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0 <br />(Name of Agency) <br />BY SIGNATURE, THE AUTHORIZED OFFICIAL AGREES AND ASSURES THAT: <br />1. Services will be provided in accordance with State and Federal laws, <br />rules and policies. <br />2. The agency will comply with State and Federal requirements for equal op- <br />portunity employment. <br />3, cThe agency will onfidentiality ocomply <br />client/patient information <br />requirements relating to <br />4. The privacy of the service recipient will be maintained. <br />ihout rgad to ae, sex* race, religion, <br />5 Servicemarital sstatus, parity, oorwill be provIded wpresenceoorrdegreegof disability except as <br />oth2rW1se required by law. <br />6. No residency requirements for services other than state residence, will <br />be imposed. <br />7. Services shall not be denied based on inability to pay. <br />p. Arrangements shall be made for communications to take place in a lan- <br />g�„ga undArgt.nnd by the recipient. <br />l provide services <br />th <br />andards <br />g the Minnesota lDepartment of Public nSafety niprogram <br />The agency andstandarrdsoftacceptedopro- <br />fessional groups. <br />10. The Minnesota Department of Public Safety will be provided, upon re- <br />quest, with one copy of any contract executed as part of the project. <br />11. The agency will report accomplishments of the project to the Executive <br />Director of the Children's Trust Fund. Such reports will be submitted <br />no 'later than 45 days after the completion of the grant year. The re- <br />ports shall be suitable for sharing of information with other projects. <br />12. Project funds shall not be used for programs and services involving ter- <br />tiary prevention. <br />