HomeMy WebLinkAboutContract 53600 DocuSign Envelope ID:592AD963-DB4B-44A1-8740-EC61C99E3155
TEXAS WORKFORCE COMMISSION
PERFORMING AGENCY CONTRACT
CSC No.53600
TEXAS WORKFORCE COMMISSION
TWC Contract Number 1 2920PEN035
TITLE INFORMATION RELEASE CONTRACT
-- -
Name City of Fort Worth for the benefit of Fort Worth Police Department
505 505 W.Felix Street
City/State/Zip City/State/Zip Fort Worth, TX 76115
Telephone Number (817)392-4244
Contract Period
This Contract shall begin on March 1,2620 and shall terminate.on February 28,2025 unless amended by
mutual written agreement of the parties.
Funding Information
The total amount of this Contract will not exceed the sum of $7,500.00
Remarks
This Contract is contingent on Recipient's acceptance of and compliance with the terms and conditions of
this Contract and any referenced attachments.
Summary
Type of Access:
Online access only
Number of online users and rate:
1-10 for$1,500/year for 5 years
The information to be provided by TWC will include:
• wage records (WR)and,
• unemployment compensation claim benefit data(Ul).
Prior contract reference: This contract replaces and supersedes all previous contracts, including
2917PEN021.
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2020
Cln'01 FORTWORTh'
CITYSECRETARY
.gam OFFICIAL RECORD
on Release Contract:Aug-18 CITY SECRETr4RY
TWC Contract Number: 2920PEN035 � UVORTFi �')(
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TEXAS WORKFORCE COMMISSION
PERFORMING AGENCY CONTRACT
Signature Authority
Each person signing this Contract hereby warrants that he or she has been fully authorized by the
respective organization to;
Execute this Contract on hehalf ol'the organization. and
• Validly and legally bind the organization to all the terms,performances, and provisions of this
Contract:
Agency Approval Recipient Approval
_
Agency: Texas Workforce Commission Recipient: City of Fort Worth for the benefit of
Fort Worth Police Department
1/17/2020 �eS�1, �� Mar 3,2020
Jesus J.chapa(Mar 3, 20)
Heather Hall Date Jesus. J Chapa Date
Chief Information Officer Assistant City Manager
OFFICIAL.RECORD
Information Release Contract:Aug-18 CITY SECRETARY
TWC Contract Number: 2920PEN035 FT WORTH,TX
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PERFORMING AGENCY CONTRACT
TABLE OF CONTENTS
General Terms and Conditions
Section 1 Purpose and Legal Authority
Section 2 Term, Termination, and Amendment
Section 3 Consideration
Section 4 Protecting the Confidentiality of TWC Information
Section 5 Records and Audit
Section 6 Breach of Agreement,Default, and Remedies
Section 7 Miscellaneous
Attachment A Statement of Work—Project Obligations
Attachment B Safeguards for TWC Information
Attachment C Texas Workforce Commission User Agreement
Attachment D Cover Sheet for Transmitting User Agreement and Training Certificate
Attachment E Intentionally omitted
Attachment F Intentionally omitted
Attachment G Certificate of Destruction for Contractors and Vendors
Attachment H Quarterly Self-Assessment Report
Information Release Contract:Aug-18
TWC Contract Number: 2920PEN035
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PERFORMING AGENCY CONTRACT
TEXAS WORKFORCE COMMISSION
INFORMATION RELEASE CONTRACT
GENERAL TERMS AND CONDITIONS
SECTION 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 detail 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 least 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 Confidentiality 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
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 into Recipient's records, files or data compilations.
Information Release Contract:Aug-18
TWC Contract Number: 2920PEN035
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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 Federal Regulations (C.F.R.)Part 603.
SECTION 5—Records and Audit
Recipient shall keep and maintain complete and accurate records sufficient to allow Agency,the Texas State
Auditor's Office,the United States government, and their authorized representatives to determine Recipient's
compliance with this Contract.
SECTION 6—Breach of Agreement,Default, 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 shall
surrender to Agency all TWC Information that has not previously been returned to Agency, and any
other records relevant to this Contract.
6.3 Termination of this Contract under Section 6.2 of these General Terms and Conditions will not limit
Agency from pursuing penalties under state and federal law for the unauthorized disclosure of TWC
Information.
6.4 Agency shall undertake any other action 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 by
Agency in enforcing this Contract and responding to Recipient's 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.
Recipient shall not release any TWC Information in response to a request made under the Public
Information Act or any other law,regulation, or ordinance addressing public access to government
records.
Information Release Contract:Aug-18
TWC Contract Number: 2920PEN035
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7.2 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 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 court action brought directly or indirectly by reason of this Contract shall be in a court of competent
jurisdiction in Travis County, Texas. NOTHING IN THIS SECTION SHALL BE CONSTRUED
AS A WAIVER OF SOVEREIGN IMMUNITY BY AGENCY.
7.4 Agency's failure to enforce any provision of this Contract does 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 agreement 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.
7.12 The following provisions survive the expiration or earlier termination of this Contract: Sections 4.2, 5,
6.2, 6.3, 7.1, 7.2, 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.
Information Release Contract:Aug-18
TWC Contract Number: 2920PEN035
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Attachment A
INFORMATION RELEASE CONTRACT BETWEEN TEXAS WORKFORCE COMMISSION
AND
CITY OF FORT WORTH FOR THE BENEFIT OF
FORT WORTH POLICE DEPARTMENT
STATEMENT OF WORK—PROJECT OBLIGATIONS
SECTION 1—Project Abstract
1.1 Contract Purpose. 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 and fugitives; and to assist in locating
persons with outstanding warrants (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 specified.
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 and
• CMES, CTCS, and BPCS: unemployment compensation claims benefit data.
2.1.2 Number of Users. Subject to Section 3.1,Agency will grant access to the screens listed in
Section 2.1.1 to a maximum of ten(10) "Users," all of whom must be direct Recipient
employees.
2.1.3 Availability. 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
3.1 Online Access.
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3.1.1 Annual Fee and Payment. Recipient shall pay Agency a one thousand five hundred dollar
($1,500.00) annual subscription fee for the online access described in Section 2.1. The annual
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 (30) 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 Documents. 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 Document Submission and Maintenance. Before Agency EAGLE Support will issue a User
ID and password to a prospective User,Agency EAGLE Support 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 completed Cover Sheet for
Transmitting User Agreement and Training Certificate ("Cover Sheet"),Attachment D. Agency
may deny access to any prospective User on security grounds. Recipient must maintain on file
all original Training Certificates and User Agreements.
3.1.4 User Document Renewal. On April 1,2020 the online access of each User established under a
prior contract will be terminated unless Agency EAGLE Support 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 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 EAGLE Support
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.
3.1.6 Notice of User Employment Change. 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 law and this Contract.
3.1.7 Changes 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.
3.1.8 Instructions. Recipient shall be solely responsible for disseminating to Users any instructions
provided by Agency regarding navigation of online access to TWC Information.
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3.2 Additional Requirements.
3.2.1 Security Safeguards. 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 Contract.
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 Enduring Obligation. Termination or expiration of this 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 compliance 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 quarterly 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 Identity Theft Protection. In case of unauthorized disclosure of TWC Information by Recipient,
Recipient shall 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 Significant Change. 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 or guarantee the accuracy of TWC Information. TWC
Information includes data provided to Agency by third parties, including employers and
employees.
Information Release Contract—Feb 17
TWC Contract Number:2920PEN035
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SECTION 4—Contact Persons
4.1 Designation. The Parties designate the following primary liaisons for implementation of this Contract:
Agency Contact Person Recipient Contact Person
Christopher Murphy Michael Munday
External Data Exchange Contracts (EDEC) Program Support Division Manager
Procurement and Contract Services Department City of Fort Worth for the benefit of
Texas Workforce Commission Fort Worth Police Department
1117 Trinity Street, Room 342T 505 W. Felix Street
Austin, TX 78701 Fort Worth, TX 76115
Phone: 512-936-6402 Phone: 817-392-4244
Fax: 512-936-0219
Email: DEContractsgtwe.state.tx.us Email: Michael.munday@fortworthtexas.gov
Send invoices to:
Carol Davis
Procurement Specialist
City of Fort Worth for the benefit of
Fort Worth Police Department
505 W. Felix Street
Fort Worth, TX 76115
Phone: 817-392-4220
Email: carol.davis@fortworthtexas.gov
4.2 Notice. Any notice required under this Contract must be given to the other Party's Contact Person.
4.3 Notice to Alternate. 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 Change. 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.
SECTION 5—Effect on Other Contracts
The Parties agree that this Contract supersedes and replaces all other contracts between them for information
release or data sharing, including 2917PEN021.
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Attachment B
SAFEGUARDS FOR TWC INFORMATION
1. "Recipient"in this Contract shall maintain sufficient safeguards over all 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 incorporated in any
manner into Recipient's records,files or data compilations.
2. Monitorina. 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 and fugitives; and to assist in locating persons with outstanding warrants. 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. Storage. 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 all personnel having access to TWC Information about all confidentiality
requirements 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 acknowledges that all
personnel who will have access to TWC Information have been instructed as required.
7. Disposal. Recipient shall 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,in accordance with Attachment G, Certificate of Destruction
for Contractors and Vendors, which is attached to this contract and incorporated for all purposes.
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.
11. Authorized Disclosure. TWC Information may only be disclosed:
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11.1 to employees under the direct hiring-and-firing 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 TWC 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 suspects that the security or integrity of TWC
Information has or may have been compromised 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 Recipient's facility,without the prior written authorization of Agency.
16. Public Information Act. Under Texas Labor Code § 301.085,TWC Information is not"public information"for
purposes of 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 Information. Federal regulations
dictate the handling of subpoenas for TWC Information. Recipient shall comply with the requirements of 20 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 Regulation. Recipient shall comply with all requirements of Safeguards for TWC Information(Attachment
B of this Contract)relating to safeguarding TWC Information 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. Screening—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. Screening;—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 shall ensure 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 entity.
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Attachment C
TEXAS WORKFORCE COMMISSION USER AGREEMENT
I,
(User's Printed Name) (User's Social Security Number)
(User's work phone number) (Print User's work street address)
(Print User's employer) (Print User's work email)
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 I use one
belonging to anyone else. As an online User with access to confidential TWC data("TWC Information"),I understand that I will be
held personally accountable for my actions and for any activity performed under my User ID. I understand that the use of TWC
Information is limited to the following Limited Purpose only:to assist in criminal investigations;to assist in locating
defendants,witnesses and fugitives; and to assist in locating persons with outstanding warrants. 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 or employer except as necessary for the Limited Purpose. I understand that I am not allowed
access to TWC Information about myself.
1 will not enter any unauthorized data or make any changes to data. I will not disclose any TWC Information orally,electronically,in
written or printed form,or in any other manner without prior written authorization from TWC. I will not disclose any TWC
Information to other governmental entities,including law enforcement entities.
I understand that under Texas Labor Code§301.085,all TWC Information 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 could be combined with other publicly 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 jail,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 network,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 years or life in prison,a fine of$2,000-$10,000,or both.
I have read and had explained to me 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 of User Date signed
Supervisor Approval:I have instructed the User listed above about all confidentiality requirements applicable 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 Date signed
Approval of Contract Signatory or Contact Person named in Contract:
Signature of Contract Signatory or Recipient Contact Person Printed Name Date signed
All fields on this agreement are required. Employer must retain signed original and give a copy to User. Employer must send copy of User Agreement to
TWC EAGLE Support as specified on the required Cover Sheet,Attachment D to this Contract.
Information Release Contract—Feb 17
TWC Contract Number:2920PEN035
Page 7 of 12
DocuSign Envelope ID:592AD963-DB4B-44A1-8740-EC61C99E3155
TEXAS WORKFORCE COMMISSION
INFORMATION RELEASE CONTRACT
Attachment D
COVER SHEET FOR TRANSMITTING USER AGREEMENT AND TRAINING CERTIFICATE
To: EAGLE Support
via email to: EAGLEsupport@twc.state.tx.us
(Document must be scanned and encrypted before sending)
via fax to: 512-463-6394
Number of pages including cover sheet:
via mail to: EAGLE Support
Texas Workforce Commission
101 East 151h Street,Room 0330
Austin, TX 78778-0001
From: City of Fort Worth for the benefit of
Fort Worth Police Department (Recipient)
(Recipient Contact Person)
(Recipient Contact Person email)
Re: User Agreement(s) and Training Certificate(s) attached
Instructions:
• User Agreement and Training Certificate must be submitted together for each individual.
• 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 regarding the User Agreement, please email EAGLEsupportAtwc.state.tx.us
Information Release Contract—Feb 17
TWC Contract Number: 2920PEN035
Page 8 of 12
DocuSign Envelope ID:592AD963-DB4B-44A1-8740-EC61C99E3155
TEXAS WORKFORCE COMMISSION
INFORMATION RELEASE CONTRACT
Texas Workforce Commission Attachment G
Certificate of Destruction for Contractors and Vendors
Hard copy and electronic media must be sanitized prior to disposal or release for reuse. The TWC tracks,documents,and verifies media sanitization
and disposal actions. The media must be protected and controlled by authorized personnel during transport outside of controlled areas. Approved
methods for media sanitization are listed in the NIST Special Publication 800-88,Guidelines for Media Sanitization.
http://Gsrc.nist.govlpublications/nistpubs/800-88/NISTSP800-88 with-errata.pdf
Contact Name Title Company Name and Address Phone
You may attach an inventory of the media if needed for bulk media disposition or destruction.
Media Type Media Title/Document Name
HARD COPY I I ELECTRONIC
Media Description
(Paper,Microfilm,Computer Media,Tapes,etc.)
Dates of Records
Document/Record Tracking Number TWC 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 -->
Reused Internally Destruction Disposal
Final Disposition of Media Reused Externally Returned to Manufacturer
Other:
Comments:
If any TWC Data is retained, indicate the type of storage media, physical locations(s),and any planned destruction date.
Description of TWC Data Retained and Retention Requirements:
Proposed method of destruction for TWC approval: Type of storage media?
Physical location?
Planned destruction date?
Within five(5)days of destruction or purging,provide the TWC with a signed statement containing the date of clearing,purging or destruction,
description of TWC data cleared,purged or destroyed and the method(s)used.
Authorized approval has been received for the destruction of media identified above and has met all TWC Records Retention Schedule requirements
including state,federal and/or internal audit requirements and is not pending any open records requests.
Records Destroyed by: Records Destruction Verified by:
Signature Date Signature Date
Be sure to enter name and contact info for who completed the data destruction and who verified data destruction in the fields above.
Send the signed Certificate of Destruction to:
TWC: Information Security Office, Rm. 0330A, 101 E. 15th Street, Austin,TX 78778-0001
GP Revised: 09-02-15
Information Release Contract—Feb 17
TWC Contract Number:2920PEN035
Page 9of12
DocuSign Envelope ID:592AD963-DB4B-44A1-8740-EC61C99E3155
TEXAS WORKFORCE COMMISSION
INFORMATION RELEASE CONTRACT
Texas Workforce Commission Attachment G
Certificate of Destruction for Contractors and Vendors
INSTRUCTIONS FOR CERTIFICATE OF DESTRUCTION
Hard copy and electronic media must be sanitized prior to disposal or release for reuse. The TWC tracks,documents,and verifies media sanitization
and disposal actions. The media must be protected and controlled by authorized personnel during transport outside of controlled areas. Approved
methods for media sanitization are listed in the NIST Special Publication 800-88,Guidelines for Media Sanitization.
htto://csrc nist gov/aublications/nistoubs/800-88/NISTSP800-88 with-errata odf
IRS Publication 1075 directs us to the FISMA requirements and NIST guidelines for sanitization and disposition of media used for
federal tax information(FTI). These guidelines are also required for sensitive or confidential information that may include personally
identifiable information (PII)or protected health information(PHI). NIST 800-88,Appendix A contains a matrix of media with minimum
recommended sanitization 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 media in common use:
• Hard Copy. Hard copy media is physical representations of information. Paper printouts, printer and facsimile ribbons, drums,
and platens are all examples of hard copy media.
• Electronic(or soft copy). 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 media. 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 media. 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 media. 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 media. 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 TWC approval.
6. Send the signed Certificate of Destruction to:
Texas Workforce Commission FAX to: 512-463-3062
Information Security Office
Room 0330A or send as an email attachment to:
101 E. 151h Street
Austin,TX 78778-0001 ciso()twc.state.tx.us
Final Distribution of Original to: Chief Information Security Officer
Certificate
Copy to: 1. Your Company Records Management Liaison-or-Information Security Officer
2. TWC Contract Manager
GP Revised: 09-02-15
Information Release Contract—Feb 17
TWC Contract Number:2920PEN035
Page 10 of 12
DocuSign Envelope ID:592AD963-DB4B-44A1-8740-EC61C99E3155
TEXAS WORKFORCE COMMISSION
INFORMATION RELEASE CONTRACT
Attachment H
QUARTERLY SELF-ASSESSMENT REPORT
Failure 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("Recipient")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 1.2 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 instructed 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 TWC 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 j ail, 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 and 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 with the Yes: _ No: _
requirements of 20 C.F.R. § 603.9 found in Safeguards for TWC Information
(Attachment B)and the TWC Contract.
11. 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
TWC Contract Number:2920PEN035
Page 11 of 12
DocuSign Envelope ID:592AD963-DB4B-44A1-8740-EC61C99E3155
TEXAS WORKFORCE COMMISSION
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
EAGLEsupport@twe.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 that:
All 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 for benefit of
Fort Worth Police Department—2920PEN035
Return this Report to:
External Data Sharing Contracts Manager I Procurement and Contract Services Department
Texas Workforce Commission 11117 Trinity Street,Room 342T I Austin,Texas 78701
Email: SelfAssessmentReports@twc,state.tx.us
Fax: 512-936-0219
Information Release Contract—Apr 2016
TWC Contract Number:2920PEN035
Page 12 of 12
IacU
MSIt U k A 0
Certificate Of Completion
Envelope Id:592AD963DB4B44A18740EC61C99E3155 Status:Delivered
Subject:Please DocuSign:Unsigned Document.pdf
docSegld:
docType:
Source Envelope:
Document Pages: 18 Signatures:1 Envelope Originator:
Certificate Pages:5 Initials:0 Christopher Murphy
AutoNav:Enabled 101 E.15th Street,Room 0154-B
Envelopeld Stamping:Enabled Austin,TX 78778
Time Zone:(UTC-06:00)Central Time(US&Canada) christopher.murphy@twc.state.tx.us
IP Address:204.65.0.20
Record Tracking
Status:Original Holder:Christopher Murphy Location:DocuSign
1/17/2020 8:25:48 AM christopher.murphy@twc.state.tx.us
Signer Events Signature Timestamp
Heather Hall Sent:1/17/2020 8:29:22 AM
Heather.hall@twc.state.tx.us Viewed:1/17/2020 8:31:20 AM
Chief Information Officer/IT Director Signed:1/17/2020 8:31:33 AM
Texas Workforce Commission
Security Level:Email,Account Authentication
Signature Adoption:Pre-selected Style
(None) Using IP Address:75.27.138.74
Signed using mobile
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Jesus Chapa Sent:1/22/2020 9:55:08 AM
jesus.chapa@fortworthtexas.gov Viewed:1/22/2020 10:40:34 AM
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted:1/22/2020 10:40:34 AM
ID:70bb7dcl-1681-4af6-95fe-adb65f5aef4a
In Person Signer EventsSignature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Michael Munday Sent:1/17/2020 8:31:34 AM
michael.munday@fortworthtexas.gov VIEWED Viewed:1/22/2020 9:55:07 AM
Security Level:Email,Account Authentication
(None) Using IP Address:209.194.29.100
Electronic Record and Signature Disclosure:
Accepted:1/22/2020 9:55:07 AM
ID:51994427-05be-44el-b326-5c30ddleld2e
Carbon Copy Events Status Timestamp
Witness Events_ Signature Timestamp
Notary Events Signature Timestamp
- - - - - - - ---- -- ------- - -
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 1/22/2020 9:55:08 AM
Certified Delivered Security Checked 1/22/2020 10:40:34 AM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
Electronic Record and Signature Disclosure created on:7/13/2017 5:20:33 PM
Parties agreed to:Jesus Chapa,Michael Munday
CONSUMER DISCLOSURE
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How to contact Carahsoft obo Texas Workforce Commission:
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to request paper copies of certain information from us, and to withdraw your prior consent to
receive notices and disclosures electronically as follows:
To contact us by email send messages to: heather.hall@twe.state.tx.us
To advise Carahsoft obo Texas Workforce Commission of your new e-mail address
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To confirm to us that you can access this information electronically, which will be similar to
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ACCEPTED AND AGREED:
CITY OF FORT WORTH CONTRACT COMPLIANCE MANAGER:
By signing I acknowledge that I am the
person responsible for the monitoring and
administration of this contract, including
By: -Jesus J.Chapa(Mar 3, 20) ensuring all performance and reporting
Namc: Jesus J. Chapa requirements.
,I'Ale: Assistant City Manager
APPROVAL RECOMMENDED: MB Mundgy
By: MB Munday(Mar 3,2020)
Name: Michael B. Munday
d- Title: Technology Services Manager
By: E win Kraus(Mar 3,2020)
Name: Edwin Kraus APPROVED AS TO FORM AND
Title: Chief of Police ""s'" `' LEGALITY:
ATTEST: . Q,
-
„By: JB Strong(Mar 3, 20)
* ° �•. 'Name: John B. Strong
By: Title: Assistant City Attorney
Name: Mary J. Kayser +�
Title: City Secretary CONTRACT AUTHORIZATION:
M&C: N/A
Date Approved:
Form 1295 Certification No.: Not Required
OFFICIAL.RECORD
CITY SECRETARY
FT WORTH, TX
i