92434-CA r Owner Certifications- Section 811 Program

OWNER CERTIFICATIONS SECTION 811 PROGRAM

U.S. Department of Housing
and Urban Development
Office of Housing
Federal Housing Commissioner

OMB Control NO. 2502-0470
(exp. 8/31/2013)

Public reporting burden for this collection of information is estimated to average 0.5 hour (30 minutes) per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintain the data needed, and completing and reviewing the collection
of information. HUD may not collect this information and you are not required to complete this form, unless it displays a currently valid OMB
control number.
This information collection is necessary to ensure that viable projects are developed. It is important to obtain information from
applicants to assist HUD in determining if nonprofit organizations initially funded continue to have the financial and
administrative capacity needed to develop a project and that the project design meets the needs of the residents. The
Department will use this information to determine if the project meets statutory requirements with respect to the development
and operation of the project, as well as ensuring the continued marketability of the project. This information is required in
order to obtain benefits. This information is considered non-sensitive and no assurance of confidentiality is provided.

The Owner, to the best of its knowledge and belief, hereby assures and certifies that it will comply with respect to the following:
1.

CERTIFICATION IN CONNECTION WITH THE DEVELOPMENT AND OPERATION OF A SECTION 811
SUPPORTIVE HOUSING FOR PERSONS WITH DISABILITIES PROJECT:
The Fair Housing Act (42 U.S.C. 3601–19) and implementing regulations at 24 CFR part 100 et seq.; Executive Order 11063,
as amended by Executive Order 12259 (3 CFR, 1959–1963 Comp., p. 652 and 3 CFR, 1980 Comp., p. 307) (Equal
Opportunity in Housing Programs) and implementing regulations at 24 CFR part 107; title VI of the Civil Rights Act of 1964
(42 U.S.C. 2000d-2000d-4) (Nondiscrimination in Federally Assisted Programs) and implementing regulations at 24 CFR part
1; the Age Discrimination Act of 1975 (42 U.S.C. 6101–6107) and implementing regulations at 24 CFR part 146; section 504
of the Rehabilitation Act of 1973 (29 U.S.C. 794) and implementing regulations at part 8 of this title; title II of the Americans
with Disabilities Act, 42 U.S.C. 12101 et seq.; 24 CFR part 8; Executive Order 11246, as amended by Executive Orders
11375, 11478, 12086, and 12107 (3 CFR, 1964–1965 Comp., p. 339; 3 CFR, 1966–1970 Comp., p. 684; 3 CFR, 1966–1970
Comp., p. 803; 3 CFR, 1978 Comp., p. 230; and 3 CFR, 1978 Comp., p. 264, respectively) (Equal Employment Opportunity
Programs) and implementing regulations at 41 CFR chapter 60; Executive Order 11625, as amended by Executive Order
12007 (3 CFR, 1971–1975 Comp., p. 616 and 3 CFR, 1977 Comp., p. 139) (Minority Business Enterprises); Executive Order
12432 (3 CFR, 1983 Comp., p. 198) (Minority Business Enterprise Development); and Executive Order 12138, as amended by
Executive Order 12608 (3 CFR, 1977 Comp., p. 393 and 3 CFR, 1987 Comp., p. 245) (Women's Business Enterprise); the
Violence Against Women Act (VAWA) requirements set forth in 24 CFR Part 5, subpart L; and other applicable federal, state,
and local laws prohibiting discrimination and promoting equal opportunity.

2.

DRUG-FREE WORKPLACE ACT
Provide drug-free workplaces in accordance with the Drug-Free Workplace Act of 1988 (41 U.S.C. 701) by:
a.

publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing,
possession, or use of a controlled substance is prohibited in the sponsor's workplace and specifying the
actions that will be taken against employees for violation of such prohibition;

b.

establishing an ongoing drug-free awareness program to inform employees about - (l) the
dangers of drug abuse in the workplace;
(2) the sponsor's policy of maintaining a drug-free workplace;
(3) any available drug counseling, rehabilitation, and employee assistance programs; and
(4) the penalties that may be imposed upon employees for drug abuse violations occurring in the
workplace;

c.

making it a requirement that each employee to be engaged in the performance of the capital advance be given a copy
of the statement required by paragraph (a);

d.

notifying the employee in the statement required by paragraph (a) that, as a condition of employment under the
capital advance, the employee will (1) abide by the terms of the statement; and
(2) notify the employer in writing of his or her conviction for violation of a criminal drug statute occurring in the
workplace no later than five calendar days after such conviction;

e.

notifying HUD in writing, within ten calendar days after receiving notice under subparagraph (d)(2) from an
employee or otherwise receiving actual notice of such conviction.

f.

taking one of the following actions, within 30 calendar days of receiving notice under subparagraph (d) (2), with
respect to any employee who is so convicted (1) taking appropriate personnel action against such an employee, up to and including termination,
consistent with the requirements of the Rehabilitation Act of 1973, as amended; or
(2)

3.

requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation
program approved for such purposes by a Federal, State, or local health, law enforcement, or
other appropriate agency;

g.

making a good faith effort to continue to maintain a drug-free workplace through implementation of
paragraphs (a), (b), (c), (d), (e) and (f);

h.

providing the street address, city, county, state, and zip code for the site or sites where the performance of work in
connection with the grant will take place.

DESIGN AND CONSTRUCTION STANDARDS
It will comply with HUD's design and construction standards, the Uniform Federal Accessibility Standards and
HUD's implementing regulations at 24 CFR part 40, Section 504 of the Rehabilitation Act of 1973 and HUD's
implementing regulations at 24 CFR part 8, and for covered multifamily dwellings designed and constructed for first
occupancy after March 13,1991, the design and construction requirements of the Fair Housing Act of 1988 and
HUD's implementing regulations at 24 CFR part 100, and the Americans with Disabilities Act of 1990. In addition,

it must certify compliance with the Architectural Barriers Act of 1968 and its implementing regulations at 24 CFR
Part 40.

4.

ACQUISITION AND RELOCATION
It will comply (or has complied) with the acquisition and relocation requirements of the Uniform Relocation Assistance and
Real Property Acquisition Policies Act of 1970, as amended (URA), implemented by regulations at 49 CFR part 24, and 24
CFR § 891.155(e).
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5.

LEAD-BASED PAINT POISONING PREVENTION ACT
It will comply with the requirements of the Lead-Based Paint Poisoning Prevention Act (42 U.S.C. 4821-4846) and
implementing regulations at 24 CFR part 35 (except as superseded in § 891.325(b).

6.

DAVIS-BACON
It will comply with the Davis-Bacon Requirements and the Contract Work Hours and Safety Standards Act.

7.

FLOOD DISASTER PROTECTION ACT OF 1973
It will comply with the requirements under the Flood Disaster Protection Act of 1973 (42 U.S.C. 4001-4128) and the
Coastal Barrier Resources Act (16 U.S.C. 3601).

8.

NATIONAL ENVIRONMENTAL POLICY ACT
It will comply with the National Environmental Policy Act of 1969 (NEPA) (42 U.S.C. 4321) and applicable related
environmental authorities at 24 CFR Part 50.4 and HUD's implementing regulations at 24 CFR Part 50.

9.

CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND COOPERATIVE AGREEMENTS
No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or
employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal
contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative
agreement, and the extension, continuation, renewal, amendment or modification of any Federal contract, grant,
loan, or cooperative agreement.
If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of
Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or
cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to
Report Lobbying," in accordance with its instructions.
The undersigned shall require that the language of this certification be included in the award documents for all
subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative
agreements) and that all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was
made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction
imposed by section 1352, title 31, U.S.Code. Any person who fails to file the required certification shall be subject
to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

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10.

COMPLIANCE WITH OMB CIRCULAR A-129
It has complied with OMB Circular A-129, Managing Federal Credit Programs, and that it has been unable to
obtain the necessary funds to develop the project from private sources upon terms and conditions equally
favorable as the terms and conditions available under the Section 811 program.

11.

CERTIFICATION REGARDING RESIDENTS' ACCEPTANCE OF SUPPORTIVE SERVICES The
owner certifies that it will not require residents to accept any supportive services as a condition of occupancy.

12 .

TRUTH AND ACCURACY
It certifies that the information provided to HUD in its application under the Section 811 Supportive Housing for Persons
with Disabilities is true and accurate, to the best of its knowledge.

Signature of Authorized Certifying Official

Title

Owner Organization

Date

WARNING
I/We, the undersigned, certify under penalty of perjury that the information provided above is true and correct.
WARNING: Anyone who knowingly submits a false claim or makes a false statement is subject to criminal and/
or civil penalties, including confinement for up to 5 years, fines, and civil and administrative penalties.
(18 U.S.C. §§ 287, 1001, 1010, 1012, 1014; 31 U.S.C. §3729, 3802)

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