HomeMy WebLinkAboutContract 41362TEXAS WORKFORCE COMMISSION
PERFORNIING AGENCY CONTRACT
4
TWC Contract
Number
2911PEN036
TITLE
INFORMATION RELEASE CONTRACT
Recipient
Name
City of Fort Worth Police Department
Mailing Address
350 W. Belknap St.
City/State/ZipCity/State/Zip
Fort Worth TX 76102
Telephone Number
817-3924266
Contract Period
Begin Date
January 1, 2011
1 End Date
December 31, 2013
Funding Information
The total amount of this contract will not exceed the sum of
$4,500.00
Remarks
This contract is contingent on.Recipient's acceptance of and compliance with
the terms and conditions of
this contract and any referenced attachments.
Data Sharing Agreement
Online access only
Number of online users and rate: 140 for $1,500/year
Signature Authority
Each person signing this contract on behalf of Agency or Recipient hereby warrants that he or she has
been fully authorized by the respective organization to:
• Execute this contract on behalf of 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 Police Department
L rry E. Te ple ate
Thomas Higgins
Date
Executive Director
AasiAm:bCity Manager
APPROVED AS TO FORM AND L
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CITY SECRETARY
Assis t City Attorney
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Date: orma ion K lease Contract: December 2010 d o0 J \ °�1�6
TWC Contract Number: 2911PEr
036
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TEXAS WORKFORCE COMMISSION
PERFORMING AGENCY CONTRACT
TABLE OF CONTENTS
General Terms and Conditions
Section I
Purpose and Legal Authority
Section 2
Term, Amendments, and Termination
Section 3
Consideration
Section 4
Protecting the Confidentiality of Records
Section 5
Inspection and Audit
Section 6
Breach of Agreement, Default, and Remedies
Section 7
Miscellaneous
Attachment A
Statement of Work - Project Obligations
Attachment AI
Protection of Confidentiality - 20 C.F.R. § 603.9
Attachment A2
TWC Data Security Policy
Attachment A3
Quarterly Self -Assessment Report
Attachment A4
TWC User Information Security Agreement
Attachment A5
Cover Sheet for Transmitting User Agreement
Information Release Contract: December 2010 TWC Contract Number: 2911PEN036
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PERFORMING AGENCY CONTRACT
TEXAS WORKFORCE COMMISSION
INFORMATION RELEASE CONTRACT
GENERAL TERM5 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, hereinafter collectively referred to as "the Parties," pursuant to Texas
Labor Code §§ 301.061 and 302.002(c) with respect to Agency's release of proprietary information to
Recipient. The obligations of the Parties are set forth in detail in Attachment A which is made a part
hereof.
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, Amendments, and Termination
2.1 This contract shall be 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 parry
specifying a termination date at least thirty (30) calendar days after the date of Lite notice. Such
termination shall not relieve Recipient of the obligation to pay for all services prior to such termination
at the rates provided herein, nor shall it entitle Recipient to any refund of the yearly subscription fee for
online access to Agency records.
2.3 In the event of an emergency, Agency may suspend Recipient's online access without advance notice,
and will reinstate access at the earliest practical time.
2.4 Agency may suspend all services without notice if Agency suspects a violation of the security provisions
in Attachment A, Section 3. Services will remain suspended until Agency has fully investigated any
suspected security violations and is satisfied that resumption of service will not result in security
breaches. In the event of an extended suspension of service, Agency will notify Recipient as soon as
possible.
2.5 Termination of this contract will not end Recipient's responsibility to protect the confidentiality of all
Information obtained from Agency pursuant to this contract and remaining in Recipient's custody or
control.
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TEXAS WORKFORCE COMMISSION
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SECTION 3 - Consideration
3.1 Recipient agrees to pay Agency for services described in Attachment A.
3.2 Notwithstanding the rates set forth in Attachment A, Agency may unilaterally revise rates upon written
notice to Recipient of at least thirty (30) calendar days.
SECTION 4 -Protecting the Confidentiality of Records
4.1 "Information" means any records obtained by Recipient from Agency, including records and data
compilations provided orally, electronically, or on paper. Information shall also include records
obtained by Recipient through online access to Agency electronic files. Recipient shall ensure that
Information is used only for purposes authorized by law and consistent with this contract. Use of
Information shall be subject to the provisions of this contract even if the Information is converted by
Recipient into another format or medium or incorporated in any manner into Recipient's records, files,
or data compilations.
4.2 Recipient shall limit access to Information to its officers and employees who need access to the
Information to achieve the purpose listed in Attachment A, Section 1. Recipient shall not transfer the
authority or ability to access or maintain Information under this contract to any other person or entity.
4.3 Recipient shall create and maintain a system to store and process Information, including that maintained
in electronic format, such as magnetic tapes or discs, in such a way that unauthorized persons cannot
obtain Information by any means. Recipient shall ensure that such system is sufficient to allow an audit
of compliance with the requirements of this contract. Recipient shall store Information in a place
physically secure from access by unauthorized persons.
4.4 Recipient shall comply with 20 Code of Federal Regulations (C.F.R.) § 603.9, incorporated herein by
reference, regarding safeguarding Information and insuring its confidentiality. A copy of 20 C.F.R.
§ 603.9 is attached as Attachment Al.
4.5 Recipient shall instruct all personnel having access to 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 Information. Recipient acknowledges that all
personnel who will have access to Agency Information have been instructed in accordance with the
terms of this contract.
4.6 Recipient shall notify Agency immediately if a security violation of this contract is detected, or if
Recipient suspects that the security or integrity of Information or any Agency data has been or may be
compromised in any way.
4.7 Recipient shall dispose of Information and any copies thereof after the purpose set out in
Attachment A, Section I, is achieved, except for Information possessed by any court. Disposal means
return of Information to Agency or destruction of Information, as directed by Agency. Disposal
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includes deletion of personal identifiers in lieu of destruction. In any case, Recipient shall dispose of all
Information within thirty (30) calendar days after the termination or expiration of this contract.
4.8 Texas Labor Code § 301.08 ) provides that unemployment compensation information is not public
information for purposes of the Public Information Act, Texas Government Code, Chapter 552.
Recipient shall not release any Information in response to a request made under the Public Information
Act or to a request made under any other law, regulation, or ordinance addressing public access to
government records. Recipient shall inform Agency within twenty-four (24) hours of receipt by
Recipient of service of a subpoena or citation in any action seeking access to Information.
4.9 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 Information.
SECTION 5 —Inspection and Audit
5.1 Recipient shall fully cooperate 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 Information, including Information
maintained electronically, and to all workplaces used by personnel who have access to Information.
5.2 Recipient shall keep and maintain full, true, and complete and accurate records as necessary to fully
disclose to Agency, the Texas State Auditor's Office, the United States government, and their authorized
representatives sufficient information to determine compliance with this contract.
SECTION 6 —Breach of Agreement, Default, and Remedies
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
Information disclosure being processed) until Agency is satisfied that corrective action has been taken to assure
that there will be no future breach. In the absence of prompt and satisfactory corrective action to cure default
and assure future compliance with contract requirements, this contract shall be cancelled and Recipient shall
surrender to Agency all Information and copies thereof that have not previously been returned to Agency, and
any other Information relevant to this contract, which was obtained under this contract. Cancellation of this
contract shall not limit Agency from pursuing penalties under state and federal law for the unauthorized
disclosure of confidential Information. Agency shall undertake any other action under this contract, or under
any law of the State or of the United States, to enforce this contract, secure satisfactory corrective action, and
return of the Information. 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 This contract shall be construed, interpreted, and applied in accordance with the laws of Texas,
excluding its choice of law rules. Venue of any suit brought under this contract shall be in a court of
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competent jurisdiction in Travis County, Texas. NOTHING IN THIS SECTION SHALL BE
CONSTRUED AS A WAIVER OF SOVEREIGN IMMUNITY BY AGENCY.
7.2 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.
7.3 Agency's failure to enforce any provision of this contract does not constitute a waiver of that provision
or any other provision.
7.4 Recipient, its employees, agents, contractors, and subcontractors agree to indemnify and hold harmless
Agency, the State of Texas, and their employees and officials for any loss, damages, judgments, and
costs of liability arising 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
Information by Recipient.
7.5 If any provision of this contract is held to be unenforceable by a court, this contract shall be construed as
if such provision did not exist and the unenforceability of such provision will not render any other
provision or provisions of this contract unenforceable.
7.6 This contract is the entire agreement between the Parties. Any changes, deletions, extensions, or
amendments shall be in writing and signed by both parties, except for revisions to rates as described in
Section 3.2 of these General Terms and Conditions.
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CONTRACT NUMBER mu Jul.
I`flT71r'1"iiviifT1
INFORMATION RELEASE CONTRACT BETWEEN TEXAS WORKFORCE COMMISSION
AND
CITY OF FORT WORTH POLICE DEPARTMENT
STATEMENT OF WORK —PROJECT OBLIGATIONS
SECTION 1—Project Abstract
The purpose of this contract is to provide Recipient with Agency's current unemployment compensation
Information as follows.
■ Direct online access to Agency computer files for the following:
• Wage Records;
• Unemployment Compensation Claim Benefit Information - limited access; and
• Employer Master File Inquiry.
Subject to the security and confidentiality provisions of this contract, Recipient shall use Information obtained
from Agency solely for the following specific purpose: to assist in locating fugitives, witnesses, suspects,
and other persons of interest in ongoing criminal investigations and to assist in verifying employment
information related to criminal investigations. Any other use of the Information by Recipient shall be a
breach of this contract.
SECTION 2 —Obligations of Agency
2.1 Agency authorizes online "read-only" access to the following Agency mainframe computer screens:
• Wage Records File (BN75 screen);
• Unemployment Compensation Claim Benefit Information - limited access (CMES, CTCS, and
BPCS screens); and
• Employer Master File Inquiry (IRS6 screen).
2.2 Online access to Agency's data will routinely be available to Recipient Users on Monday through
Friday, 8:00 a.m. to 5:00 p.m. Central Time, excluding State holidays. Access to Agency's data may not
be available at other times due to Agency's computer maintenance needs.
2.3 Agency reserves the right to conduct monitoring, evaluation, and audit of Recipient's access to Agency's
Information, as provided under this contract.
2.4 Agency records include Information provided to Agency by third parties including employers and
employees. Agency does not warrant or guarantee the accuracy of Information provided under this
contract.
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SECTION all — Obligations of Recipient
3 A Recipient shall not release or otherwise make accessible to any other party, the Information obtained
hereunder except as specifically required in order to discharge the official duties described herein.
Recipient shall not release any Information without the written consent of Agency. Recipient shall
maintain sufficient safeguards over all Information obtained from Agency to prevent unauthorized
access to or redisclosure of any Information provided hereunder.
3.2 Security measures utilized by Recipient for the protection of Agency's confidential Information will
conform, at a minimum, to the federal regulations contained in 20 C.F.R. Part 603 and to the Texas
Workforce Commission Data Security Policy, Attachment A2.
3.3 Ali Recipient Users granted access under this contract to Agency data must execute Agency's User
Information Security Agreement and complete TWC Information Technology Security Awareness
training prior to being assigned a security password for online access to Agency data. A copy of the
User Information Security Agreement is attached as Attachment A4. A copy of an executed User
Information Security Agreement with certification of completion of TWC Information Technology
Security Awareness training must be received by the Agency contact person listed in this contract
before a Security Password will be issued. Each User Information Security Agreement submitted must
be cosigned by the supervisor of the Recipient User. Executed Recipient User Information Security
Agreements must be submitted by Recipient contact person listed in this contract with a completed
Cover Sheet for Transmitting User Information Security Agreement which is attached as Attachment
A5.
3.4 Recipient must maintain on file a signed copy of the User Information Security Agreement and
certification of completion of TWC Information Technology Security Awareness training for each
Recipient User. The security password for an individual Recipient User shall be immediately revoked
upon termination of that individual or upon reassignment of a Recipient User into a position not
authorized to access Agency's Information. Recipient shall notify Agency within three (3) calendar days
of the resignation or termination of a Recipient User. Failure to revoke access of a Recipient User who
has been terminated or reassigned and inform Agency of any termination or reassignment of a Recipient
User shall be a breach of this contract and may result in immediate suspension of all access and
termination of the contract as well as other penalties provided by law and this contract. All security
codes, Recipient User names and passwords issued under this contract shall be cancelled upon the
expiration of the contract. One (1) year after the Begin Date of this contract and each year on the
anniversary date of the Begin Date of this contract for the term of this contract so long as the contract or
any renewal thereof shall be operative, access by a Recipient User shall be cancelled unless within thirty
(30) calendar days of the anniversary date Recipient submits a new User Information Security
Agreement executed by Recipient User no more than thirty (30) calendar days prior to the date
submitted, with an attached certification of completion of TWC Information Technology Security
Awareness training dated no more than thirty (30) calendar days before submission. Agency will grant
access to a maximum of ten (10) Recipient Users, all of whom shall be direct Recipient employees.
Recipient shall screen potential Users and shall submit User Information Security Agreements for only
those employees whom Recipient has determined shall pose no threat to the security of Agency
Information.
3.5 Recipient Users shall not change or update any Information contained in Agency's computer stored files.
Recipient Users shall not use any automated system or software to make multiple queries of Agency's
computer stored files.
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3.6 Recipient shall not place Information obtained from Agency on mobile, remote, or portable storage
devices; nor shall Recipient remove storage media from the facility used by Recipient without the prior
written authorization of Agency.
3.7 Recipient Users are authorized to access Agency's Information for the official purposes listed in Section
1 of this Attachment A only and may not divulge information obtained under this contract to any other
individual or entity, except as strictly required to accomplish the official purposes listed in Section 1 of
this Attachment A.
3.8 Recipient agrees to adopt and implement security guidelines and to ensure that only authorized
Recipient Users will have access to view Agency's confidential Information and that any screen dump
or other extraction of Agency Information will be protected from unauthorized use or redisclosure.
3.9 Recipient will be solely responsible for disseminating any Information provided by Agency to the
remainder of Recipient Users.
3.10 Recipient agrees to notify Agency immediately if a security violation of this contract is detected, or if
Recipient suspects that the security or integrity of Agency's Information has been or may be
compromised in any way.
3.11 Texas Labor Code § 301.085 provides that unemployment compensation information is not public
information for purposes of Texas Government Code, Chapter 552. Recipient shall not release any
Information obtained from Agency under this contract in response to a request made under Texas
Government Code, Chapter 552, or to a request made under any other law, regulation, or ordinance
addressing public access to government records.
3.12 Recipient will pay each invoice on or before the 30th calendar day following the date of receipt of the
bill from Agency. Recipient shall send the payment to the address listed on the invoice along with a
copy of the invoice.
3.13 Recipient will treat Wage Records; Unemployment Compensation Claim Benefit Information, and
Employer Tax Records obtained from Agency as confidential as required under Texas Labor Code
§ 301.081 and the Social Security Act of 1934.
3.14 Recipient shall establish and maintain security safeguards and procedures to guarantee the
confidentiality of all Information obtained from Agency. Such safeguards shall, at a minimum, comply
with the requirements found at 20 C.F.R. § 603.9, a copy of which is attached as Attachment Al and
the requirements included in this contract.
3.15 Recipient's procedures to safeguard Information provided shall be subject to audit by Agency.
3.16 Recipient shall be responsible to provide and maintain its own computer hardware and software to
accomplish the necessary computer communications linkages with Agency's mainframe data base.
3.17 Recipient agrees to accept liability for any damage to Agency's hardware, software, or Information
when such damage is caused by the actions of employees or agents of Recipient, whether authorized or
unauthorized Users pursuant to this contract.
3.18 Recipient shall pay a fifteen hundred dollar ($1,500.00) annual subscription fee for the online access
described in Section 2.1 of this Attachment A. The twelve (12) calendar month period covered by the
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yearly subscription fee begins on the Begin Date listed in this contract, Payment of the yearly
subscription fee is due within thirty (30) calendar days from the Begin Date listed in this contract. The
} early subscription fee is nonrefundable and shall not be prorated in the event of early termination of
this contract or suspension of services. Recipient shall send the payment to the address listed on the
invoice and shall include with the payment a copy of the invoice.
3.19 Recipient shall submit to Agency afully-executed Quarterly Self -Assessment Report, a copy of which is
attached as Attachment A3, on the next -occurring quarterly filing date after the Begin Date of this
contract, 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 the
calendar month preceding the filing date.
SECTION 4 —Contact Persons
In ail communications with Agency, Recipient shall include a reference to the TWC Contract Number. The
Parties designate the following primary liaisons for implementation of this contract:
AGENCY CONTACT PERSON
External Data Sharing Contracts Manager
Office of General Counsel
Texas Workforce Commission
101 E. 15th St., Room 608
Austin, TX 78778-0001
Phone: 512-463-1607 or 512-936-2134
Fax: 5124634426
Email: ORC ontracts.Managementktwc. state.tx.us
RECIl'IENT CONTACT PERSON
James N. Janning
Intelligence Analyst
City of Fort Worth Police Department
350 W. Belknap St.
Fort Worth, TX 76102
Phone: 817-392-4266
Email: James.Janning@fortworthgov.org
RECIPIENT BILLING INFORMATION
Same as above.
Recipient may request a change in Recipient Contact Person by submitting to Agency a written request signed
by the same individual with signature authority who signed on behalf of Recipient on page one of this contract.
All changes in Recipient Contact Person must be approved in writing by Agency. Agency shall provide
Recipient with written notification of any change in Agency Contact Person.
Information Release Contract: December 2010
TWC Contract Number: 2911PEN036
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Attachment Al
PROTECTION OF CONFIDENTIALITY
CHAPTER V--EMPLOYMENT AND TRAINING ADMINISTRATION, U.S. DEPT. OF LABOR
PART 603-4NCOME AND ELIGIBILITY VERIFICATION SYSTEM
SUBPART A --INCOME AND ELIGIBILITY VERIFICATION SYSTEM
20 C.F.R. § 603.9 What safeguards and security requirements apply to disclosed information?
(a) In general. For disclosures of confidential UC information under § 603.5(d)(2) (to a third party (other than an
agent) or disclosures made on an ongoing basis); § 603.5(e) (to a public official), except as provided in paragraph
(d) of this section; § 603.5(f) (to an agent or contractor of a public official); § 603.6(b)(1) through (4), (6), and
(7)(i) (as required by Federal UC law); and § 603.22 (to a requesting agency for purposes of an IEVS), a State or
State UC agency must require the recipient to safeguard the information disclosed against unauthorized access or
redisclosure, as provided in paragraphs (b) and (c) of this section, and must subject the recipient to penalties
provided by the State law for unauthorized disclosure of confidential UC information.
(b) Safeguards to be required of recipients.
(1) The State or State UC agency must:
(i) Require the recipient to use the disclosed information only for purposes authorized by law and
consistent with an agreement that meets the requirements of § 603.10;
(ii) Require the recipient to store the disclosed information in a place physically secure from access by
unauthorized persons;
(iii) Require the recipient to store and process disclosed information maintained in electronic format, such
as magnetic tapes or discs, in such a way that unauthorized persons cannot obtain the information by
any means;
(iv) Require the recipient to undertake precautions to ensure that only authorized personnel are given access
to disclosed information stored in computer systems;
(v) Require each recipient agency or entity to:
(A) Instruct all personnel having access to the disclosed information about confidentiality requirements,
the requirements of this subpart B, and the sanctions specified in the State law for unauthorized
disclosure of information, and
(B) Sign an acknowledgment that all personnel having access to the disclosed information have been
instructed in accordance with paragraph (b)(1)(v)(A) of this section and will adhere to the State's or
State UC agency's confidentiality requirements and procedures which are consistent with this
subpart B and the agreement required by § 603.10, and agreeing to report any infraction of these
rules to the State UC agency fully and promptly.
(vi) Require the recipient to dispose of information disclosed or obtained, and any copies thereof made by
the recipient agency, entity, or contractor, after the purpose for which the information is disclosed is
served, except for disclosed information possessed by any court. Disposal means return of the
information to the disclosing State or State UC agency or destruction of the information, as directed by
the State or State UC agency. Disposal includes deletion of personal identifiers by the State or State
UC agency in lieu of destruction. In any case, the information disclosed must not be retained with
personal identifiers for longer than such period of time as the State or State UC agency deems
appropriate on a case -by -case basis; and
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(vii) Maintain a system sufficient to allow an audit of compliance with the requirements of this part.
(2) In the case of disclosures made under § 603.5(d)(2) (to a third party (other than an agent) or disclosures made
on an ongoing basis), the State or State UC agency must also —
(i) Periodically audit a sample of transactions accessing information disclosed under that section to assure
that the entity receiving disclosed information has on file a written release authorizing each access. The
audit must ensure that the information is not being used for any unauthorized purpose;
(ii) Ensure that all employees of entities receiving access to information disclosed under § 603.5(d)(2) are
subject to the same confidentiality requirements, and State criminal penalties for violation of those
requirements, as are employees of the State UC agency.
(c) Redisclosure of confidential UC information.
(1) A State or State UC agency may authorize any recipient of confidential UC information under paragraph (a)
of this section to redisclose information only as follows:
(i) To the individual or employer who is the subject of the information;
(ii) To an attorney or other duly authorized agent representing the individual or employer;
(iii) In any civil or criminal proceedings for or on behalf of a recipient agency or entity;
(iv) In response to a subpoena only as provided in § 603.7;
(v) To an agent or contractor of a public official only if the person redisclosing is a public official, if the
redisclosure is authorized by the State law, and if the public official retains responsibility for the uses of
the confidential UC information by the agent or contractor;
(vi) From one public official to another if the redisclosure is authorized by the State law;
(vii) When so authorized by Section 303(e)(5), SSA, (redisclosure of wage information by a State or local
child support enforcement agency to an agent under contract with such agency for purposes of carrying
out child support enforcement) and by State law; or
(viii) When specifically authorized by a written release that meets the requirements of § 603.5(d) (to a third
party with informed consent).
(2) Information rediscooud under paragraphs (c)(1)(v) and (vi) of this section must be subject to the safeguards in
paragraph (b) ofthis section.
(d) The requirements of this section do not apply to disclosures of UC information to a Federal agency which the
Department has determined, by notice published in the Federal Register, to have in place safeguards adequate to
satisfy the confidentiality requirement of Section 303(a)(1), SSA.
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Attachment A2
TEXAS WORKFORCE COMMISSION DATA SECURITY POLICY
It is the policy of the Texas Workforce Commission (Agency) to promote a secure environment for employees
and clients, and to maintain management controls necessary for the safekeeping of Agency's resources and
assets.
Employees, physical property, and information related to the conduct of Agency operations are assets, entrusted
to the care of agency by the citizens of this state. Safeguarding the security and integrity of these assets and
using them in a cost-effective manner are basic responsibilities of Agency.
The Agency relies heavily on its electronic data processing systems to meet its operational, financial, and
informational requirements. It is essential that these critical systems are protected from accidents and misuse of
all kinds, and that both the computer system and the data that they process be operated and maintained in a
secure environment.
It will be the responsibility of the Data Security Manager of the RECIPIENT AGENCY to determine and assign
the computer access codes required for a user to perform the assigned job duties. Access to computerized data
will be limited to just that data needed to do the assigned job.
It is the responsibility of the Data Security Manager of the RECIPIENT AGENCY to make certain that all users
are aware of, and comply with, the Agency's rules and regulations within their office.
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Attachment A3
QUARTERLY SELF -ASSESSMENT REPORT
Recipient confirms that it is in compliance with the following requirements of 20 C.F.R. § 603.9:
1. Recipient uses the disclosed Information only for purposes authorized by law and consistent with the allowed use set forth in
the contract between Recipient and the Texas Workforce Commission (Agency). Yes: No.
2. Recipient stores the disclosed Information in a place physically secure from access by unauthorized persons.
Yes: No:
3. Recipient stores and processes disclosed Information. maintained in electronic format, such as magnetic tapes or discs, in such
a way that unauthorized persons cannot obtain the Information by any means. Yes: No.
4. Recipient undertakes precautions to ensure that only authorized personnel are given access to disclosed Information stored in
computer systems. Yes: No:
5. Recipient has instructed all personnel having access to the disclosed Information about confidentiality requirements, the
requirements of 20 C.F.R. § 603.9, and the sanctions specified in State law for unauthorized disclosure of information (Each
violation is a Class A Misdemeanor, punishable by a fine of $4,000, a year in jail, or both). By your signature below you
acknowledge that all personnel having access to the disclosed Information have been instructed in accordance with
paragraph (b)(1)(v)(A) of 20 C.F.R. § 603.9. Yes: No:
6. Recipient adheres to the Agency confidentiality requirements and procedures which are consistent with 20 C.F.R. § 603.9
and the requirements of the contract between Recipient and Agency and shall report any infraction of these rules to Agency
fully and promptly. Yes: No:
7. Recipient disposes of Information disclosed or obtained, and any copies thereof made by Recipient, after the purpose for
which the Information is disclosed is served or asrequired by court order. Disposal means return of the Information to
Agency or destruction of the Information, as directed by Agency. Disposal includes deletion of personal identifiers in lieu of
destruction. Yes: No:
8. Recipient ensures that the Information disclosed shall not be retained with personal identifiers for longer than such period of
time as TWC deems appropriate. Yes: No:
9. Recipient maintains a system sufficient to allow an audit of compliance with the requirements of 20 C.F.R. Part 603 and the
contract between Recipient and Agency.
Yes: No: [Describe, in an attachment, your system that allows audit of compliance.]
By signature hereon, the contract signatory or the entity's internal auditor certifies that:
All statements and information prepared and submitted in the response to this Quarterly Self -Assessment Report are
current, complete, and accurate.
Signature
Printed Name, Title
Date
Contract Number 2911PEN036
Return this Report to: External Data Sharing Contracts Manager � Office of General Counsel
Texas Workforce Commission � 101 East 15t`' Street, Room 608 � Austin, Texas 78778-0001
Fax: 5124634426
Email: ORContracts.Management@,twc.state.tx.us
Information Release Contract: December 2010 TWC Contract Number: 2911PEN036
Page 8 of 10
TEXAS WORKFORCE COMMISSION
INFORMATION RELEASE CONTRACT
I,
Attachment A4
CONTRACT NUMBER 2911PEN036
TEXAS WORKFORCE COMMISSION
USER INFORMATION SECURITY AGREEMENT
(Print Name) (Social Security Number)
(User phone number) (User work street address) (User email)
acknowledge that, as a Recipient User, I will be assigned a personal User Identification Code (User ID) and password that I will use to
activate computer devices that access the Texas Workforce Commission's computer system. I understand that I will be held
personally accountable for my actions and any activity performed under my User ID. Under no circumstances will I allow my Use
ID and confidential password to be used by any other individual, nor will I use one belonging to someone else. I understand that
any violation of this User Agreement including allowing any other individual to use my User ID or confidential password may
be a violation of the Texas Penal Code and may result in the termination of the contract between Texas Workforce
Commission and City of Fort Worth Police Department for online data access. The use of Information obtained from the
Texas Workforce Commission's computer system is limited to the followine purpose only: to assist in locating fugitives,
witnesses, suspects, and other persons of interest in ongoing criminal investigations and to assist in verifying employment
information related to criminal investigations.
I understand that online access under the above -described contract is limited to: Wage Records File (BN75 screen);
Unemployment Compensation Claim Benefit Information on limited access (CMES, CTCS, BPCS screens); and Employer
Master File Inquiry (IRS6 screen).
I will not enter any unauthorized Information, or make any changes to Information. I will not disclose any Information
without prior authorization from the Texas Workforce Commission. I understand that under Texas Labor Code § 301.085 all
information I obtain from the Texas Workforce Commission under this User Agreement is confidential and that a person
commits an offense if the person solicits, discloses, receives, or uses, or authorizes, permits, participates in, or acquiesces in
another person's use of, unemployment compensation information that reveals: (1) identifying information regarding any
individual or past or present employer or employing unit, 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 or
employing unit. Such an offense is a Class A Misdemeanor.
Violating a data security system or allowing unauthorized access by another party is a Class A Misdemeanor under
Chapter 33 of the Texas Penal Code, which is punishable by a fine of $4,000, a year in jail, or both. Intentionally causing a computer
to malfunction or knowingly altering data without authorization that results in personal or property damage may constitute a felony of
the second degree.
I have read and have had explained to me the security and confidentiality requirements of 20 C.F.R. Part 603 and the contract
with the Texas Workforce Commission. I understand and agree to abide by these requirements. I also understand that if I violate any
of these standards I may be subject to disciplinary action or prosecution under one or more applicable statutes, and I may jeopardize
the contract with the Texas Workforce Commission.
Signature of User Date Printed Name
Supervisor Approval: I have instructed the User listed above about all confidentiality requirements applicable to data obtained under
the contract with the Texas Workforce Commission including the requirements of 20 C.F.R. Part 603 as well as the sanctions specified
in the Information Release Contract and in state law for unauthorized disclosure of information.
Signature of Supervisor
Contract Signatory or Recipient Contact Person Approval:
Date
Signature of Contract Signatory or Recipient Contact Person Date
Printed Name
Printed Name
Distribution Instructions for User• Information Security Agreement: Entity employing the User• must retain the original user
agreement. The User must be provided a copy by their employer. The entity employing the User must transmit a copy to the Texas
YVorkforce Commission and must attach the fo11o1ving cover sheet.
Information Release Contract: December 2010
TWC Contract Number: 2911PEN036
Page 9 of 10
TEXAS WORKFORCE COMMISSION
INFORMATION RELEASE CONTRACT
Attachment A5
COVER SHEET FOR TRANSMITTING USER INFORMATION SECURITY AGREEMENT
To: RACF Administration
via email to: racf.administration(c�r�,twc.state.tx.us
(Document must be scanned and encrypted before sending)
via fax to: 512-463-6394
via mail to: RACF Administration
Texas Workforce Commission
101 East 15th Street, Room 0330
Austin, Texas 7877&0001
From: City of Fort Worth Police Department (Recipient)
(Recipient contact person name)
(Recipient contact person email)
Re: TWC Contract Number 2911PEN036
Enclosed are the following documents:
1) Completed TWC User Information Security Agreement
2) TWC Information Technology Security Awareness training certificate
Note: The TWC User Information Security Agreement must accompany the TWC Information Technology
Security Awareness training certificate and include all signatures and the contract number. For questions on
processing the TWC User Information Security Agreement, please email the RACF Administrator at
racf.administration@twc.state.tx.us.
Information Release Contract: December 2010 TWC Contract Number: 2911PEN036
Page 10 of 10
TWC Contract/Amendment Number: 2911PENU36
CONTRACT/AMENDMENT LANGUAGE CHANGE CERTIFICATION FORM
Please check the appropriate box and sign below:
❑ No Changes. I hereby certify that no changes have been made to documents contained in
this Contract/Amendment package.
❑ Changes to Demographic Information. I hereby certify that changes in demographic
information items only (such as contact or signatory) have been made to documents
contained in this Contract/Amendment package. Pen and ink corrections have been entered,
initialed and the revised areas have been flagged.
❑ Changes to Contract/Amendment Terms and Conditions. I hereby certify that changes to
the contract/amendment 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
contract/amendment 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 regarding the proposed pen and ink changes that I will be contacted by a
TWC representative to discuss them.
City of Fort Worth Police Department
APPROVED AS TO FORM AND LEGALITY
rp
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Assistant City Attomey
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