Laserfiche WebLink
Affidavit <br />Under penalty of perjury, the undersigned officials certify that they have read and understand their obligations under <br />the Equitable Sharing Agreement and that the information submitted in conjunction with this Document is an accurate <br />accounting of funds received and spent by the Agency under the Justice and/or Treasury Guides during the reporting <br />period and that the recipient Agency is in compliance with the National Code of Professional Conduct for Asset Forfeiture. <br />The undersigned certify that the recipient agency is in compliance with the nondiscrimination requirements of the <br />following laws and their Department of Justice implementing regulations: Title VI of the Civil Rights Act of 1964 (42 U.S.C. <br />§ 2000d et seq.), Title IX of the Education Amendments of 1972 (20 U.S.C. § 1681 et seq.), Section 504 of the Rehabilitation <br />Act of 1973 (29 U.S.C. § 794), and the Age Discrimination Act of 1975 (42 U.S.C. § 6101 et seq.), which prohibit <br />discrimination on the basis of race, color, national origin, disability, or age in any federally assisted program or activity, or <br />on the basis of sex in any federally assisted education program or activity. <br />During the past fiscal year, has the Agency been part of any <br />proceedings alleging discrimination by the Agency? ~ Yes Q No <br />If you answered yes, complete Table H. Please disclose (1) all proceedings pending <br />before any court or administrative agency, (2) any nondiscrimination laws the <br />Agency has been found in violation of, and (3) any settlement agreements the <br />Agency has entered into during the last fiscal year. <br />Agency Head <br />t <br />Signature: ''~~ <br />Name: Wayn Wozni <br />Title: Chief of Police <br />Date: ,~~~f ` () <br />Final Instructions: <br />Governing Body Head <br /> .-, <br />; <br /> f, <br />'`` <br />''° 't`'~°--~--~~ <br />~°-~~ <br />Signature: ~ <br />. <br />-- <br />''~ : '" ; <br />Name: Kevin Kennedy <br />Title: Mayor <br />Date: ~ ~i:. l ', r f.:, , <br />Step 1: Click button to save in PDF format for your records <br />Step 2: Click button to save in XML format <br />Step 3: E-mail the XML file as attachment to aca.submitC~usdoj.gov <br />Step 4: Fax a signed copy of THIS PAGE ONLY to (202) 616-1344 <br />Note: The Agency will not be in compliance until the a-mail and the fax of this page are received. <br />FOR AGENCY USE ONLY <br />Entered by <br />Entered on <br />FY End: 12/31 /2009 <br />NCIC: OH0183400 Agency: North Olmsted Police Phone:440-777-3535 <br />State:OH Contact:Jamie Gallagher E-mail:gallagherjCmorth-olmsted.com <br />Page 5 of 5 March 2009 <br />Version 1.7 <br />