HomeMy WebLinkAboutContract 48779CII'1'YY ��� 1
CONTRACT NO•
TWC Contract - Amendment Number: 2917PEN021
CONTRACT/AMENDMENT LAlVGUAGE CHANGE CERTIFICATION FORM
Ple�se cbeck the appropriate boz aad sign belo�v:
❑ No Changes. I hereby certify that no changes have been made to documents contained in
this ContracdAmendment package.
� Changes to Demographic Inforaiation. I hereby certify that chan�es in demo�raphic
uLformation items only�such as contact or si�natory) have been made to documents
contained in this ContracdAmendment package. Pen and ink corrections have been entered,
initialed and the revised areas have been flagged.
❑ Changes to ContracUAmendment Terms and Conditions. I hereby certify that changes to
the contracdamendment terms and conditions have been proposed. The proposed changes
have been entered on all copies of the documents in pen and ink, initialed, and the revised
areas have been flagged. I understand that I am to sign and then send all copies of the
contracdamendment back to TWC for evaluation of the proposed changes. If the proposed
changes are approved by the TWC signatory, they will be initialed and my copy (and the
fiscal agent's copy, if applicable) will be returned to me, I understand that if there are any
questions or issues regazding the proposed pen and ink changes that I will be contacted by a
TWC representative to discuss them.
City of Fort Worth �Be�a#�e�- �r-fh e ��� e a.�-� ��. b �n �-�� �- e�
-f-1� e Fo r�-VJ a r'�h Pcl [ c e D� p c�-�� e�� �'�
�' 6�u�' ��� 3� 7i) I �
Valerie R. Washington
Assistant CiTy Managex
��,
Date
OFFICIAL RECORD
CITY SE�it�1'AI�Y
F% VIIOR"r'H, 7X
PTexas �i%rkforce �orrirriission
A Member of Texas Workforce Solutions
February 24, 2017
Lesley Yencho, Criminal Intelligence Analyst
CityofFortWorth -{o��-Fb�e ust.�;�d b�+�r��� c-F
3900 Barrett Street -Fi�e Fc�-l-��'�or+►-� Pol�ce I�z�Oa_:--I-r��e��+L�
Fort Worth, TX 76103
Re: TWC Contract/s or Amendment/s
Dear Ms. Yencho:
Enclosed are original signature copies of the Contracbs or Amendment/s iisted below:
2917PEN021
Michelle Smith
512-936-3296
Andre� /�Icantar. Ch,iirm�n
Commissinncr Iteprcscntin,
d�e I'uMic
Ruth R. Flughs
C'ommi>sioncr Reprexnting
kimplo; ers
,�ui���, ni�<«��
Cummnsioncr Krprescniin,
La6ur
L:�m I;. I'empl�
lieccuii�c Directur
Please sign all the copies of the Contract/s or Amendmends where indicated and complete the
Contract/Amendment Language Change Certification Form for each transaction.
Retain one (1) set for your records and provide one (1) set to your Fiscal Agent (if applicable)
and retum one (1) set to:
John Griffin
Texas Workforce Commission
Contract Services Deparkment
101 East 15th Street, Room 350-T
Austin, Texas 78778-0001
If you have any questions or need additional assistance regarding the contents of these documents
prior to signature, please contact the contract manager at the number indicated above.
Sincerely,
Marisela Otero
Director, Contract Services Departlnent
MR:jg
Enclosures
101 E. I ith Street • r�uslin, '�e�as 7877Q-0001 •(51?) -t63-?�3? • Rela�• Texas: 800-73�-2939 ( TDD) 300-7;� ?938 ( Voice) •.� ww.texasworkForce.orR
Equal Opportunily Employ�r / Program
_�EXAS_
WORKFORCE SOLUTIONS
.*�,�.--
TEXAS WORKFORCE COMMISSION
'° TWG`Contract Num6er 2917PEN021
'i'ITLE , . , = INFORMATION RELEASE CONTRACT
_'. , : '.. ; Reci..:ient
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rtie Ci ofFortWorth -�arf{ �s�a��db iz-F�i�o-F�L�e
�et,Address 3900 Barrett Street � r L��o �h Pc f �c� De tL� i+v�e�i�"
y/State/Zi � Fort Worth, TX 76103
ephone N. umber, (817) 378-1572
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' ' Contract Period '
This Contract s1��11.b'egin o� 1k�aF�6 1, 2017 and sha�l terminate on February 2$, 2a2.0 unless amended
by mutual.written agi'e�ment of�lie�par�ies - .
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' Fnnding Informat'ron ;�
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The total amount of this Contract will not exceed the sum of $4,500.00
- - R��ua�ks
This Contraet is contingent on Recipient's acceptance of and compliance with the terms and conditions of
this Contract and an referenced attachments.
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Type of Access . ,
Online:access o�ly - -
Ori Line Ac�ess . - - .
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Nwnber of onlule users and;rate :'' � _
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Z'he ii�orma�ion to be prov_'�a�a ay;�� w7�i ��j�ae:
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� unernp�o�erit c.ompensatic�n c�atm her��fi� ciat;� {�UI), �
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2914PEN052: >_;- � ; :
Information Release Conhact: May-16
TWC Contract Number: 2917PEN021
2/24/2017 10:38 AM
Page 1 of 7
TEXAS WORKFORCE COMMISSION
PERFORIvffNG AGENCY CONTRACT
' ' `Si nafiire Authan
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` Each person,'�xgnin;g this Contract hereby wa€rants;that he or she has beeri. fully authonzed by the
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resp.ect�ve organiza�ion to: ;
• Exeeute this Contract :o� beha�lf' of fhe orgatuzation, and -:
•'Validly and legall� bind the :or�art`ization'to all tlie terms; per�orinarices, and �provisions of t�iis
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' : _ ':enc A - rov�I � ._ :.: . `: .. . - :: R�ci ient �i`- rov�l
Agency: Texas Workforce Commission Recipient: City of Fort Worth ' -�;
-1 us� a�,�l bznefi+��}-i,� Fi��� l�'c,<f-C�� Pzl�cr e�
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Lisa ichardson Date Valerie R. Washington Date -�;
Chief Information Officer Assistant Ci Mana er '
Information Release Contract: May 16
TWC Contract Number: 29] 7PEN023
2/24/2017 10:38 AM
Page 2 of 7
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TEXAS WORKFORCE COMMISSION
PERFORMING AGENCY CONTRACT
TABLE OF CONTENTS
General Terms and Conditions
Section 1 Pu ose and Le al Authori
Section 2 Term, Termination, and Amendment
Section 3 Consideration
Section 4 Protectin the Confidentiality of TWC Information
Section 5 Records and Audit
Section 6 Breach of A eement, Default, and Remedies
Section 7 Miscellaneous
Attachment A Statement of Work — Pro'ect Obli ations
Attachment B Safe ards for TWC Information
Attachment C Texas Workforce Commission User A eement
Attachment D Cover Sheet for Transmittin User A eement and Trainin Certificate
Attachment E "Intentionall omitted"
Attachment F, I Intentionall omitted"
Attachment G Certificate of Destruction for Contractors and Vendors
Attachment H Quarterly Self-Assessment Report
Information Release Contract: May 16
TWC Contract Number: 2917PEN023
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TEXAS WORICFORCE COMNIISSION
P$RFORMING AGENCY CONTRACT
TEXAS WORKFORCE COMMISSIOIV
INFORMATION RELEA5E CONTRACT
GENERAL TERMS AND CONDITIONS
SECTIOIV 1— Purpose and Legal Authority
1.1 This Contract sets forth the obligations of the Texas Workforce Commission ("Agency") and the
Recipient identified on the cover page (each a"Party" and together "the Parties") with respect to
Agency's release of confidential data to Recipient. The obligations of the Parties are set forth in detai( in
Attachment A.
1.2 Subject to certain limitations, the Interlocal Cooperation Act, Texas Government Code, Chapter 791,
authorizes Recipient to enter into contracts for services with governmental entities, including state
agencies.
SECTION 2— Term, Termination, and Amendment
2.1 This Contract is effective from the Begin Date to the End Date specified on the cover page.
2.2 Either Party may suspend or terminate this Contract at any time, on written notice to the other Party
specifying a termination date at teast thirty (30) calendar days after the date of the notice. Suspension or
termination shall not relieve Recipient of the obligation to pay for all services provided before
suspension or termination at the rates specified herein, nor shall it entitle Recipient to any refund of the
annual subscription fee for online access to Agency records.
2.3 No modification will be valid unless in writing and signed by both Parties, except for rate revisions
made under Section 3.2 of these General Terms and Conditions.
SECTION 3 — Consideration
3.1 Recipient shall pay Agency for the services described, and at the rates set forth, in Attachment A.
3.2 Notwithstanding Section 3.1 of these General Terms and Conditions, Agency may unilaterally revise
rates upon written notice to Recipient of at least thirty (30) calendar days.
SECTION 4— Protecting the Confidentiaiity of TWC Information
4.1 "TWC Information" means records maintained by Agency, and records obtained by Recipient from
Agency under this Contract, including (1) records and data compilations provided electronically, on
Information Release Contract: May 16
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TEXAS WORKFORCE COMMISSION
PERFORMING AGENCY CONTRACT
paper, or via online access or e-mail, (2) records and data compilations that Recipient has converted into
another format or medium (such as handwritten or electronic notes), and (3) records and data
compilations incorporated in any manner inio Recipient's records, files or data compilations.
4.2 Recipient shall protect the confidentiality of TWC Information and comply with all statutory, regulatory
and contract requirements. Confidentiality is required by Texas Labor Code §§ 301.081 and 301.085,
the Social Security Act of 1934, and 20 Code of Fed�ral Regulations (C.F.R.) Part 603.
SECTION 5— Records and Audit
Recipient shall keep and maintain comptete and accurate records sufficient to allow Agency, the Texas 5tate
Auditor's Office, the United States government, and their authorized representatives to determine Recipient's
compliance with this Contract.
SECTION 6— Breach of Agreement, Defautt, and Remedies
6.1 If Recipient or any official, employee, or agent of Recipient fails to comply with any provision of this
Contract, including timely payment of Agency's invoices, Agency may suspend services to Recipient
(including any data requests being processed) until Agency is satisfied that corrective action has been
taken to assure there will be no future breach.
6.2 In the absence of prompt and satisfactory corrective action to cure default and assure future compliance
with Contract requirements, Agency shall terminate this Contract immediately and Recipient sha11
surrender to Agency all TWC Information that has not previously been returned to Agency, and any
other records relevant to this Contract.
63 Termination of this Contract under Section 6.2 of these General Terms and Conditions will not lirnit
Agency from pursuing penalties under state and federal law for the unauthorized disclosure of TWC
Information.
6.4 Agency shall undertake any other aciion under this Contract or under any law of this State or of the
United States, to enforce this Contract and to secure satisfactory corrective action and return of TWC
Information.
6.5 Agency shall take other remedial actions permitted under state or federal law to enforce this Contract
and 20 C.F.R. Part 603 including seeking damages, penalties, and restitution for all costs incurred hy
Agency in enforcing this Contract and responding to RecipienYs breach.
SECTION 7 — Miscellaneous
7.1 Texas Labor Code § 301.085 provides that unemployment compensation records are not "public
information" for purposes of the Public Information Act, Texas Government Code, Chapter 552.
Information Release Contract: May 16
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TEXAS WORKFORCE COMMISSION
PERF017MING AGENCY CONTRACT
Recipient shall not release any TWC Information in response to a request made under the Public
Information Act or any other ]aw, regulation, or ordinance addressing public access to government
records.
7.2 Recipient shall notify Agency within twenty-four (24) hours of the receipt of any subpoena, other
judicial request, ar request for appearance for testimony upon any matter concerning TWC Information.
Federal regulations at 20 C.F.R. § 603.7 dictate the handling of subpoenas for TWC Information.
7.3 This Contract is made in and performed in the State of Texas, and shall be construed, interpreted, and
applied in accordance with the laws of the State of Texas, excluding its choice of law rules. Venue of
any caurt action brought directly or indirectly by reason of this Contract shall be in a court of competent
jurisdiction in Travis County, Texas. NOTHING IN THTS SECTION SHALL BE CONSTRiTED
AS A WAIVER OF SOVEREIGN IMMiJ1vITY BY AGENCY.
7.4 Agency's failure to enforce any provision of this Contractdoes not constitute a waiver of that provision
or any other.
7.5 Recipients agrees to indemnify and hold harmless Agency, the State of Texas, and their employees and
officials for any loss, damages, judgments, and costs arising or resulting from any acts or omissions or
alleged acts or omissions of Recipient or its employees, agents, contractors, and subcontractors,
including the inappropriate release or use of TWC Information.
7.6 Recipient shall be responsible and liable for any damages resulting from a breach by Recipient including.
damages and losses of third parties. Recipient shall reimburse Agency for any costs incurred by Agency
in reimbursing third parties damaged by Recipient's breach and costs incurred in attempts by Agency to
limit third party losses resulting from Recipient's breach.
7.7 Recipient agrees to accept liability for any damage to Agency's hardware, software, or TWC
Information when such damage is caused by the actions of employees, contractors, subcontractors or
agents of Recipient, whether or not the individual was an authorized User under this Contract.
7.8 If any provision of this Contract is held to be unenforceable by a court, this Contract will be construed as
if such provision did not exist and the unenforceability of such provision will not render any other
provisions of this Contract unenforceable.
7.9 This Contract is the entire agreemeni between the Parties.
7.10 The subject headings used in this Contract are for convenience only and are not intended to expand or
limit meanings.
7.11 Attachments listed in the Table of Contents are incorporated in their entirety as terms and conditions of
this Contract.
Information Release Contract: May 16
TWC Contract Number: 291'IPEN023
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TEXAS WORKFORCE COMIvIISSION
PERFORMING AGENCY CONTRACT
?.12 The foltowing provisions survive the expiration or earlier termination of this Contract: Sections 4.2, 5,
6.2, 6.3, 7.1, ?.2, 7.5, 7.6, and 7.7 of these General Terms and Conditions; Sections 3.2.3, 3.2.4, and
3.2.5 of Attachment A; and Attachment B.
Remainder of Page Intentionally Left Blank
Information Reiease Contract: May 16
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TEXAS WORKFORCE COMMISSION
INFORMAT`ION RELEASE CONTRACT
Attachment A
INFORMATION RELEASE CONTRACT BETWEEN TEXAS WORKFORCE COMMISSION
AND
CITY OF FORT WORTH -Fc v�s�° u-+�� �e-��{zf� �
-t-l�e For-��vo��{� PoliceDP��.rf�N��
STATEMENT OF WORK — PROJECT OBLIGATIONS �'
SECTION 1 — Project Abstract
1.1 Contract Pur�ose, The purpose of this Contract is to provide Recipient with access to confidential
Agency data, to ensure that Recipient will maintain the confidentiality of the data, and to require
Recipient to reimburse Agency for costs of providing access at the rates set out in this Contract.
1.2 Authorized Use of TWC Information. Subject to the security and confidentiality provisions of this
Contract, Recipient is authorized to use TWC Information solely for the following purpose: to assist in
criminal investigations; to assist in locating defendants, witnesses, fugitives and persons with
outstanding warrants in criminal cases (the "Limited Purpose"). Any other use of TWC Information
by Recipient is a breach of this Contract.
1.3 References. Section references are to sections of this Attachment A unless otherwise specifted.
SECTION 2— Obligations of Agency
2.1 Online Access.
2.1.1 Description. Agency agrees to provide online "read-only" access to the following Agency
mainframe computer screens:
• BN75: wage records file;
• CMES, CTCS, and BPCS: unemployment compensation claim benefit data; and
2.1.2 Number of Users. Subject to Section 3.1, Agency will gant access to the screens listed in
Section 2.1.1 to a �naximum of ten(10) "Users," all of whom must be direct Recipient
employees.
2.1.3 Availabilitv. Online access will routinely be available Monday through Friday, 8:00 a.m. to
5:00 p.m. Central Time, excluding State holidays, although Agency does not guarantee access
during these periods. Agency may terminate or limit access without notice based on business
necessity or in the event of an emergency.
SECTION 3— Obligations of Recipient
Information Release Contract — Aug - 16
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TEXAS WORKFORCE COMMISSION
INFORMATION RELEASE CONI`RACT
3.1 Online Access.
3.1.1 Annual Fee and Pa m�en_t. Recipient shall pay Agency a one thousand five handred dollar
($1,500.00) annual subscription fee for the online access described in Section 2.1. The annua(
subscription fee covers the twelve (12) month period that begins on the Begin Date. Payment of
the annual subscription fee is due within thirty (30) days of Recipient's execution of this
Contract. The annual subscription fee is nonrefundable and will not be prorated in case of early
termination of this Contract or suspension of services. Recipient shall pay Agency the annual
subscription fee for each subsequent contract year within thirty (34) days of the beginning of
each contract year, Recipient shall send payment to Texas Workforce Commission, Revenue
and Trust Management, P.O. Box 322, Austin, TX 78767-0322.
3.1.2 User pocuments. All prospective online Users must execute a Texas Workforce Commission
User Agreement ("User Agreement"), Attachment C, and complete online TWC Information
Technology Security Awareness Training ("SecuriTy Training").
3.1.3 User pocument Submission and Maintenance. Before Agency RACF Administration will issue
a User ID and password to a prospective User, Agency RACF Administration must receive from
Recipient Contact Person (designated in Section 4.1) copies of a completed User Agreement and
certificate of completion of Security Training ("Training Certificate"), with a cornpleted Cover
Sheet for Transmitting User Agreement and Training Certificate ("Cover Sheet"), Attachment D.
Agency may deny access to any prospective User on security graunds. Recipient must maintain
on file all original Training Certificates and User Agreements.
3.1.4 Annual User Renewal. Each year, on the first day of the month following the anniversary of the
Begin Date, the online access of each User will be terminated unless Agency RACF
Administration has received for the User, from Recipient Contact Person, copies of a new User
Agreement and new Training Certificate executed or dated, respectively, no more than thirty (30)
calendar days before submission, with a completed Cover Sheet.
3.1.5 Notice of User Employment Chan�e. Recipient shall notify Agency within three (3) calendar
days of a User's termination, resignation, or reassignment into a position not requiring access to
TWC Information, so that the User's password can be immediately revoked. Failure to provide
such notice is a breach of this Contract and may result in immediate suspension of all online
access, termination of this Contract, and other penalties provided by 1aw and this Contract.
3.1.6 Chan es Prohibited. Users shall not change or update any TWC Information contained in
Agency's computer stored files. Users shall not use any automated system or software to make
multiple queries of Agency's computer stored files.
3.1.7 Instructions. Recipient shali be solely responsible for disseminating to Users any instructions
provided by Agency regarding navigation of online access to TWC Information.
3.2 Additional Requirements.
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TEXAS WORKFORCE COR�IMISSION
INFORMATION RELEASE CONfiRACT
3.2.1 Securi . Safe ug ards. Recipient shall establish, maintain, and comply with security safeguards
and procedures to protect the confidentiality of all TWC Information. Recipient shall comply
with the requirements in Safeguards for TWC Information, Attachment B. Failure to comply
with any requirement of Attachment B is a breach of this Contraci.
3.2.2 Suspension. Agency may suspend all services without notice if Agency suspects a violation of
the security provisions in Attachment B. Services will remain suspended until Agency has fully
investigated any suspected security violations and is satisfied that resumption of services will not
result in security breaches. In the event of an extended suspension of services, Agency will
notify Recipient as soon as possible.
3.2.3 Endurin� Obli�ation. Termination or expiration ofthis Contract will not end Recipient's
responsibility to protect the confidentiality of TWC Information remaining in Recipient's
possession, under Recipient's control, or held by a third party subject to contract or agreement
with Recipient.
3.2.4 Audit. Recipient's security safeguards and procedures, as well as Recipient's access to and use
of TWC Information, are subject to monitoring, evaluation and audit by Agency.
3.2.5 Inspections. Recipient shall cooperate fully with any on-site inspections and monitoring
activities of Agency. So that Agency may audit Recipient's campliance with the requirements of
state and federal law and this Contract, Recipient shall permit Agency access to all sites
containing TWC Information (including sites where data is maintained electronically), and to all
workplaces used by personnel who have access to TWC Information.
3.2.6 Self-Assessment Report. Recipient shall submit to Agency a fully-executed Quarterly Self-
Assessment Report, Attachment H, on the next-occurring quarterty filing date after the Begin
Date, and on each quarterly filing date for as long as this Contract is in effect. The quarterly
filing dates are January 1, April 1, July 1, and October 1. Each report must have been signed
within thirty (30) days preceding submission.
3.2.7 Identitv Theft Protection. In case of unauthorized disclosure of TWC Information by Recipient,
Recipient sha11 purchase identity theft protection service for all individuals whose information
was disclosed without authorization. The protection service shall cover each individual for a
two-year period and must include, at a minimum, automatic fraud alerts to the individual.
3.2.8 Si�;nificant Chan�e. Recipient agrees to notify Agency in writing within ten (10) calendar days
of any significant change affecting Recipient and Recipient's identity, including but not limited
to changes in its ownership or control, name, governing board membership, authority of
governing board, officeholders, or vendor identification number.
3.2.9 Computer Resources. Recipient shall provide and maintain its own computer hardware and
software to accomplish the necessary computer communications linkages with Agency.
3.2.10 Data Source. Agency does not warrant ar guarantee the accuracy of TWC Information. TWC
Information includes data pravided to Agency by third parties, including employers and
employees.
InformaYion Release Contract — Aug - 16
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TEXAS WORKFORCE COMNIISSION
1NFORMATION RELEASE CONTRACT
SECTION 4 — Contact Persons
4.1 Desi ir�ion. The Parties designate the following primary liaisons for implementation of this Contract:
Agency Contact Person
Michelle D. Smith
External Data Exchange Contracts (EDEC)
Procurement and Contract Services Department
Texas Workforce Commission
1117 Trinity Street, Room 104AT
Austin, TX 78701
Phone: 512-936-3296
Fax: 512-463-2990
Email: RSMContracts(a�twc.state,tx,us
Recipient Contact Person
Lesley Yencho
Criminal Intelligence Analyst
City of Fort Worth �se-Be����— for�-k�
3900 Barnett Street �ise ahd ba.nefi�e-F-f-b��
F�;-f-6�c�r+�� i'a(�c�DePa:'fihen-F'
Fort Worth, TX 76103 LLL
Phone; 817- 378-1500
Email: Lesley.Yencho�fortwo��thtexas.�ov
Send invoices to:
Denise Joyner
Procurement Specialist
City of Fort Worth �e�iee-Be�e� %r-I-he u.se a-r,d
3900 Banett Street �e"�{'tc-F-f�t,e �c�-U)et'-�-i� Pol«e
Fort Worth, TX 76103 ���'`"�'ne�t-J-��
Phone: 817-392-4227
Email: Denise.Joynernfortwortll.�ov
4.2 Notice. Any notice required under this Contract must be given to the other Party's Contact Person.
4.3 Notice to Altemate. If Recipient designates an alternate Contact Person, written notification by Agency to
one (1) of the Recipient Contact Persons will satisfy any notification requirement of this Contract.
4.4 Chan�e. Recipient may request a change in Recipient Contact Person by submitting to Agency Contact
Person a written request on organizational letterhead signed by the person who signed this Contract on
behalf of Recipient, or by a successor with authority to bind Recipient contractually. The request must
include the TWC Contract Number, the name of the person being replaced, and the name of the new
Recipient Contact Person, with job title, work address, phone number, and email address. No change in
Recipient Contact Person is effective until acknowledged in writing by Agency.
4.5 Communications. Recipient shall include the TWC Contract Number in all communications with Agency.
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TEXAS WORKFORCE COMIvIISSION
INFORMATION RELEASE CONTRACT
Attachment B
SAFEGUARDS FOR TWC INFOI2IVIA,TIOIV
"Recipient" in this Contract shall maintain sufficient safeguards over afl TWC Information to prevent unauthorized
access to or disclosure of TWC Information:
"TWC Information" means records maintained by Agency (TWC), and records obtained by Recipient from
Agency under this Contract, including (1) records and data compilations provided electronically, on paper, or via
online access or e-mail, (2) records and data compilations that Recipient has converted into another format or
medium (such as handwritten or electronic notes), and (3) records and data compilations incarporated in any
manner into Recipient's records, files or data compilations.
2. Monitorine. Recipient shall monitor its Users' access to and use of TWC Information, and shall ensure that TWC
Information is used only for the following "Limited Purpose": to assist in criminal investigations; to assist in
locating defendants, witnesses, fugitives and persons with outstanding warrants in criminal cases. Recipient
shall also ensure that TWC Information is used only for purposes authorized by law and in compliance with all other
provisions of this Contract.
3. Stora�e. Recipient shall store TWC Information in a place physically secure from access by unauthorized persons.
4. Protection. Recipient shall store and process TWC Information, including that maintained in electronic format, such
as magnetic tapes or discs, in such a way that unauthorized persons cannot obtain TWC Information by any means.
5. Access. Recipient shall undertake precautions to ensure that only authorized personnel are given access to TWC
Information stored in computer systems,
6. Instruction. Recipient shall instruct a11 personnel having access to TWC Information about all confidentiality
reyuirements including the requirements of 20 C.F.R. Part 603 as well as the sanctions specified in this Contract and
under state and federal law for unauthorized disclosure of TWC Information. Recipient acknawledges that all
personnel who will have access to TWC Information have been instructed as required.
7. Disposal. Recipient shali dispose of TWC Information and any copies thereof after the Limited Purpose is achieved,
except for TWC Information possessed by any court. Disposal means return of TWC Information to Agency or
destruction of TWC Information, as directed by Agency. Disposal includes deletion of personal identifiers in lieu of
destruction. In any case, Recipient shall dispose of all TWC Information within thirty (30) calendar days after the
termination, cancellation, or expiration of this Contract, or as required by federal, state, or local government
approved records retention requirements.
8. System. Recipient shall establish and maintain a system sufficient to allow an audit of compliance with the
requirements of this Attachment B and the other provisions of this Contract.
9. No Disclosure or Release. Recipient shall not disclose or release any TWC Information other than as permitted in
this Contract, without prior written consent of Agency.
10. Unauthorized Disclosure. It is a breach of this Contract to disclose TWC Information orally, electronically, in
written or printed form, or in any other manner without the prior written consent of Agency:
10.1 to any contract employee of Recipient or any individual not employed by Recipient;
10,2 to another government entity, including a law enforcement entity;
10.3 to Recipient employees who do not have a need to use TWC Information for the Limited Purpose.
Inforrnation Release Contract—Aug- 16
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TEXAS WORKFORCE COMMISSION
INFORMATION RELEASE CONTRACT
11. Authorized Disclosure. TWC Information may only be disclosed:
11.1 to employees under the direct hiring-and-�ring control of Recipient who have a need to use the TWC
Information for the Limited Purpose; and
11,2 in a criminal judicial proceeding if the TWG Information is introduced in court as a sealed record with access
limited to the prosecutor, defendant, judge, and jury.
12. Security Violation. Recipient shall monitor access of Users and shall notify Agency within twenty-four (24) hours if
a security violation of this Contract is detected, or if Recipient suspeats that the security or integrity of TWC
Information has or may have been compramised in any way.
13. Format. TWC Information is subject to the requirements of this Contract even if the TWC Information is converted
by Recipient into another format or medium, or incorporated in any manner into Recipient's records, files, or data
compilations. �
14. Access Limited. Recipient shall limit access to TWC Information to its employees who need access to achieve the
Limited Purpose.
15. Mobile Device and Removal. Recipient shall not place TWC Information on mobile, remote, or portable storage
devices, or remove storage media from RecipienYs facility, without the prior written authorization of Agency.
16. Public Information Act. Under Texas Labor Code § 301.085, TWC Infortnation is not "public information" for
purposes af the Public Information Act, Texas Government Code, Chapter 552. Recipient shall not release any TWC
Information in response to a request made under the Public Information Act or under any other law, regulation, or
ordinance addressing public access to government records.
17. Subpoena. Recipient shall notify Agency within twenty-four (24) hours of the receipt of any subpoena, other judicial
request, or request for appearance for testimony upon any matter concerning TWC Inforrnarion. Federal regulations
dictate the handling of subpoenas for TWC Information. Recipient shall comply with the requirements of ZO C.F.R.
§ 603.7 in responding to any subpoena, other judicial request, or request for appearance for testimony upon any
matter concerning TWC Information.
18. Federal Re ug lation. Recipient shall comply with all requirements of Safeguards for TWC Information (Attachment
B of this Contract) relating to safeguarding TWC Infor►nation and insuring its confidentiality.
19. Unauthorized Lookup. A User shall not access TWC Information listed under the User's SSN or the SSN of a co-
worker, family member, or friend.
20. Screenin�-, Online Users. Recipient shall screen potential Users and seek online access only for employees that
Recipient has determined pose no threat to the security of TWC Information.
21. Screenin� — All Handlers. Recipient shall permit access to TWC Information only to employees that Recipient has
determined pose no threat to the security of TWC Information.
22. Internet. Recipient shall not transmit any TWC Information over the Internet unless it is encrypted using at least
256-bit encryption.
23. Screen Dump. Recipient's security guidelines shalt ensnre that any screen dump or other extraction of TWC
Information will be protected from unauthorized use or disclosure.
24. No Transfer. Recipient shall not transfer the authority or ability to access or maintain TWC Information under this
Contract to any other person or enYity.
Information Release Contract — Aug - 16
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TEXAS WORKFORCE COMMISSION
INFORMATION RELEASE CONTRACT
TEXA5 WORI�'ORCE COMMISSION USER AGREEMENT
(User's Printed Name)
(User's work phone number)
(Print User's employer)
(User's Social Security Number)
(Print User's work street address)
(Print User's work email)
Attachment C
acknowledge that I will be assigned a personal User ID and password to gain access to the Texas Workforce Commission (TWC)
computer system. Under no circumstances will I allow my User ID or password to be used by any other individual, nor will T use one
belonging to anyone else. As an online User with access to confidential TWC data ("TWC Information"),1 understand that I will be
held personally accountable for my actions and for any acrivity performed under my User ID. I understand that the use of TWC
Information is limited to the foUowing Limited Purpose only: to assist ia criminal investigations; to assist in locating defendaots,
witnesses, fugitives and persons with oufstanding warrants in criminal cases. I understand that TWC maintains a record of the
individuals and employers whose TWC Information I gain access to, and that I am not allowed access to TWC Information about any
individual ar employer except as necessary for the Limited Purpose. I understand that I am not allowed access to TWC Information
about myself.
I will not enter any unauthorized data or make any changes to data. I wiil not disclose any TWC Information orally, electronically, in
written or printed form, or in any other manner without prior written authorization from TWC. I wil! not disclose any TWC
Information to other governmental entities, including law enforcement entities.
I understand that under Texas Labor Code § 301.085, all TWC Infarmation I obtain under this User Agreement is confidential and that
it is a criminal offense to solicit, disclose, receive or use, or to authorize, permit, participate in, or acquiesce in another person's use of
TWC Information that reveals: (1) identifying information regarding any individual or past or present employer; or (2) information
that foreseeably cou(d be combined with other public(y available information to reveal identifying information regarding any
individual or past or present employer. This offense is punishable by as much as a year in jaif, a fine up to $4,000, or both.
I understand that under Texas Penal Code § 33.02(a), it is a criminal offense knowingly to access a computer, computer nerivork, or
computer system without the effective consent of the owner. Depending on the circumstances, the offense is punishable by 180 days
in jail up to 99 yeazs or life in prison, a flne of $2,000-$10,000, or both.
I have read and had e�cplained to tne the confidentiality and security requirements of 20 C.F.R. § 603.9 and of my employer's contract
with TWC. I understand and agree to abide by these requirements. I understand that if I violate any of these requirements or any
provision of this User Agreement, I will jeopardize my employer's contract with TWC.
Signature ofUser Date signed
Supervisor Approval: I have instructed the User listed above about all confidentiality requirements applicabie to TWC Information
obtained under the contract with TWC, including the requirements of 20 C.F.R. § 603.9 and the sanctions specified in the Contract and
in state law for unauthorized disclosure of TWC Information.
Signature of Supervisor
Printed Name
Approval of Contract Signatory or Contact Person named in Contract:
Signature of Contract Signatory or Recipient Contact Person Printed Name
Date signed
Date signed
All fields on this agreemeot are required. Empioyer must retain signed origiaal and give a copy to User. Employer must send copy of User Agreemept to
TWC RACF AdmioistraHon ss specified oa the required Cover Sheet, Attachment D to t6is Conhac�
Tnformation Re(ease Conttact — Aug - I6
TWC ContracYNumber: 2917PEN021
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TEXAS WORKFORCE COMMISSION
1NFORMATION RELEASE CONTRACT
Attachment D
COVER SHEET FOR TRANSMITTING USER AGREEMENT AND TRAINING CERTIFICATE
To: RACF Administration
via email to: racf.admnna,twc.state.tx.us
� (Document must be scanned and encrvated before sending)
via fax to: 512-463-6394
Number of pages including cover sheet:
via mail to: RACF Administration
Texas Workforce Commission
101 East 15th Street, Room 0330
Austin, TX 78778-0001
From: City of Fort Worth ' ecipient)
� -F�r��sea-„�1 be�f�if-c�-Ffi-h�� G�-,rfWcr�1-, (�cltcz ������Z,--h��l„�
111-
(R.ecipient Contact Person)
(Recipient Contact Person email)
Re: Agreement(s) and Training Certificate(s) attached
Instructions:
• User Agreement and Training Certificate must be submitted tog1ether for each individaal.
� Only one cover sheet is required if submitting documents for more than one User at the same time.
• An incomplete User Agreement will be rejected.
• For questions resardine the User A�reement. please email racf.admn(�hvc.state.�.us
Information Release Contract — Aug - 16
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Page 8 of 12
TEXAS WORKFORCE COlbIIvIISSION
INFORMATION RELEASE CONTRACT
Texas Workforce Commission Attachment G
Certificate of Destruction for Co�tracfors and Vendors
Hard copy and electronic media must ba sanitized prior to disposal ar release for reuse. The TWC tracks, documents, and verifies media sanitization
and disposai actions. The media mnst be protecfed and controlled by authorized personnei during transport outside of controlled areas. Approved
methods for media sanitization are listed in the NIST Special Pubiicatlon 800-88, Guldelines for Media
SanitiZation. http://csrc.nist.aov/pubfications/nistqubsB00-88/NISTSP800-88 wfth-errata.pdf
_. __ .
Contact IYame Tltle Com an IVame and Address Phone
You may attach an inventory of the media if needed for buik media d+sposition or destruction.
Media T e Media Tiile / Document Name
HARD COPY ELECTRONIC
Media Description
(Paper, Microfiim, Computer Media, Tapes, etc,)
Dates of Records
Document / Record Trackin Number 7WC Item Number Make / Model Serial Number
CLEAR Who Completed? Who Verified?
Item Sanitization PURGE Phone Phone
DESTROY DATE Completed
Sanitization Method and/or Product Used 3
Reuseti tniemally �=� � Destruction / Disposai
Final Disposition of Medfa Reused Extemaily �r� Retumed to Manufacturer
Other:
Comments•
!f any TyVC Data;is ret�a�nied, indica#et�ie fjr�e�ofsto�agsmecii�;:physical iocatiorts(s), and any planned destruction date.
Descri tion of 7V11C Dafa Retained and t�eten�bn`Re^ uiremenfis :.� �
Pr000sed method of destruction for TWC aoaroval: TypB Of StoF'age.Tt'tedta? .,; .
,.Pj�p�ical lacaiion?
Pl�nned.d'estii�cflon date?
Within iive (5} days of destreietion ar purging, provitle tfie'PINC with a signed statemerrt cont�ining ttie date af clearing, purging or destruction,
description of TWC data cleared, purged or desfroyed anii #fie method(s) used.
Authorized approval has been recelved for the destrucUon oi media tdentified above and has met all TWC Records Retention 5chedule requirements
inciuding state, federal and/or fntemal audft requiremenfs and is not pending any open records requests.
Records Destrbyed by: :' ;: Records Destruction Verified by:
- �`.
� �;'
Si nature qate ;4 Si na#ure Date
Be sure to enter name and contact Info for who completed the data destructlon and who verified data destruction in the fieids aBove.
Send the signed Certificate of Destruction to:
TWC: Informaiion Security Office, Rm. 0330A, 101 E. 15th Street, Austin, TX 78778-0001 ,
GP Revised: 09-02-15
Information Release Contract—Aug- 16
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TEXAS WORKFORCE COMMISSION
INFORMATION RELEASE CONTRACT
Texas Workforce Commission Attachment G
Certificate of Destruction for Contractors and Vendors
INSTRUCTIONS FOR CERiIFiCATE OF DESTRUCTION
Hard copy antl eiectronic metlia must be sanitized prior to disposal or release for reuse. The 7wc tracks, documents, ana vennes meaia sarnuzan
and disposaf actions. The medfa must be protected and controlfed by authorized personnei during fransport outside of controlied areas. Approved
methods for media saniGzation ane listed 'm the NIST Special Pubiicat(on 800-88, Guidelines for Media
Sanitization. http://csrc,nist.caov/oublfcations/nistoubs/800-88/NISTSP800-88 Wtth-errata.udfi
IRS Publication 1075 directs us to the FISMA requirements and NIST guidelines for sanitization and disposition of inedia used
for federal tax information (FTIj. These guidelines are also required for sensitive or confidential information that may include personaliv
identifiable information (PIt) or protected health information (PHIj. NIST 800-88, Appendix A contai�s a matrix of inedia with minimum
recommended sani6zation techniques for clearing, purging, or destroying various media types. This appendix is to be used with the
decision flow chart provided in NIST 800-88, Section 5.
There are two primary types of inedia in common use:
e Hard Coav. Hard copy media is physical representations of information. Paper printouts, printer and facsimile ribbons, drums,
and platens are all examples of hard copy media.
Etectronic (or soft coqv}. Electronic media are the bits and bytes contained in hard drives, random access memory (RAM),
read-only memory (ROM), disks, memory devices, phones, mobile computing devices, networking equipment, and many other
types listed in NIST SP 800-88, Appendix A.
1. For media being reused within your organization, use the CLEAR procedure for the appropriate type of inedia. Then validate the
media is cleared and document the media status and disposition.
2. For media to be reused outside your organization or if leaving your organization for any reason, use the PURGE procedure for the
appropriate type of inedia. Then validate the media is purged and document the media status and disposition. Note that some
PURGE techniques such as degaussing will typically render the media (such as a hard drive) permanently unusable.
3, For media that will not be reused, use the DESTRUCTION procedure for the appropriate type of inedia. Then validate the media is
destroyed and document the media status and disposition.
4. For media that has been damaged (i.e. crashed drive) and cannot be reused, use the DESTRUCTION procedure for the appropriate
type of inedia. Then validate the media is destroyed and document the media status and disposition.
5. If immediate purging of all data storage components is not possible, data remaining in any storage component will be protected to
prevent unauthorized disclosures. Within twenty (20) business days of contract expiration or termination, provide TWC with a signed
statement detailing the nature of TWC data retained type of storage media, physical location, planned destruction date, and the
proposed methods of destruction for 7WC approval.
6, 5end the signed Certificate of Destruction to:
Texas Workforce Commission
Information Security Office
Room 0330A
101 E. 15�' Street
Austin, TX 78778-0001
Final Distribution of
Certificate
Originai to:
Copy to;
Information Release Contract — Aug - 16
TWC Contract Number: 2917PEN021
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Page ] 0 of 12
FAX to: 512-463-3062
or send as an email attachment to:
willie. harvevCa?twc.state. bc. us
Wiflie Harvey, Chief Infomiation Security O�cer 512-463-8372
1, Yout Gompany Records Management Liaison - or - Information Security Officer
2. TWC Contract Manager
GP Revised: 09-02-15
TEXAS W(�RKFORCE COMMISSION
INFORMATION RELEASE CONTRACT
Attachment H
QUARTERLY SELF-ASSESSMENT REPORT
Faiture to submit this report by due date can result in termination of all access to TWC Information.
The entity receiving TWC Information under TWC Contract ("RecipienY') confirms it is in compliance with the
requirements of the Contract and the Safeguards for TWC Information (Attachment B of the Contract), during the
previous period, to include the following:
1. Recipient used the disclosed TWC Information only for purposes authorized by law Yes: � No: _
and consistent with the Limited Purpose set forth in Section i.2 of Attachment A of
the Contract.
2. Recipient stored the disclosed TWC Information in a place physically secure from Yes: _ No: _
access by unauthorized persons. This includes hard copies of the information.
3. Recipient stored and processed disclosed TWC Information maintained in electronic Yes: _ No: _
format outside of the recipient computer systems in such a way that unauthorized
persons cannot obtain the TWC Information by any means.
4. Recipient took precautions to ensure that only authorized personnel were given Yes: _ No: _
access to disclosed TWC Information that is stored in recipient's computer systems.
5. Recipient has inshucted all personnel having access to the disclosed TWC Yes: _ No: _
Information about confidentiality requirements, the requirements of 20 C.F.R. §
603.9 found in Safeguards for 7`WC Information (Attachment B), and the sanctions
specified in State law for unauthorized disclosure. (Each violation is a Class A
Misdemeanor, punishable by a fine of $4,000, a year in jail, or both).
6. Recipient adhered to confidentiality requirements and procedures that are consistent Yes: _ No: _
with, and meet the requirements of the TWC Contract.
7. Recipient agreed to report any infraction(s) of these requirements and procedures to Yes; _ No: _
TWC fully a.nd promptly.
8, Recipient disposed of disclosed TWC Information, and any copies thereof made by Yes: _ No: _
Recipient, after the purpose for which the TWC Information was disclosed, is
served, or as required by court order. (Disposal means return of the TWC
Information to TWC or destruction of the TWC Information, as directed by TWC.
Disposal includes deletion of personal identifiers in lieu of destruction.)
9. Recipient ensured that the disclosed TWC Information is not retained with personal Yes: _ No: _
identifiers for longer than such period of time as TWC deems appropriate.
10. Recipient maintained a system sufficient to allow an audit of compliance wifh the Yes; _ No: _
requirements of 20 C.F.R. § 603.9 (Attachment B} and the TWC Contract.
I 1. Attached is a description of the system referred to in Item 10. Recipient ensured Yes: _ No: _
that any copies of any logs sent to TWC do not contain Sensitive PII. Remember to
secure originals containing PII.
Information Release Contract — Apr 2016
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Page 1 l of 12
TEXAS WORKFORCE COMIvIISSION
INFORMATION RELEASE CONTRACT
12. Recipient maintained as a minimum, the encryption requirements of FIPS 140-2 and Yes: _ No: _
encrypt the data at the minimum of 256-bit AES encryption.
13. Annual Renewal of Contract User Agreement and training certifications per the Yes: _ No: _
Contract terms are on file and copies have been submitted to
RACF.A dministration@twc.state.tx.us.
14. All users have completed the training within the previous 12 months. Yes: _ No: _
By signature hereon, the Contract signatory or the entity's internal auditor certifies t6at:
Al] statements and information submitted in response to this Quarterly Self-Assessment Report are current,
accurate, and complete.
Signature
Date
Printed Name and Title City of Fort Worth �e�i�ee-B�•2917PEN02I
-�cr, u5 e cz.�,d b�-ne-f �t c F-I-h e.
Return this Report to: Fa r+ ��s �;�-h Pr I r c� �1 e��,=hn � �, i-
LLL
External Data Sharing Contracts Manager � Procurement and Contract Services Department �
Texas Workforce Commission � 1117 Trinity Street, Room 304AT � Austin, Texas 78701
Email: SelfAssessmentReports(�a,rivc.state.tY.us
Fa�t: 512-936-0219
Information Release Contract— Apr 2016
TWC Contract Number: 2917PEN021
2/24/2017 10:39 AM
Page 12 of 12
APPROVAL RECOMMENDED:
/ l
By: �"=�E
Chief Joel F. Fitzgerald
Chief of Police
Date:
CONTRACT COMPLIANCE MANAGER:
By signing I acicnowledge that I am the peison responsible
for the monitoring and administration of this contract, including
ensuring all performance and reporting requirements.
Michael B. Munday
Technology Services Manager
Date: 0�(o20lp�0%%
APPROVED AS TO FORM AND LEGALITY:
:
Dat
��. .� ;.
Jessica San'gsvang � �
Assistant City Attorney II
e: �_� � � 1
CONTRACT AUTHORIZATION:
No M&C Required
ATTES ��
By: ! �
Mary J. Ka
l "�� � �''a �.`'1/0�
.� : ''•.'��
�' � '_
�� ��
City Secretary "�:�q"�'s�� ��
i Y! `� Lii
Date:
���1/�� � s�.
Form 1295 Certification No: NOT REQUIRED
This agreement does not require City Council approval.
'�F�ICIAi. RECORD
CITqf SECRETARY
FT. WORTH, TX