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Lutheran Family Services in the Carolinas <br />ATTACHMENT F <br />CERTIFICATION REGARDING ENVIRONMENTAL TOBACCO SMOKE <br />Cabatrus Cowtty Department of Social Services <br />Certification for Contracts. Grants. Loans and Cooperative Agreements <br />Public Law 103-227, Part C-Environmental Tobacco Smoke, also known as the Pro- <br />Children Act of 1994 (Act), requires that smoking not be permitted in any portion of any <br />indoor facility owned or ]eased or contracted for by an entity and used routinely or <br />regularly for the provision of health, day care, education, or library services to children <br />under the age of 18, if the services are funded by Federal programs either directly or <br />through State or local goverruneuts, by Federal grant, contract, loan, or loan guarantee. <br />The law does not apply to children's services provided in private residences, facilities <br />funded solely by Medicare or Medicaid Funds, and portions of facilities used for inpatient <br />drug or alcohol treatment. Failure to comply with the provisions of the law may result in <br />the imposition of a civil monetary penalty of up to $1,000 per day and/or the imposition <br />of an administrative compliance order on the responsible entity. <br />By signing and submitting this application, the Contractor certifies that it will comply <br />with the requirements of the Act. The Contractor further agrees that it will require the <br />language of this certification be included in any subawards which contain provisions for <br />children's services and that all subgrantees shall certify accordingly. <br />Signature <br />Title <br />Lutheran Family Services in the Carolinas Q.) 7. U 7 <br />Agency/Organization Date <br />(Certification signature should be same as Contract signature) <br />(Federal Certification -Environmental Toobacco Smoke) (06/04) Page 1 of 1 <br />F- ~( <br />