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DOEF 1600.5 OMB Contro~ 3 <br />~76-94 ) 191Q-L_.JC <br />All Other Editions Are Obsolete <br /> <br />The applicant agrees to submit requested data to the Department of Energy regarding programs and activities developed by the <br />Applicant from the use of Federal assistance funds extended by the Department of Energy. Facilities of the Applicant (including the~ <br />physical plants, buildings, or other structures) and all records, books, accounts and other sources of information pertinent to the <br />Applicant's compliance with the civil dghts laws shall be made available for inspection during normal business hours of request of an <br />officer or employee of the Department of Energy specifically authorized to make such inspections. Instructions in this regard will be <br />provided by the Director, Office of Civil Rights, U.S. Department of Energy. <br /> <br />This assurance is given in consideration of and for the purpose of obtaining any and all Federal grants, loans, contracts (excluding <br />procurement contracts), property, discounts or other Federal assistance extended after the date hereof, to the Applicants by the <br />Department of Energy, including installment payments on account after such data of application for Federal assistance which are <br />representations and agreements made in this assurance, and that the United States shall have the dght to seek iudicial enforcement ~f <br />this assurance. This assurance is binding on the Applicant, the successors, transferees, and assignees, as well as the person(s) <br />whose signatures appear below and who are authorized to sign this assurance on behalf of the Applicant. <br /> <br />Applicant Certification <br /> <br />The Applicant certifies that it has complied, or that, within 90 days of the date of the grant, it will comply with all applicable requireme'~s <br />of 10 C.F.R. § 1040.5 (a copy will be furnished to the Applicant upon wdtten request to DOE).. <br /> <br />Designated Responsible Employee <br /> <br />(704) 633-6633 <br /> <br />Name and Title Printed or Typed) <br />Signature <br /> <br />Telephone Number <br />Date <br /> <br />CABARRUS COUNTY DEPARTMENT OF <br />AGING <br /> <br />Applicant's Name <br /> <br />331 CORBAN AVENUE <br />CONCORD, NORTH CAROLINA 28025 <br /> <br />(704) 788-9899 <br /> <br />Telephone Number <br /> <br />Address Date <br /> <br />Authorized Official: <br />President, Chief Executive Officer <br />or Authorized Designee <br /> <br />Name and Title (Printed or Typed) <br />Executive Director <br /> <br />Signature <br /> <br />Telephone Number <br />(704) 788-9899 <br /> <br />Date <br /> <br /> <br />