other · K-5
K-5 - USDOT Title VI Non-Discrimination Assurances - North Park Road Improvements 2
Page 7 of 8
Text from the PDF text layer; check the PDF for anything that matters. 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 ___________________
CITY of TIFFIN, IOWA 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, ___________________
CITY of TIFFIN, IOWA 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, ___________________
CITY of TIFFIN, IOWA will there upon revert to and vest in and become the
absolute property of ___________________ and its assigns.*
CITY of TIFFIN, IOWA
(*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.)
Sources
- sharepoint (K-5 - USDOT Title VI Non-Discrimination Assurances - North Park Road Improvements 2.pdf) — where it was found ↗ first seen Oct 12, 2026
Data last updated October 15, 2026. Built from the archive's documents; see how the data is built.