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Date Part B Page of EQUAL OPPORTUNITY EMPLOYMENT 6TATEKENT NA~E OF APPLICANT In carrying out the work of this this will Bid, Agency not discriminate against any employee or applicant for employment because of race,-color, religion, national origin, sex, age, handicap or political affiliations. The Agency will take affirmative action to ensure that applicants are employed, and that employees are treated during employment without regard to their race, color, religion, national origin, sex, age, handicap, or political affiliations. Such action willi include, but not be limited to, the following: employment, upgrading, demotion or transfer, recruitment or recruitment advertising, layoff or termination, rates of pay or other forms of compensation and selection for training, including apprenticeship. This Agency agrees to post in conspicuous places, available to all and employees applicants for employment, a notice of its non-discrimination policies. For positions paid wholly or in part by Older Americans Act funds, preference in hiring will be given to qualified persons 60 or older, subject to merit requirements, if applicable. This will, in all Solicitations Agency or advertisements for'employees placed by or on behalf of the Agency, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, sex, age, handicap or political affiliations. This Agency will incorporate the foregoing requirements of this paragraph in all subcontracts for services, should this Bid be accepted and funded. Date Authorized Signature {~resident, Cha~rm~n of Board, or comparable authorized official) Title of Full-time and Part-time Positions Total Number Proposed to be funded wholly or in-part with Older Proposed A~ericaDs Act Title I~I and N.C. State Funds 1991-92 Number of positions filled-by Minorities Number of positions filled by 60+ persons Number of positions filled by Women . /