RD 400-4 Assurance Agreement

The Rural Alaska Village Grant (RAVG) Program

RD400-4

State and Local Governments

OMB: 0572-0150

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Position 3
USDA
Form RD 400-4
(Rev. 06-10)

ASSURANCE AGREEMENT
(Under Title VI, Civil Rights Act of 1964)

FORM APPROVED
OMB No. 0575-0018
OMB No. 0570-0061
OMB No. 0570-0062
OMB No. 0572-0137

The
(name of recipient)

(address)

(''Recipient'' herein) hereby assures the U. S. Department of Agriculture that Recipient is in compliance with and will continue to comply
with Title VI of the Civil Rights Act of 1964 (42 USC 2000d et. seq.), 7 CFR Part 15, and Rural Housing Service, Rural BusinessCooperative Service, Rural Utilities Service, Risk Management Agency, or the Farm Service Agency, (hereafter known as the "Agency")
regulations promulgated thereunder, 7 C.F.R. § 1901.202. In accordance with that Act and the regulations referred to above, Recipient
agrees that in connection with any program or activity for which Recipient receives Federal financial assistance (as such term is defined
in 7 C.F.R. § 15.2) no person in the United States shall, on the ground of race, color, or national origin, be excluded from participation in,
be denied the benefits of, or be otherwise subjected to discrimination.
1. Recipient agrees that any transfer of any aided facility, other than personal property, by sale, lease or other conveyance of
contract, shall be, and shall be made expressly, subject to the obligations of this agreement and transferee's assumption thereof.
2. Recipient shall:
(a) Keep such records and submit to the Government such timely, complete, and accurate information as the Government may
determine to be necessary to ascertain our/my compliance with this agreement and the regulations.
(b) Permit access by authorized employees of the Agency or the U.S. Department of Agriculture during normal business
hours to such books, records, accounts and other sources of information and its facilities as may be pertinent to ascertaining
such compliance.
(c) Make available to users, participants, beneficiaries and other interested persons such information regarding the provisions
of this agreement and the regulations, and in such manner as the Agency or the U. S. Department of Agriculture finds necessary
to inform such persons of the protection assured them against discrimination.
3. The obligations of this agreement shall continue:
(a) As to any real property, including any structure, acquired or improved with the aid of the Federal financial assistance, so
long as such real property is used for the purpose for which the Federal financial assistance is made or for another purpose which
affords similar services or benefits, or for as long as the Recipient retains ownership or possession of the property, whichever is
longer.
(b) As to any personal property acquired or improved with the aid of the Federal financial assistance, so long as Recipient
retains ownership or possession of the property.
(c) As to any other aided facility or activity, until the last advance of funds under the loan or grant has been made.
4. Upon any breach or violation this agreement the Government may, at its option:
(a) Terminate or refuse to render or continue financial assistance for the aid of the property, facility, project, service or activity.
(b) Enforce this agreement by suit for specific performance or by any other available remedy under the laws of the United
States or the State in which the breach or violation occurs.
Rights and remedies provided for under this agreement shall be
cumulative.
In witness whereof,
(name of recipient)

on this

date has caused this agreement to be executed by its duly authorized officers and its seal affixed hereto, or, if a natural person, has
hereunto executed this agreement.
Recipient
(S E A L)
Date
Attest:
Title

Title

According to the Paperwork Reduction Act of I995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The
valid OMB control number for this information collection is 0575-0018, 0570-0061, 0570-0062 and 0572-0137. The time required to complete this information is
estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed,
and completing and reviewing the collection of information.

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File Created2013-11-22

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