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Home My WebLink About11-13 Title VI Galavan Streamline Additional Information Rev. 9/11/13 FTA Title VI Plan Checklist Title VI prohibits discrimination in FTA services, programs or benefits on the basis of Race, Color, or National Origin. [To check boxes:1)double-click cursor on box, 2) "check box form field options"will appear, 3) under "Default Value". click "Checked", 4) click "OK". I Date/Time: 10-24-2013/2:00 pm Agency/ City: Human Resource Development Council District IX/Bozeman MT Title VI Contact: Lee Hazelbaker ❑ Request Title VI Contract Attachment ❑ Request Title VI Coordinator/ Liaison Business Cards ❑ Request Title VI Pamphlets ❑ Request clarification of instructions to this checklist ❑ Request clarification of MDT LEP Plan Section 1: Title VI Program required Authority: FTA Circular 4702.16 Chapter III for FTA sub-recipients can be accessed at htt www.fta.dot.2ov/le.gislatinn law/12349 14792.htmi. Which sections apply to this Title VI Plan? ® Section 2: Transit Provider ❑ Section 3: First time Applicant ❑ Section 4: MPO ❑ Section 5: State Agency 1 Rev. 9/11/13 Section 2: TRANSIT PROVIDER's TITLE VI PROGRAM: Title VI prohibits discrimination in FTA services, programs or benefits on the basis of Race, Color, or National Origin. [To check boxes:1)double-click cursor on box, 2) "check box form field options"will appear, 3) under "Default Value", click "Checked", 4) click "OK". ] Date/Time: 10/24/2013/1:05 pm Agency/ City: Human Resource Development Council District IX/Bozeman MT Title VI Contact: Lee Hazelbaker ❑ Request Title VI Contract Attachment ❑ Request Title VI Coordinator/ Liaison Business Cards ❑ Request Title VI Pamphlets ❑ Request clarification of instructions to this checklist ❑ Request clarification of MDT LEP Plan Authorities: (FTA Circular 4702.1B, Chapter 3[and general requirements]) Title VI Program Requirements - Exemption: Title VI program requirements may be waived but Title VI obligations may not. Compliance with DOT Title VI regulations is required even with exemption from submitting a Title VI program. ❑ Exempt: Must be approved by Regional FTA ® Non-exempt: Must submit FTA Title VI Plan ® Date of approval 11,26,2013 by recipient's board of directors/appropriate governing entity/or officials responsible for policy decisions prior to submission to FTA. ® Copy of board resolution, meeting minutes, or similar documentation (Attach) ❑ Date and copy of Title VI Assurance ❑ to FTA (occurs prior to passing through FTA funds) ® Date of submittal 12 6 2013 of transit provider Title VI Program to State of Montana. o Submitted either electronically ❑ or hard copy❑ ❑ Date that schedule for submission of this documentation was proposed 10 9 2013 by transit provider. ❑ Schedule for submission 12/31/2013 1 Rev. 9/11/13 ® Copy of notice that informs public that recipient complies with Title VI and informs public of protections against discrimination, how to file Title VI discrimination complaint, and alleging discrimination based on race, color or national origin. (Race and color are not the same.) Sub-recipient may adopt MDT Title VI pamphlet at http://www.mdt.mt.pov/publications/docs/brochures/dbe eeo/titlevi pamphlet pdf. ® Adopt MDT Title VI pamphlet ❑ Create own Date available: ® Notice to passengers that notifies them they can file complaint with State or directly with transit provider alleging discrimination based on race, color or national origin. (Race and color are not the same.) [State includes this notice on Title VI pamphlet which includes complaint form.] ❑ List of(conspicuous and accessible) locations where notice is posted. Posting may be on websites, in transit vehicles, and in reception areas or offices. Additional requirements are at Chap. III-5. of FTA Circular 4702.16. Streamline and Galavan buses Karst Stage Office HRDC Home Office Streamline/Galavan Office Complaint form: Sub-recipients may adopt MDT suggested form at http-.L/Www.mdt.mt.gov/publica and/or on Title VI pamphlet. ® Adopt MDT suggested complaint form and Title VI pamphlet complaint form ❑ Create own Date available: Complaint log: ❑ List of Title VI related complaints, investigations, or lawsuits filed with transit provider since date of last submission. Sub-recipient may adopt suggested complaint log format below: ® Adopt ❑ Create own Date available: Investigation Date Allegations: Was Status Final Comments (1), Lawsuit filed Race (R), complainant findings (L) , or Color (C), male (M) or Complaint or National female (F)? (C) Origin (NO) 2 Rev. 9/11/13 Public Participation Plan: This is the Transit provider's outreach plan to engage minority, LEP, or other traditionally underserved populations. [Title VI Public Meetings form is available for use by providers at http://www.mdt.mt.gov/other/civilrights/external/title vi public hearing form docx or http://www.mdt.mt.gov/other/civilrights/external/title vi public hearing form pdf. ❑ Summary of outreach efforts made since last Title VI submission. Transit provider may adopt MDT Public Involvement Plan. Copies are available from Tom Stuber. ® Adopt MDT Public Involvement Plan ❑ Create own Date available: LIMITED ENGLISH PROFICIENCY (LEP) PLAN: ❑ Submit copy of transit provider's LEP plan based on DOT LEP Guidance or transit provider may adopt MDT LEP Plan at http://www.mdt.mt.gov/other/civilrights/external/limited_english_proficiency_plan_2012.pdf. ® Adopt MDT LEP Plan ❑ Create own Date available: MINORITY REPRESENTATION ON PLANNING AND ADVISORY BODIES: If transit provider has a non-elected transit related planning board, advisory council, or committee, please submit: ❑ Completed table depicting racial breakdown of the membership. Transit provider may adopt suggested table below depicting racial breakdown. ® Adopt suggested table below depicting racial breakdown. ❑ Create own Date available: Board, Council, or Committee Name Member# 27 21 a c c v 3 Q 2 c0 d Q Streamline Advisory Board 10 9 1 4m im 5f 3 Rev. 9/11/13 ® Description of efforts made to encourage participation of minorities: We advertise when openings occur and seek qualified applicant with no regard to race color or nation of origin Please contact Tom Stuber at (406) 444-9216 or stuberaa mt.gov or Bill Anderson at (406) 444-6334 or bianderson@mt.gov with questions about FTA Circular 4702.1B. 4