause ori:)inally conlaoned in Section 301 of Executive
<br />Orde' 10925, (Jr the cl~US8 contamecl on Section 201 of Executive Order No. 11114: thai it I)Q. has, [J has not.
<br />filed all requllcd compliance reports: and Ihat representatJons, Indicating submission 01 required complIance
<br />reports. slgl1ed by proposed suhcontractors, will be oblained prior to subcontract awards
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<br />III AFFlliMATlVE ACTIOI~ PROGRAM (check appropriate box)
<br />ftle contractor represents that (1) it ~ has developed and has on tile [] has not developed and does not have
<br />or. Ille at each l:stabllShmf:nt affirmative action programs as reQuire(] by the rules and regulations of Ihe Secre-
<br />tary of Labor 141 CFR 60,1 and 60,2), 0r (2) It [] has not previously bad contracts subject to the wlitten affirm-
<br />ative actIon program requllement of the rules and regulations of the Secretary of LaMr,
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<br />IV CER11FICATION OF ~JOI'JSEGREGATED FACILITIES
<br />The contractor ccrtil,cs ihallt (Ioes not maintaIn or provide for employees'tacilltles which are segregate(j on th~
<br />baSIS 0.1 r ace, color, religIon ,ex or national Orlgll1, whether such facilities are segregated by directIve or on a de
<br />facto baSiS The offclOr furtlwr agrees that he '.'1111 not maontaon SUCh segregated lacilihes
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<br />V ThC' c~ollacl recipient "grelos as a necessary cond,tlon for reimbursement 01 costs, to prepare monthly andloc
<br />Quarterly progless reports In a timely mannel, and In accordance with mstructlons furnished by the Texas
<br />Olllce of TraffiC Safety
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<br />VI CLF AN AIR ACT COMPLlI\NCE
<br />For all contracts In excess nt S 100,000, the lecipient agrees 10 comply wllh all applicable standards, crders, or
<br />legul~II")ns ISc,lJecl PIJ";IJ<l"IIC the Cle'/Il All Act ot 1970, Vlotations shall be repacted to OTS and the Hegional
<br />011lC8 01 the Envllonrner,tal P,ulection Agency
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<br />VII PRINCIPAL PLACE OF rEHFORMANCE'
<br />The 'ocation 01 the plant 01 place ot bUSIness where the item(s) will be prOduced or the prmcipal services '.'1111
<br />be performed under the contr~ct IS
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<br />CITY __~~Il_, ~la~C?S
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<br />.._.__COUNTY~X~_STATE___.1'e}~
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<br />Vllt ASSUI1ANCE The cOl1trJr.t /fJClplenl hll'eby assures compliance '.'11th all telms, conditions and general and
<br />speCial prOVISions for th,:; contract, including attachments,
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<br />~ CONTRAcrOR"S PROJc.(T DIRECOR
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<br />DAT'E
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