Loading...
HomeMy WebLinkAboutCALIFORNIA, STATE OF, EMPLOYMENT DEVELOPMENT DEPARTMENT - 2016Cleared N-2016-169 C tits ,„ lr 1 CSG - SR 7- 1, 7 STATE OF CALIFORNIA 1�eo dAQP� V2. EDD CUSTOMER CODE: E00663 STANDARD AGREEMENT STD, 213 (Rev 06103) PROJE;CTiACTIVITY CODE: 2151051 I, This A reement is entered into between the Agency and the State of California Contractor named below: REQUESTER AGENGY NAME Santa Ana Police Department STATE OF 0ALIFORNIA—CONTRAGTOR`5 NAME Employment Development Department 2 The term of this A reement is: December 1, 2016 through November 30, 2019 3 The maximum amount $747,00 of this Agreement is: Seven Hundred Forty Seven Dollars and Zero Cents 4. The parties agree to comply with the terms and conditions of the following exhibits which are by this reference made a part of the A reement: Exhibit A Scope of Work 2 Pages Attachment Al Specifications 3 Pages Exhibit B Budget Detail and Payment Provisions 2 Pages Exhibit C" General Terms and Conditions GTC 610 Exhibit 1) Protection of Confidentiality 3 Pages Attachment D1 Confidentiality Agreement l Page Attachment D2 indemnity Agreement 1 Page Attachment D3 Statement of Responsibility 1 Page !terns shown with an Asterisk ("), are hereby incorporated by reference and made part of this Agreement as if attached hereto, Thes docurrlgnts can be viewed at: ivww.d s.ca. ovIolsIRescumesIStandardContractLan IN WITNESS WHEREOF, this Agreement has been executed by the parties hereto. STATE OF CALIFORNIA CONTRACTOR catlfarnta ices mien nlGenera! Services Use Onfy CONTRACTOR'S NAME (if other than an indiv#dual, stale whether a corooration, oarinershiD, etc.) Employment Development Department. BY (Authorized Signatwe) DATE SIGNED(Do not type) PRINTED NAME AND TILE OF PERSON S#iNING Xochitl Montano, Manager, Contract Services Group ADDRESS P.D. Box 826880, MIC 62-C Sacramento, CA 94280-0001 AGENCY Santa Ana Police Gerardo Mouet Actina City Manager ADDRESS 20 Civic Center Plaza (M-31), Santa Ana, CA 92702 Exempt per: J)G!� 4 (n,o SIA 5 ATTEST. 10. MA. RIA HUIZAR Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney Laura A. Rossini Senior Assistant City Attorney RECONIMENDED FOR APPROVAL: Carlos Rojas Chief of Police CI'T'Y OF SANTA ANA DAVID CAVAZ City Manager MG 2 9 2016 Gerardo Mouet Acting City Manager ff 6 -, a a/ MARIA D. HUIZAR CLERK OF THE COUNCIL EDD Agreement No, M7104377 EDD/SAPD Customer Code: E00663 Page 1 of 2 EXHIBIT A (Standard Agreement) This Agreement is entered into by and between the Employment Development Department, hereinafter referred to as the EDD, and the Santa Ana Police Department, hereinafter referred to as the SAPD. It sets forth the terms and conditions for the release and use of the EDD's confidential information. SCOPE OF WORK i. Purpose The EDD agrees to provide confidential Employer and Client Address information to the SAPD, The SAPD agrees to use the confidential information provided by the EDD under this Agreement for the investigations of felonies or suspected felonies. il, Legal Authority 1. The EDD shall make this information available to the SAPD pursuant to CUIC Section 1095(i). 2, The SAPD shall request and use the specified information in accordance with California Penal Code Section 830.1. Ill. Contract Representatives 1, The EDD's contact persons are: CONTRACT NEGOTIATIONS, CONFIDENTIALITY, AND TECHNICAL ASSISTANCE Claire Dodson, or Designee Employment Development Department Information Security Office, MIC 33 I.O. Bax 826880 Sacramento, CA 94280-0001 Phone: (916) 651-2885 E-mail: Claire. Dodson0_edd.ca.gov Cc: I SOPrivacyDiselosureUnit@edd.ca.clov- FISCAL Erlinda Matienzo, or Designee Employment Development Department Accounts Receivable Unit, MIC 70 P.Q. Box 826880 Sacramento, CA 94280-0001 Phone: (915) 654-7844 E-mail: Erlinda,Matienzoaedd.ca. ov EDD Agreement No. M7104377 EDDISAPD Customer Code: E00663 Page 2 of 2 EXHIBIT A (Standard Agreement} 2, The SAPD contact persons are: CONTRACT NEGOTIATIONS AND FISCAL MATTERS ADMINISTRATION Douglas McGeachy, Deputy Chief Patricia Quezada, Senior Accounting 60 Civic Center Plaza (M-18) Assistant Santa Ana, CA 92702 60 Civic Center Plaza (M-18) Phone: 714-245-8304 Santa Ana, CA 92702 E-mail: dmcgeachy@santa-ana,org Phone: 714-245-8048 E-mail: pquezada@santa-ana.org CONFIDENTIALITY AND DATA SECURITY ASSIGNMENTS Data Security and Integrity: Boris Duran Internal distribution of the EDD products: Chris Revere 3, Either party may make changes to the Contract Representatives information above by giving written notice to the other party, Said changes shall not require an amendment to this Agreement. ATTACHMENT Al (Standard Agreement) SPECIFICATIONS EDD Agreement No, M7104377 EDD/SAPD Customer Code: E00663 Page 1 of 3 I, METHODOLOGY 1. The SAPD staff authorized under this Agreement to request the EDD's confidential information: a. Completes and submits the EDD forms—"Request for Wage and Claim Information" (DE 8720) for individuals who are being sought by law enforcement. b, Uses the information provided by the EDD for the sole purpose of locating any felony victim, suspect, missing person, potential witness, or person for whom a felony arrest warrant has been issued. 2. The EDD will not process or return illegible DE 8720. 3. On matching SSNs, the EDD produces the Abstract System (ABS) reports authorized under this Agreement. 4. On a quarterly basis, the EDD Invoices SAPD for all SSN transactions key entered (matched and/or unmatched SSNs). II. RESPONSIBILITIES 1. The EDD agrees to: a. Provide an electronic template of the DE 8720 form for the SAPD to reproduce. b, Provide a PowerPoint "completion instructions" training module to be used by the SAPD to train its staff on how to complete the EDD forms and read the ABS reports provided by the EDD. c. Use the SSNs provided by the SAPD on the EDD forms DE 8720 under the assigned Customer Cade: E00663, to search the EDD files. On positive matches, the EDD will provide the following EDD ABS reports, (1) Employer Address (DE. 4989) (2) Client Address d. Process only the DE 8720 requests that are completed to the EDD's specifications and mailed by the SAPD to the EDD's Information Security Office at: Employment Development department Document Management Group, MIC 96 P. O. Box 826880 Sacramento, CA 94280.0001 EDD Agreement No. M7104377 EDDISAPD Customer Code: EOO663 Page 2of3 ATTACHMENT Al (Standard Agreement) e. Mail the ABS reports to the SAPID staff person assigned responsibility for the internal security, confidentiality, and dissemination of the EDD's confidential information to other SAPID staff: Name and Title: Chris Revere, Commander Agency /dame: Santa Ana Police Department Mailing Address; 60 Civic Center Plaza (M-18) Santa Ana, CA 92702 f. Monitor and determine status of the data and ensure that the terms, conditions, and disclosure constraints stipulated in this agreement are followed, This compliance review is part of the EDD contract monitoring process. 2. The SAM:? agrees to: a. Request only the EDD information specifically authorized under this Agreement, b. Train all SAPID staff authorized to use and request the EDD's confidential information under this Agreement, on the proper completion of the DE 8720, c, Submit all requests under the EDD Customer Code: E00663, and use the preparer code field on the DE 8720 forms for internal distribution purposes. d. Request the ABS reports authorized in this Agreement on form DE 8720 on an "as needed" basis. Mail the forms completed to the EDD specifications to: Employment [development Department Document Management Group, MIC 96 P. 0. Box $26880 Sacramento, CA 94280-0001 e. Use the specified EDD ABS reports only to locate any felony victim, suspect, missing person, potential witness, or person for whom a felony arrest warrant has been issued. f. Comply with the California Unemployment Insurance Code (CUIC) on any matters pertaining to the access, use, and/or release of data under this Agreement. Failure to comply with this provision shall be deemed a breach of this Agreement, and shall be grounds for cancellation of this Agreement. 9 Oversee the SAPD staff in their use of confidential information received from the EDD. h. Instruct all the SAPID staff with access to the information provided by the EDD under this Agreement regarding the: (1) the confidential nature of the information; (2) the requirements of this Agreement; (3) the need to adhere to the security and confidentiality provisions outlined in Exhibit D — Protectlon of Confidentiality Provisions; and (3) the sanctions and penalties against unauthorized use or disclosure found in CUIC Sections 1094 and 2111, the California Civil Code Section 1798.55, and the California Penal Code Section 502. L Ensure that all SAPID staff assigned to work with the information provided by the EDD have signed the EDD Confidentiality Statement (Attachment D1, Rev 05114114). j. Comply with Title 20, Code of Federal Regulations Section 643.9 with respect to any of the EDD confidential information. k. Use the information provided by the EDD only as specifically authorized under this agreement. The CUIC 1095(u) prohibits a private collection agency from using any the EDD information the HA obtains under this Contract. Therefore, nothing in this Contract shall be EDD Agreement No, M7104377 EDD/SAPD Customer Code; E00663 Page 3 of 3 ATTACHMENT All (Standard Agreement) construed to authorize or permit a private collection agency to use the EDD information for any purpose. Violation of this paragraph will be a basis for terminating the Contract. I. Dispose of the EDD's confidential information using an approved method of confidential destruction, m. Not release the EDD's confidential information to any other public or private entity without the EDO's prior written consent. n. Cooperate with the EDD's authority to monitor this Agreement in accordance with Exhibit D, Section II, paragraphs (e) and (f). o. Pursuant to federal law, if SAPD fails to comply with any provision of this Agreement, including timely payment of the EDD's costs under this Agreement, this Agreement shall be suspended and no further disclosures will be made until the EDD is satisfied that corrective action has been taken and there will be no further breach, In the absence of prompt and satisfactory corrective action, this Agreement will be cancelled, and SAP® shall surrender to the EDD all confidential information obtained under this Agreement which has not been previously returned to the EDD, and any other information relevant to the Agreement (20 C.F.R., Part 603.10(c)(1)). 3. Joint Responsibilities, Doth parties agree to: a. Designate staff to have primary responsibility for program liaison, coordination of activities, and to meet, when necessary, to further redefine specific program procedures. b, Not disclose any of the EDD or the SAPD information to any person or agency other than those authorize specifically under this Agreement. c. Cooperate fuliy and furnish such assistance as may be mutually agreed upon by the parties hereto as being necessary and appropriate for proper performance of this Agreement. 4. Disputes: In the event of a dispute between the EDD and the SAPD over any part of this Agreement, the dispute may be submitted to nonbinding arbitration upon the consent of both the EDD and the SAPD, An election for arbitration pursuant to this provision shall not preclude either party from pursuing any remedy for relief otherwise available. III. ACCURACY ASSESSMENT Individual employers and claimants report the information in the EDD's files, Since the EDD is not the originator of the information disclosed, the EDD cannot guarantee the accuracy of the information. IV. TERMINATION CLAUSE This Agreement may be terminated by either party by giving written notice 30 days prior to the effective date of such termination. EDD Agreement No, M7104377 EDD/ SAPD Customer Code: E00663 Page 1 of 2 EXHIBIT B (Standard Agreement) I. BUDGET DETAIL AND PAYMENT PROVISIONS a, The maximum amount of this Agreement shall not exceed Seven Hundred Forty Seven Dollars and No Gents ($747,00). b. In consideration of the performance and completion of the foregoing in a satisfactory manner, and upon receipt of a detailed invoice, in triplicate, quarterly in arrears, the SAPD shall reimburse the EDD the total amount due, based on the following product rate structure: Requested Products Rate Structure ................... .................................................. .... y,,,,.,.,.........,.....,,«...,.,.........,..,.....................„.,s...,,........,,...........,.......,,..,.......,...�......,..,..�,,,..,�......... FORMULA If the cumulative number of Then the cost for Current i Then the cost for requests per product type, ; C? per requested product l Archive Data € per quarter is, j -ata type shall be: (UI/DINVage) per i requested product type ' I be ............................,,.,,....,.,,,...,,w..,....,,.,.,......,......,.,,,,..._..,....., 7,.. ,.......... ._,,.,.,...,..,.,.........,..,................... ,......................... ,..,,,,.,,,,.,,...h,,.,.,,. ,,.,....,,.,,...,sha...11 .. ..l 100 or less $ 1.0375 $2.075 101 -500 ................................................................'25.....,.,,.._.,,....._,.......,,,.,.,..,.,,,...,,., ........ _....... _.........�.01...or ,.�,.,..,...,........,,5n,.,,.,......,.........,,..,.�....«..) .875 more .............�....,.,.......,,.,,......,,.........................._...,.,,,,..n.,,.,.....,..,,,...,,.,,,,...,.,.,,...,,.,..,.,,,,.,....,,..,.....,,,,.._.,,,,,,,..,.,,.,....,,.,,....,...,.1,..,,...,,., ., ,. , c. The SAPD shall be charged for the total number of products requested, Each Social Security Number (SSN) submitted may generate 1 to 2 products, depending on the types of ABS reports requested. d. The maximum amount of this contract has been computed, based on an estimated 30 SSNs per quarter, as follows: EDD ABSTRACT FORMULA COST Em to er Address DE 4089 1 product 30 x 1,0375 x 120 $373.50 Client Address 1 roduct 30 x 1.0375 x 12Q $373,50 Total for 3 -year contract $747.00 e. The EDD Invoices will reference the EDD Contract No. M7104377 and the EDD customer cede E00663; and shall be submitted for payment to: Patricia Quezada, Senior Accounting Assistant Santa Ana Police Department 60 Civic Center Plaza (M-18) Santa Ana, CA 92702 f. The SAPD payments must reference the EDD Invoice Number, the EDD contract number M7104377, and the customer code E00663; and be submitted to: Employment Development Department Accounting Section, MIC 70 P.O. Box 826217 Sacramento, CA 94230-6217 EDD Agreement No, M7104377 EDD1 SAPD Customer Code: E00663 Page 2 of 2 EXHIBIT IS (Standard Agreement) g. Payment will be made in accordance with, and within the time specified in, Title 1, Division 3,6, Part 3, Chapter 4,5 of the Government Code. h, Nothing herein contained shall preclude advance payments, pursuant to Article 1, Chapter 3, Part 1, Division 3, Title 2 of the Government Code of the State of California. EXHIBIT D (Standard Agreement) PROTECTION OF CONFIDENTIALITY EDD Agreement Number: M7104377 IDD/ SAPID Customer Codes: E00663 Page 1 of 3 Federal and state confidentiality laws, regulations, and administrative policies classify all the Employment Development Department (EDD) information provided under this Agreement as confidential. The federal and state laws prohibit disclosure of the EDD's confidential information to the public and mandate its protection against loss and against unauthorized access, use, disclosure, modification, or destruction. SAPD must therefore, agree to the following security and confidentiality requirements: I. ADMINISTRATIVE SAFEGUARDS a. Adopt policies and procedures to ensure use of the EDD's confidential information solely for purposes specifically authorized under this Agreement that meet the requirements of Title 20, Code of Federal Regulations §603.10. b. Warrant by execution of this Agreement, that no person or selling agency has been employed or retained to solicit or secure this Agreement upon agreement or understanding for a commission, percentage, brokerage, or contingent fee. In the event of a breach or violation of this warranty, the EDD shall have the right to annul this Agreement without liability, in addition to other remedies provided by law. c. Warrant and certify that in the performance of this Agreement SAPD will comply with all applicable statutes, rules and/or regulations, and Agreement information security requirements, including but not limited to the following: • California unemployment Insurance Code §1094 (Disclosure Prohibitions) • Title 20, Code of Federal Regulations §603.9 and §603.10 (Federal Unemployment Compensation Safeguards and Security Requirements) • California Civil Code §1798, et seq. (Information Practices Act) California Renal Code §502 (Computer Fraud Act ) • Title 6, U,S. Code §552a (Federal Privacy Act Disclosure Restrictions) w Title 42, U.S. Code §503 (Social Security Act) • Title 18, U.S. Code §1905 (Disclosure of Confidential Information) d, Except for state agencies, agree to indemnify the EDD against any loss, cost, damage or liability resulting from violations of these applicable statutes, rules and/or regulations, and Agreement information security requirements. e. Protect the EDD's information against unauthorized access, at all times, in all forms of media. Access and use the information obtained under this Agreement only to the extent necessary to assist in the valid administrative needs of the program receiving such information, and only for the purposes defined in this Agreement, f. Keep all the EDD's confidential information completely confidential. Make this information available to authorized personnel on a "need -to -know" basis and only for the purposes authorized under this Agreement. "Need -to -know" refers to those authorized personnel who need Information to perform their official duties in connection with the use of the information authorized by this Agreement. Confidentiality Requirements STD, (Rev 03108/2016) EDD Agreement Number: M7104377 EDD! SAPD Customer Codes: E00663 Page 2of3 EXHIBIT D (Standard Agreement) g. Notify the EDD Help Desk at (916) 654-1010, immediately upon discovery, that there may have been a breach in security which has or may have resulted in compromise to the confidential information. For purposes of this section, immediately is defined within 24 hours of discovery of the breach. The notification shall be by phone and email, It is not sufficient to simply leave a message. The notification must include a detailed description of the incident (such as time, date, location, and circumstances) and identify responsible personnel (name, title and contact information). The verbal notification shall be followed with an email notification to <InformationSecurityOfficea@edd.ca.gov>, 11, MANAGEMENT SAFEGUARDS a. Acknowledge that the confidential information obtained by SAPD under this Agreement remains the property of the EDD. b, Instruct all personnel assigned to work with the information provided under this Agreement regarding the following: + Confidential nature of the EDD information, • Requirements of this Agreement. Sanctions specified in federal and state unemployment compensation laws and any other relevant statutes against unauthorized disclosure of confidential information provided by the EDD. c. Require that all personnel assigned to work with the information provided by the EDD complete the EDI~} Confidentiality Agreement (Attachment D1): d. Return the following completed documents to the EDD Contract Services Group: a The EDD Indemnity Agreement (Attachment D2); Required to he completed by the SAPD Chief Financial Officer or authorized Management Representative, unless SAPD is a State Agency. o The EDD Statement of Responsibility Information Security Certification (Attachment D3): Required to be completed by the Information Security Officer or authorized Management Representative. e. Permit the EDD to make on-site inspections to ensure that the terms of this Agreement are being met. Make available to the EDD staff, on request and during on-site reviews, copies of the EDD Confidentiality Agreement (Attachment D1) completed by personnel assigned to work with the EDD's confidential information, and hereby made a part of this Agreement. f. Maintain a system of records sufficient to allow an audit of compliance with the requirements under subsection (d) of this part, Permit the EDD to make on-site inspections to ensure that the requirements of federal and state privacy, confidentiality and unemployment compensation statutes and regulations are being met including but not limited to Social Security Act §1137(a)(5)(B). III. USAGE, DUPLICATION, AND REDISCLOSURE SAFEGUARDS a. Use the EDD's confidential information only for purposes specifically authorized under this Agreement. The information is not admissible as evidence in any action or special proceeding except as provided under §1094(b) of the California Unemployment Insurance Code (CUIC). Section 1095(u) of the CUIC does not authorize the use of the EDD's confidential information by any private collection agency. b. Extraction or use of the EDD information for any purpose outside the purposes stated in this Agreement is strictly prohibited. The information obtained under this Agreement shall not be reproduced, published, sold, or released in original or any other form not specifically authorized under this Agreement. Confidentiality Requirements STD. [Rev 03/0812016] EDD Agreement Number. M7104377 EDD/ SAPD Customer Codes: E00663 Page 3 of 3 EXHIBIT D (Standard Agreement) c. Disclosure of any of the EDD information to any person or entity not specifically authorized in this Agreement is strictly prohibited. Personnel assigned to work with the EDD's confidential information shall not reveal or divulge to any person or entity any of the confidential information provided under this Agreement except as authorized or required by law. IV. PHYSICAL SAFEGUARDS a. Take precautions to ensure that only authorized personnel are given access to physical, electronic and on-line files, Store electronic and hard copy information in a place physically secure from access by unauthorized persons. Process and store information in electronic format, such as magnetic tapes or discs, in such a way that unauthorized persons cannot retrieve the information by means of computer, remote terminal, or other means. b. Secure and maintain any computer systems (network, hardware, and software applications) that will be used in the performance of this Agreement. This includes ensuring that all security patches, upgrades, and anti-virus updates are applied as appropriate to secure data that may be used, transmitted, or stored on such systems in the performance of this Agreement. c. Store all the EDD's confidential documents in a physically secure manner at all times to prevent unauthorized access, d. Store the EDD's confidential electronic records in a secure central computer facility. Where in -use on a shared computer system or any shared data storage system, ensure appropriate information security protections are in place. SAPD shall ensure that appropriate security access controls, storage protections and use restrictions are in place to keep the confidential information in the strictest confidence and shall make the information available to its own personnel on a "need -to -know" basis only. e. Store the EDD's confidential data in encrypted format when recorded on removable electronic storage media, or on mobile computing devices, such as a laptop computer. f, Maintain an audit trail and record data access of authorized users and authorization level of access granted to the EDD's data, based on job function. g. Direct all personnel permitted to use the EDD's data to avoid leaving the data displayed on their computer screens where unauthorized users may view it. Personnel should retrieve computer printouts as soon as they are generated so that the EDD's data is not left unattended in printers where unauthorized personnel may access them. h. Dispose of confidential information obtained from the EDD, and any copies thereof made by SAPD, after the purpose for which the confidential information is disclosed is served. Disposal means return of the confidential information to the EDD or destruction of the information utilizing an approved method of confidential destruction, which includes electronic deletion (following Department of Defense specifications) shredding, burning, or certified or witnessed destruction. Confidentiality Requirements STD. [Rev 431{1812096] Employment EDD Contract No. M7104377 Development EDD Customer Code No.EO0663 Department _ - EDC7I SAPC1 _tate of t atifornia ATTACHMENT 1140, DI Page 1 of EMPLOYMENT DEVELOPMENT DEPARTMENT CONFIDENTIALITY AGREEMENT Information resources maintaired by the State of California Employment Development Department (EDD) and provided to your agency may be confidential or sens1lve. Confidential and sensitive information are not open to the public and require special precautions to protect it from wrongful access, use, disclosure, modification, and destruction, The EDD strictly enforces information security, If you violate these provisions, you may be subject to administrative, civil, and/or criminal action, an employee of Santa Ana Police Do ariment PRINT YOUR NAME PRINT YOUR EMPLOYER'S NAME hereby acknowledge that the confidential and/or sens0lve records of the Employment Development Department are subject to strict confidentiality requirements Imposed by state and federal law Include the California Unemployment Insurance Code (UIC) §§1094 and 2111, the California Civil Code (CC) §1798 et seq., the California Penal Code (PC) §502, Title 5, USC §552a, Code of Federal Regulations, Title 20 part 603, and Title 18 USC §1905. acknowledge that my supervisor andlor the Contract's Confidentiality and Data 5ecur€ty Monitor rovlewed with me [he confidentiality and security INITIAL requirements, policies, and administrative processes of my organization and of the EDD, acknowledge responsibility for knowing the classification of the EDD information I work with and agree to refer questions about the classification of the INmAL- EDD information (public, sensitive, ccnffdontiai) to the person the Contract assigns responsibility for the security and confidently#ily of the EOD's data, acknowledge responsibility for knowing the privacy, confidentiality, and data secudly laws that apply to [he EDD Information I have been granted access INMAL to by my employer, including UIC §§1094 and 2111, California Government Code § 15619, CC § 1798,53, and PC § 542. C� acknowledge that wrongful access, use, modification, or disclosure of confldentiat information may be punishable as a crime andlor result In disciplinary INITIAL and/or civil action taken against me --including but not limited to: reprimand, suspension without pay, salary reduction, demotion, or dismissal---andlor fines and penalties resulting from criminal prosecution or civil lawsuits, and/or termination of contract, acknowledge that wrongful access, inspection, use, or disclosure of confidential Information far personal gain, curiosity, or any non -business related INITIAL reason is a crime under state and federa[ laws. acknowledge that wrongful access, use, modification, or disclosure of confidential information is grounds for Immediate termination of my organlzatien's INITIAL Contract with the EDD, agree to protect the following types of the EDD confidential and sensitive Information: INITIAL * Wage information * Appllcant Information • Employer informa[ion * Proprietary Information * Claimant Information * Operational Information (manuals, guldelires, procedures) • Tax Payer Information hereby agree to protect the ED D's Information on either paper or electronic form by: INITIAL * Accessing or using the EDD supplied information only as specified in the Contract for [he performance of the specific work I am assigned. • Never accessing informatlon for curioslty or personal reasons. Never showing or discussing sensitive or confidential information to or with anyone who does not have the need to know, * Pladng sensitive or confidential information only in approved locations. » Never removing sensitive or confidential information from the work site without authorization. * Following encryption requirements for all personal, sensitive, or confidential information In any portable device or media, 6111 certify that 1 have read and initialed the confidentiality statern r "rated nd will abide by them." t� vl Print Full Name (last, first, MI) Signature Santa Ana Police Department e t ® U3 a -1 Print Name of Requesting Agency �_ to Signed F_.. � check the a �ro r .hack the ,pA _p, late box4 Employee ❑ Student ❑ Subcontractor 0 volunteer ❑ Other —.M---_. . Explain Attachment ID1 IRev 051414] Employment EDD Contract No, M7104377 Development EDD Customer Code No.E00663 �,�.__�.,,.D- Department LSD/$APD state of Californ;a ATTACHMENT NO. D2 Pae I Of 1 EMPLOYMENT DEVELOPMENT DEPARTMENT INDEMNITY AGREEMENT In consideration of access to the EDD information which is personal, sensitive, or confidential, David Cavasos (Enter name of chief Financial Officer or authorized Management Representative) agrees to indemnify the EDD against any and all liability costs, damages, attorney fees, and other expenses the EDD may incur by reason of or as a result of any unauthorized use of the personal, sensitive, or confidential information or any violation of the "Confidentiality Agreement" by any and all employees of: Santa Ana Police Deoarlment (Enter Requesting Agency/Entity Name) This obligation shall be continuous and may not be changed or modified unless agreed to in writing, In addition, I understand that the following penalties may be incurred for any such misuse of the EDD Information: 1. Any individual who has access to returns, reports, or documents maintained by the EDD who fails to protect the confidential information from being published er open to the public may be punished by imprisonment in the county jail for up to one year or a fine of $20,000.00 or both, (California Unemployment Insurance Code §§ 2111 and 2122). 2. Any person who intentionally discloses information, not otherwise public, which they knew or should have known was obtained from personal information maintained by a state agency, shall be subject to civil action for invasion of privacy by the individual to whom the information pertains. (California Civil Code §1798.53). 3. Any unauthorized access to the EDD computer data, computer systems, or unauthorized use of the EDD data is punishable by a fine or imprisonment in the county jail or both. (California Penal Code §502). I certify that I have read, understand, and agree with the above terms, 14 r M1111111111 moss --fid. Gerardo Mouet Print Full Name (last, first, MI) sig ature �� ty{ Acting City Manager j 9fr1 Print Title Date Signed Santa Ana Police Department Print Name of Requesting Entity Enter Name Governmental sponsorlEntity Attaohrnent D2 (Rev 0514141 ---71f`-~ Employment EDIT Contract No. M7104377 EDDpeve,10 went EDD Customer Corte No.E00663 L7epartmer,t E©CIISARD State 0€ Cali€0rnia ATTACHMENT NO. D3 Iia e 1 of 1 EMPLOYMENT DEVELOPMENT DEPARTMENT STATEMENT OF RESPONSIBILITY INFORMATION SECURITY CERTIFICATION We, the Police Systems Manager and the Commander hereby certify that SAPID has in place the safeguards and security requirements stated in this Interagency Agreement. We therefore accept responsibility for ensuring compliance with these requirements, as set forth in Exhibit "Y' of the EDD Contract No, M7104377. IINFORMA Rte!-9FWER SIGNATURE PROQGR—M1] OR OR CHIEF INFORMATION OFFICER SIGNATURE Bor€s,� 0 E4 nA A/ W PRINT NAME OF INFORMATION SECUIRTY OFFICER Police Systems Mana er PRINT TITLE 714-245-8236 TELEPHONE NUMBER Chris Revere PRINT NAME Commander PRINT TITLE 714-245-8005 TELEPHONE NUMBER bduran santa-ana.org crevere a Santa-ana,org EMAIL ADDRESS E-MAIL ADDRESS I�1a..-z01 '% t% /7,0 1 :1 ................ T"DATE SIGNED DATE SIGNED NOTE: Return this information Security Certification to the EDD Contract Manager with the signed copies of the Contract. 1, Information Security Certification received by. EDD OONTRACT MANAGER NAME 2, The EDD information asset access approved by, DATE RECEIVED CONTRACT MANAGER OR DISCLOSURE COORDINATOR WE APPROVED (AFF, EMAIL, ETC,) ^^ NOTE: The EDD must have a signed "Information Security Certification" in its possession prior to disclosure of any personal, confidential, or sensitive information to the ISO. Attachment D3 (Rev 06 1414)