Title VI of the Civil Rights Act of 1964, and other related laws and regulations, provide that no person shall on the grounds of race, color or national origin be excluded from participation in, be denied the benefits of, or otherwise be subjected to discrimination under any program or activity receiving federal funds.
The purpose of this form is to assist you in filing a complaint with CCATD’s Title VI Coordinator. You are not required to use this form. A letter containing the same information is sufficient. However, the information requested must be provided, whether or not this form is used. ADA assistance is available upon request.
You may file a complaint against the CCATD. All complaints must be filed within 180 days of the occurrence of the alleged act or a waiver requested as indicated below. You also may file a complaint directly with the ODOT Office of Civil Rights or the FTA Office of Civil Rights.
Submit the online form here, or print out and send your completed form to the address below:
PDF Version of the Title VI Complaint form.
CCATD: Title VI Complaint Coordinator
2810 Ocean Blvd
Coos Bay, OR 97459
Title VI & ADA Complaint Form
Date:
Name:
Address: ______________________________________ City: _ State: _ Zip Code: ___ Telephone: ______________________________________
Email: __
Do you feel you were discriminated against because of your (check all that apply):
Race ☐ Disability ☐ Color ☐ National Origin ☐ Other ☐
If other, please explain:
Date & time of the alleged incident: Route and/or bus number: Driver’s name or description:
Explain as clearly as possible what happened and how you were discriminated against. Be sure to
include the names and contact information of any witnesses. If more space is needed, please use additional pages:
Have you filed this complaint with any other federal, state, or local agency or with any court? Yes ☐ No ☐
If yes, check and identify all that apply:
☐Federal Agency ☐Federal Court
☐State Agency ☐State Court
☐Local Agency ☐Local Court
Please provide information for a contact person at the Agency or Court where the complaint was filed:
Name: Address:
City: __________________________ State: Zip Code:___
Telephone: _________________________________________________________
Email: ______________________________________________________________
Please sign below. You may attach any additional written materials or other information you believe is relevant to your complaint.
Signature Date
Please send completed form to:
Mail:
Coos County Area Transportation District, PO Box 1118, Coos Bay, OR 97420
Email: drupkalvis@coostransit.org
In person:
Coos County Area Transportation District, 2810 Ocean Blvd., Coos Bay, OR 97420
Title VI Complaint Procedure
1. Title VI of the Civil Rights Act of 1964 states that “No person in the United States shall, on the grounds of race, color, religion, sex, or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance.” Any person, who believes that he/she, has been subjected to discrimination prohibited by Title VI of the Civil Rights Act of 1964, may file a complaint with Coos County Area Transportation District/Coos County Area Transportation District. A complaint may also be filed by a representative on behalf of such person. All complaints will be referred to the Coos County Area Transportation District Compliance Manager for review and action.
2. To have the complaint considered under this procedure, the complainant must file the complaint no later than 180 days after:
a. The date of alleged act of discrimination; or
b. Where there has been a continuing course of conduct, the date on which that conduct was discontinued.
In either case Coos County Area Transportation District may extend the time for filing or waive the time limit in the interest of justice if Coos County Area Transportation District specifies in writing the reason for so doing.
3. Complaints shall be in writing and shall be signed by the complainant and/or the complainant’s representative. Complaints shall set forth as fully as possible the facts and circumstances surrounding the alleged discrimination. If a person makes a verbal complaint of discrimination to an officer or employee of Coos County Area Transportation District, the person shall be interviewed by the Coos County Area Transportation District Office Manager. If necessary, the Office Manager will assist the person in reducing the complaint to writing and submit the written version of the complaint to the person for signature. The complaint shall then be handled according to the Coos County Area Transportation District’s investigative procedures.
4. Within 30 days, the Coos County Area Transportation District Compliance Manager will acknowledge receipt of the allegation, inform the complainant of action taken or proposed action to process the allegation, and advise the complainant of other avenues of redress available, such as ODOT and USDOT.
5. Coos County Area Transportation District will advise ODOT and/or USDOT within 10 days of receipt of the allegations. Generally, the following information will be included in every notification of ODOT and/or USDOT:
a. Name, address, and phone number of the complainant(s)
b. Name(s) and address(es) of alleged discriminating official(s)
c. Basis of complaint (i.e., race, color, or national origin)
d. Date of alleged discriminatory act(s)
e. Date of complaint received by the recipient.
f. A statement of complaint
g. Other agencies (state, local, or Federal) where the complaint has been filed
h. An explanation of the actions Coos County Area Transportation District has taken or proposed to resolve the issue in the complaint.
6. Within 60 days, the Coos County Area Transportation District Compliance Manager will investigate the allegation and based on the information obtained, will render a recommendation for action in a report of findings to the Coos County Area Transportation District Legal Counsel and the Coos County Area Transportation District Board of Directors. The Board of Directors will vote on action based on the report finding. The Board’s final decision will be sent to the complainant. The complaint should be resolved by informal means whenever possible. Such informal attempts and their results will be summarized in the report findings.
7. Within 90 days of receipt of the complaint, the Coos County Area Transportation District Compliance Manager will notify the complainant in writing of the final decision reached by Coos County Area Transportation District Legal Counsel and Coos County Area Transportation District Board of Directors, including the proposed disposition of the matter. The notification will advise the complainant of his/her appeal rights with ODOT and/or USDOT, if they are dissatisfied with the final decision rendered by Coos County Area Transportation District. The Coos County Area Transportation District Compliance Manager will also provide ODOT and/or USDOT with a copy of this decision and summary of findings upon completion of the investigation.
8. Contact for the different Title VI administrative jurisdictions are as follows:
Federal Transit Administration
Office of Civil Rights Attention: Title VI Program Coordinator
East Building, 5th Floor – TCR 1200 New Jersey Avenue
SE Washington, DC 20590