Letter-of-IntentDocuSign Envelope ID: E3BB5C94-006F-489E-810E-8388E40DE3A3
Aft
Washington State
VAf Department of Transportation Appendix 28.92
Letter of Intent to Comply with WSDOT Title VI Plan
In lieu of adopting a Title VI Plan, the City of Port Orchard agrees to comply with the WSDOT Title VI Plan.
The City of Port Orchard assures that no person shall on the grounds of race, color, or national origin,
as provided by Title VI of the Civil Rights Act of 1964, and the Civil Rights Restoration Act of 1987 (P.L. 100.259) be excluded
from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any program or activity. The
City of Port Orchard further assures every effort will be made to ensure nondiscrimination in all of its programs
and activities, whether those programs and activities are federally funded or not.
The Civil Rights Restoration Act of 1987, broadened the scope of Title VI coverage by expanding the definition of terms "programs
or activities" to include all programs or activities of federal aid recipients, sub -recipients, and contractors/consultants, whether such
programs and activities are federally assisted or not (Public Law 100259 [S.557] March 22, 1988).
In the event the City of Port Orchard distributes federal aid funds to a sub -recipient, the
City of Port orchard of will include Title VI language in all written agreements and will monitor for compliance.
The City of Port Orchard is responsible for initiating and monitoring Title VI activities, collecting data, preparing
reports (including Appendix 28.93) and other responsibilities as required by 23 Code of Federal Regulation(CFR) 200 and 49 Code of
Federal Regulation, WSDOT Title VI Plan, and the WSDOT Local Area Guidelines manual.
�DocuSignedb11y:
bt V P4Mt&SW, ,
Signature
Ma)
Title
Tony Lang, Public Works Director
Name and Title of Public Works/Transportation Manager
Brandy Wallace, City Clerk
Name and Title of Title VI Coordinator
Required Attachment: signed, unaltered USDOT1050.2a, Standard Title VI Assurances
10/25/2022
Date Executed
publicworks(a�-portorchardwa.gov
Email Address
cityclerk(cD-portorchardwa.gov
Email Address
DOT Form App 28.92
Revised 01/2022
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The United States Department of Transportation (USDOT) Standard Title VI/Non-Discrimination
Assurances
DOT Order No. 1050.2A
The City of Port Orchard (herein referred to as the "Recipient"), HEREBY AGREES THAT, as a condition to
receiving any Federal financial assistance from the U.S. Department of Transportation (DOT), through
Washington State Department of Transportation (WSDOT), is subject to and will comply with the
following:
Statutory/Regulatory Authorities
Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000d et seq., 78 stat. 252), (prohibits
discrimination on the basis of race, color, national origin);
49 C.F.R. Part 21 (entitled Non-discrimination In Federally -Assisted Programs Of The Department
Of Transportation -Effectuation Of Title VI Of The Civil Rights Act Of 1964);
28 C.F.R. section 50.3 (U.S. Department of Justice Guidelines for Enforcement of Title VI of the
Civil Rights Act of 1964);
The preceding statutory and regulatory cites hereinafter are referred to as the "Acts" and "Regulations,"
respectively.
General Assurances
In accordance with the Acts, the Regulations, and other pertinent directives, circulars, policy,
memoranda, and/or guidance, the Recipient hereby gives assurance that it will promptly take any
measures necessary to ensure that:
"No person in the United States shall, on the grounds of race, color, or national origin, be
excluded from participation in, be denied the benefits of, or be otherwise subjected to
discrimination under any program or activity, 'for which the Recipient receives Federal
financial assistance from DOT, including the Washington State Department of
Transportation.
The Civil Rights Restoration Act of 1987 clarified the original intent of Congress, with respect to Title VI
and other Non-discrimination requirements (The Age Discrimination Act of 1975, and Section 504 of the
Rehabilitation Act of 1973), by restoring the broad, institutional -wide scope and coverage of these non-
discrimination statutes and requirements to include all programs and activities of the Recipient, so long
as any portion of the program is Federally assisted.
Specific Assurances
More specifically, and without limiting the above general Assurance, the Recipient agrees with and gives
the following Assurances with respect to its Federally assisted program:
1. The Recipient agrees that each "activity," "facility," or "program," as defined in §§ 21.23(b) and
21.23(e) of 49 C.F.R. § 21 will be (with regard to an "activity") facilitated, or will be (with regard
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to a "facility") operated, or will be (with regard to a "program") conducted in compliance with all
requirements imposed by, or pursuant to the Acts and the Regulations.
2. The Recipient will insert the following notification in all solicitations for bids, Requests For
Proposals for work, or material subject to the Acts and the Regulations made in connection with
all Federal -Aid Highway Programs and, in adapted form, in all proposals for negotiated
agreements regardless of funding source:
"The City of Port Orchard, in accordance with the provisions of Title VI of the
Civil Rights Act of 1964 (78 Stat. 252, 42 U.S.C. §§ 2000d to 2000d-4) and the
Regulations, hereby notifies all bidders that it will affirmatively ensure that any
contract entered into pursuant to this advertisement, disadvantaged business
enterprises will be afforded full and fair opportunity to submit bids in response
to this invitation and will not be discriminated against on the grounds of race,
color, or national origin in consideration for an award."
3. The Recipient will insert the clauses of Appendix A and E of this Assurance in every contract or
agreement subject to the Acts and the Regulations.
4. The Recipient will insert the clauses of Appendix B of this Assurance, as a covenant running with
the land, in any deed from the United States effecting or recording a transfer of real property,
structures, use, or improvements thereon or interest therein to a Recipient.
5. That where the Recipient receives Federal financial assistance to construct a facility, or part of a
facility, the Assurance will extend to the entire facility and facilities operated in connection
therewith.
6. That where the Recipient receives Federal financial assistance in the form, or for the acquisition
of real property or an interest in real property, the Assurance will extend to rights to space on,
over, or under such property.
7. That the Recipient will include the clauses set forth in Appendix C and Appendix D of this
Assurance, as a covenant running with the land, in any future deeds, leases, licenses, permits, or
similar instruments entered into by the Recipient with other parties:
a. for the subsequent transfer of real property acquired or improved under the applicable
activity, project, or program; and
b. for the construction or use of, or access to, space on, over, or under real property acquired
or improved under the applicable activity, project, or program.
8. That this Assurance obligates the Recipient for the period during which Federal financial
assistance is extended to the program, except where the Federal financial assistance is to
provide, or is in the form of, personal property, or real property, or interest therein, or
structures or improvements thereon, in which case the Assurance obligates the Recipient, or
any transferee for the longer of the following periods:
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a. the period during which the property is used for a purpose for which the Federal financial
assistance is extended, or for another purpose involving the provision of similar services or
benefits; or
b. the period during which the Recipient retains ownership or possession of the property.
9. The Recipient will provide for such methods of administration for the program as are found by
the Secretary of Transportation or the official to whom he/she delegates specific authority to
give reasonable guarantee that it, other recipients, sub -recipients, sub -grantees, contractors,
subcontractors, consultants, transferees, successors in interest, and other participants of
Federal financial assistance under such program will comply with all requirements imposed or
pursuant to the Acts, the Regulations, and this Assurance.
10. The Recipient agrees that the United States has a right to seek judicial enforcement with regard
to any matter arising under the Acts, the Regulations, and this Assurance.
By signing this ASSURANCE, the City of Port Orchard also agrees to comply (and require any sub -
recipients, sub -grantees, contractors, successors, transferees, and/or assignees to comply) with all
applicable provisions governing the [the City of Port Orchard] access to records, accounts, documents,
information, facilities, and staff. You also recognize that you must comply with any program or
compliance reviews, and/or complaint investigations conducted by the [the City of Port Orchard]. You
must keep records, reports, and submit the material for review upon request to [the City of Port
Orchard, or its designee in a timely, complete, and accurate way. Additionally, you must comply with all
other reporting, data collection, and evaluation requirements, as prescribed by law or detailed in
program guidance.
[The City of Port Orchard] gives this ASSURANCE in consideration of and for obtaining any Federal
grants, loans, contracts, agreements, property, and/or discounts, or other Federal -aid and Federal
financial assistance extended after the date hereof to the recipients by the U.S. Department of
Transportation under the Federal Highway Administration. This ASSURANCE is binding on Washington
State Department of Transportation, other recipients, sub -recipients, sub -grantees, contractors,
subcontractors and their subcontractors', transferees, successors in interest, and any other participants
in the Federal -Aid Highway Program. The person(s) signing below is authorized to sign this ASSURANCE
on behalf of the Recipient.
City of Port Orchard
(Name of Recipient)
by Fned by:
r;(�PLv-t'SW'
(Signature of Authorized Official)
DATED May 2, 2022
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APPENDIX A
During the performance of this contract, the contractor, for itself, its assignees, and successors in
interest (hereinafter referred to as the "contractor") agrees as follows:
Compliance with Regulations: The contractor (hereinafter includes consultants) will comply
with the Acts and the Regulations relative to Non-discrimination in Federally -assisted programs
of the U.S. Department of Transportation, Washington State Department of Transportation, as
they may be amended from time to time, which are herein incorporated by reference and made
a part of this contract.
Non-discrimination: The contractor, with regard to the work performed by it during the
contract, will not discriminate on the grounds of race, color, or national origin in the selection
and retention of subcontractors, including procurements of materials and leases of equipment.
The contractor will not participate directly or indirectly in the discrimination prohibited by the
Acts and the Regulations, including employment practices when the contract covers any activity,
project, or program set forth in Appendix B of 49 CFR Part 21.
Solicitations for Subcontracts, Including Procurements of Materials and Equipment: In all
solicitations, either by competitive bidding, or negotiation made by the contractor for work to
be performed under a subcontract, including procurements of materials, or leases of
equipment, each potential subcontractor or supplier will be notified by the contractor of the
contractor's obligations under this contract and the Acts and the Regulations relative to Non-
discrimination on the grounds of race, color, or national origin.
4. Information and Reports: The contractor will provide all information and reports required by
the Acts, the Regulations, and directives issued pursuant thereto and will permit access to its
books, records, accounts, other sources of information, and its facilities as may be determined
by the Recipient or the Washington State Department of Transportation to be pertinent to
ascertain compliance with such Acts, Regulations, and instructions. Where any information
required of a contractor is in the exclusive possession of another who fails or refuses to furnish
the information, the contractor will so certify to the Recipient or the Washington State
Department of Transportation, as appropriate, and will set forth what efforts it has made to
obtain the information.
Sanctions for Noncompliance: In the event of a contractor's noncompliance with the Non-
discrimination provisions of this contract, the Recipient will impose such contract sanctions as it
or the Washington State Department of Transportation may determine to be appropriate,
including, but not limited to:
a. withholding payments to the contractor under the contract until the contractor complies;
and/or
b. cancelling, terminating, or suspending a contract, in whole or in part.
6. Incorporation of Provisions: The contractor will include the provisions of paragraphs one
through six in every subcontract, including procurements of materials and leases of equipment,
A
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unless exempt by the Acts, the Regulations and directives issued pursuant thereto. The
contractor will take action with respect to any subcontract or procurement as the Recipient or
the Washington State Department of Transportation may direct as a means of enforcing such
provisions including sanctions for noncompliance. Provided, that if the contractor becomes
involved in, or is threatened with litigation by a subcontractor, or supplier because of such
direction, the contractor may request the Recipient to enter into any litigation to protect the
interests of the Recipient. In addition, the contractor may request the United States to enter
into the litigation to protect the interests of the United States.
A
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APPENDIX B
CLAUSES FOR DEEDS TRANSFERRING UNITED STATES PROPERTY
The following clauses will be included in deeds effecting or recording the transfer of real property,
structures, or improvements thereon, or granting interest therein from the United States pursuant to
the provisions of Assurance 4:
NOW, THEREFORE, the U.S. Department of Transportation as authorized by law and upon the condition
that the (the City of Port Orchard) will accept title to the lands and maintain the project constructed
thereon in accordance with Title 23, United States Code, the Regulations for the Administration of
Washington State Department of Transportation, and the policies and procedures prescribed by the
Federal Highway Administration of the U.S. Department of Transportation in accordance and in
compliance with all requirements imposed by Title 49, Code of Federal Regulations, U.S. Department of
Transportation, Subtitle A, Office of the Secretary, Part 21, Non-discrimination in Federally -assisted
programs of the U.S Department of Transportation pertaining to and effectuating the provisions of Title
VI of the Civil Rights Act of 1964 (78 Stat. 252; 42 U.S.C. § 2000d to 2000d-4), does hereby remise,
release, quitclaim and convey unto the (the City of Port Orchard) all the right, title and interest of the
U.S. Department of Transportation in and to said lands described in Exhibit A attached hereto and made
a part hereof.
(HABENDUM CLAUSE)
TO HAVE AND TO HOLD said lands and interests therein unto the City of Port Orchard and its successors
forever, subject, however, to the covenants, conditions, restrictions and reservations herein contained
as follows, which will remain in effect for the period during which the real property or structures are
used for a purpose for which Federal financial assistance is extended or for another purpose involving
the provision of similar services or benefits and will be binding on the (the City of Port Orchard, its
successors and assigns.
The the City of Port Orchard, in consideration of the conveyance of said lands and interests in lands,
does hereby covenant and agree as a covenant running with the land for itself, its successors and
assigns, that (1) no person will on the grounds of race, color, or national origin, be excluded from
participation in, be denied the benefits of, or be otherwise subjected to discrimination with regard to
any facility located wholly or in part on, over, or under such lands hereby conveyed [,] [and]* (2) that the
(the City of Port Orchard will use the lands and interests in lands and interests in lands so conveyed, in
compliance with all requirements imposed by or pursuant to Title 49, Code of Federal Regulations, U.S.
Department of Transportation, Subtitle A, Office of the Secretary, Part 21, Non-discrimination in
Federally -assisted programs of the U.S. Department of Transportation, Effectuation of Title VI of the Civil
Rights Act of 1964, and as said Regulations and Acts may be amended [, and (3) that in the event of
breach of any of the above -mentioned non-discrimination conditions, the Department will have a right
to enter or re-enter said lands and facilities on said land, and that above described land and facilities will
thereon revert to and vest in and become the absolute property of the U.S. Department of
Transportation and its assigns as such interest existed prior to this instruction].*
(*Reverter clause and related language to be used only when it is determined that such a clause is
necessary in order to make clear the purpose of Title VI.)
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APPENDIX C
CLAUSES FOR TRANSFER OF REAL PROPERTY ACQUIRED OR IMPROVED UNDER THE ACTIVITY,
FACILITY, OR PROGRAM
The following clauses will be included in deeds, licenses, leases, permits, or similar instruments entered
into by the (the City of Port Orchard pursuant to the provisions of Assurance 7(a):
A. The (grantee, lessee, permittee, etc. as appropriate) for himself/herself, his/her heirs, personal
representatives, successors in interest, and assigns, as a part of the consideration hereof, does
hereby covenant and agree [in the case of deeds and leases add "as a covenant running with the
land"] that:
In the event facilities are constructed, maintained, or otherwise operated on the property
described in this (deed, license, lease, permit, etc.) for a purpose for which a U.S. Department of
Transportation activity, facility, or program is extended or for another purpose involving the
provision of similar services or benefits, the (grantee, licensee, lessee, permittee, etc.) will
maintain and operate such facilities and services in compliance with all requirements imposed
by the Acts and Regulations (as may be amended) such that no person on the grounds of race,
color, or national origin, will be excluded from participation in, denied the benefits of, or be
otherwise subjected to discrimination in the use of said facilities.
B. With respect to licenses, leases, permits, etc., in the event of breach of any of the above Non-
discrimination covenants, the City of Port Orchard will have the right to terminate the (lease,
license, permit, etc.) and to enter, re-enter, and repossess said lands and facilities thereon, and hold
the same as if the (lease, license, permit, etc.) had never been made or issued.*
C. With respect to a deed, in the event of breach of any of the above Non-discrimination covenants,
the (the City of Port Orchard will have the right to enter or re-enter the lands and facilities thereon,
and the above described lands and facilities will there upon revert to and vest in and become the
absolute property of the (the City of Port Orchard) and its assigns.*
(*Reverter clause and related language to be used only when it is determined that such a clause is
necessary to make clear the purpose of Title VI.)
C
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APPENDIX D
CLAUSES FOR CONSTRUCTION/USE/ACCESS TO REAL PROPERTY ACQUIRED UNDER THE ACTIVITY,
FACILITY OR PROGRAM
The following clauses will be included in deeds, licenses, permits, or similar instruments/agreements
entered into by (the City of Port Orchard pursuant to the provisions of Assurance 7(b):
A. The (grantee, licensee, permittee, etc., as appropriate) for himself/herself, his/her heirs, personal
representatives, successors in interest, and assigns, as a part of the consideration hereof, does
hereby covenant and agree (in the case of deeds and leases add, "as a covenant running with the
land") that (1) no person on the ground of race, color, or national origin, will be excluded from
participation in, denied the benefits of, or be otherwise subjected to discrimination in the use of
said facilities, (2) that in the construction of any improvements on, over, or under such land, and the
furnishing of services thereon, no person on the ground of race, color, or national origin, will be
excluded from participation in, denied the benefits of, or otherwise be subjected to discrimination,
(3) that the (grantee, licensee, lessee, permittee, etc.) will use the premises in compliance with all
other requirements imposed by or pursuant to the Acts and Regulations, as amended, set forth in
this Assurance.
B. With respect to (licenses, leases, permits, etc.), in the event of breach of any of the above Non-
discrimination covenants, (the City of Port Orchard) will have the right to terminate the (license,
permit, etc., as appropriate) and to enter or re-enter and repossess said land and the facilities
thereon, and hold the same as if said (license, permit, etc., as appropriate) had never been made or
issued.*
C. With respect to deeds, in the event of breach of any of the above Non-discrimination covenants,
(the City of Port Orchard will there upon revert to and vest in and become the absolute property of
(the City of Port Orchard and its assigns.*
(*Reverter clause and related language to be used only when it is determined that such a clause is
necessary to make clear the purpose of Title VI.)
110
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APPENDIX E
During the performance of this contract, the contractor, for itself, its assignees, and successors in
interest (hereinafter referred to as the "contractor") agrees to comply with the following non-
discrimination statutes and authorities; including but not limited to:
Pertinent Non -Discrimination Authorities:
• Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000d et seq., 78 stat. 252), (prohibits
discrimination on the basis of race, color, national origin); and 49 CFR Part 21.
• The Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, (42 U.S.C.
§ 4601), (prohibits unfair treatment of persons displaced or whose property has been acquired
because of Federal or Federal -aid programs and projects);
• Federal -Aid Highway Act of 1973, (23 U.S.C. § 324 et seq.), (prohibits discrimination on the basis
of sex);
• Section 504 of the Rehabilitation Act of 1973, (29 U.S.C. § 794 et seq.), as amended, (prohibits
discrimination on the basis of disability); and 49 CFR Part 27;
• The Age Discrimination Act of 1975, as amended, (42 U.S.C. § 6101 et seq.), (prohibits
discrimination on the basis of age);
• Airport and Airway Improvement Act of 1982, (49 USC § 471, Section 47123), as amended,
(prohibits discrimination based on race, creed, color, national origin, or sex);
• The Civil Rights Restoration Act of 1987, (PL 100-209), (Broadened the scope, coverage and
applicability of Title VI of the Civil Rights Act of 1964, The Age Discrimination Act of 1975 and
Section 504 of the Rehabilitation Act of 1973, by expanding the definition of the terms
"programs or activities" to include all of the programs or activities of the Federal -aid recipients,
sub -recipients and contractors, whether such programs or activities are Federally funded or
not);
• Titles II and III of the Americans with Disabilities Act, which prohibit discrimination on the basis
of disability in the operation of public entities, public and private transportation systems, places
of public accommodation, and certain testing entities (42 U.S.C. §§ 12131-12189) as
implemented by Department of Transportation regulations at 49 C.F.R. parts 37 and 38;
• The Federal Aviation Administration's Non-discrimination statute (49 U.S.C. § 47123) (prohibits
discrimination on the basis of race, color, national origin, and sex);
• Executive Order 12898, Federal Actions to Address Environmental Justice in Minority
Populations and Low -Income Populations, which ensures Non-discrimination against minority
populations by discouraging programs, policies, and activities with disproportionately high and
adverse human health or environmental effects on minority and low-income populations;
• Executive Order 13166, Improving Access to Services for Persons with Limited English
Proficiency, and resulting agency guidance, national origin discrimination includes discrimination
because of Limited English proficiency (LEP). To ensure compliance with Title VI, you must take
reasonable steps to ensure that LEP persons have meaningful access to your programs (70 Fed.
Reg. at 74087 to 74100);
• Title IX of the Education Amendments of 1972, as amended, which prohibits you from
discriminating because of sex in education programs or activities (20 U.S.C. 1681 et seq).