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HomeMy WebLinkAboutCALIFORNIA, STATE OF (EDD)Ai ,3A1P1D C 1� N-2019-232 Oct 19 2019 STATE OF CALIFORNIA - DEPARTMENT OF GENERAL SERVICES STANDARD AGRE MENT AGREEMENT NUMBER PURCHASING AUTHORITY NUMBER IB STD213tRev.03r20191 I M0113589 CONTRACTING AGENCY NAME Employment. Development Department CONTRACTOR NAME Santa Ana Police Department 2. The term of this Agreement is: START DATE December 1, 2019 or upon final approval THROUGH END DATE November 30, 2022 ➢. The maximum amount of this Agreement is: $747.00 Seven Hundred Forty -Seven Dollars and Zero Cents 4. The parties agree to complywith the terms and conditions of the following exhibits, which are by this reference made apart of the Agreement. EXHIBITS TITLE PAGES ExhibitA� Scope of Work 2 Attachment A-1 Specifications 3 Exhibit B Budget Detail and Payment Provisions 2 Exhibit C• General Terms and Conditions GTC 0412017 Exhibit D Protection of Confidentiality 3 Attachment Dl ConfidentialityAgreemenl 1 Attachment D2 Indemnity Agreement 1 Attachment D3 Statement of Responsibility 1 Items shown with an asterisk (•I, are herebyincorporatedbyreference and made parr of this agreement as ifortached hereto. These documents can be viewed athrms9/www.des.caaoW015/Resoarces IN V/(TNESS WHEREOF, THISAGREEMENTHAS BEEN EXECUTED BY THEPARTIES HERETO. _--- CONTRACTOR ---- ---- CONTRACTOR NAME (if other than an individual, state whether a corporation. Partnership, etc.) Santa Ana Police Department CONTRACTOR BUSINESS ADDRESS 20 Civic Center Plaza (M-31) PRINTED NAME OF PERSON SIGNING Kristine Ridge CONTRACTOR SEE ATTACHED SIGNATURE PAGE Manager Page 1 of 2 STATE OF CALIFORNIA -DEPARTMENT OF GENERAL SERVICES STANDARD AGREEMENT AGREEMENT NUME STD 213 (Rev.03/20191 M0113509 CONTRACTING AGENCY NAME Employment Development Department PURCHASING AUTHORITY NUMBER CONTRACTING AGENCY ADDRESS 722 Capitol Mall, MIC 62-C CRY Sacramento STATE CA ZIP 95814 PRINTED NAME OF PERSON SIGNING Rebecca Martin TITLE Manager, Contract Services Group (IT) CONTRACTING AGENCY AUTHORIZED SIGNATURE DATE SIGNED CALIFORNIA DEPARTMENT OF GENERAL SERVICES APPROVAL EXEMPTION Of Applicable) Page 2 of 2 N-2019-232 IN WITNESS WIIEREOF, the parties hereto have executed this A_reement the date and year First above written. ATTEST: DAISY GObCu Clerk of the Council APPROVED AS TO FORM: SONIA R. CARVALHO CITY OF SANTA ANA R S'I'INE RIDGE City Manager RECOMMENDED FOR APPROVAL: City Acimey wOII-- --- TA A L D ALENTIN Assistant City Attorney Chiefof police EDD Agreement No. M0113689 EDD/SAPD Customer Code: E00663 Page 1 of 2 EXHIBIT A (Standard Agreement) This Agreement is entered into by and between the Employment Development Department, hereinafter referred to as the EDD, and the Santa Ana Police Department, hereinafter referred to as the SAPID. It sets forth the terms and conditions for the release and use of the EDD's confidential information. SCOPE OF WORK I. Purpose The EDD agrees to provide confidential Employer Address and Client Address information to the SAPD. The SAPD agrees to use the EDD confidential information for locating victims, suspects, missing persons, potential witnesses, or persons for whom a felony arrest warrant has been issued, when the information is requested in the course of, and as a part of an investigation into the commission of a crime when there is a reasonable suspicion that the crime is a felony and that the information would lead to relevant evidence. II. Legal Authority The EDD shall make this information available to the SAPD pursuant to section 1095(i) of the Unemployment Insurance Code (UIC). The SAPD shall request and use the specified Information in accordance with section 1095(i) of the UIC and California Penal Code Section 830.1. III. Agreement Representatives 1. The EDD's contact persons are: AGREEMENT NEGOTIATIONS, CONFIDENTIALITY, AND TECHNICAL ASSISTANCE Kendall Groom, or Designee Employment Development Department Information Security Office, MIC 33 P.O. Box 826880 Sacramento, CA 94280-0001 Phone: (916) 651-2885 E-mail: Kendell.GroomOedd.ca.aov cc: ISOPrivacvDisclosureUnit(o)edd.ca gov FISCAL Erlinda Matienzo or Designee Employment Development Department Accounts Receivable Unit, MIC 70 P.O. Box 826880 Sacramento, CA 94280-0001 Phone: (916) 653-4227 E-mail: Erlinda.Matienzo(a)edd.ca.aov 2. The SAPD contact persons are: EDD Agreement No. M0113589 EDD/SAPD Customer Code: E00663 Page 2 of 2 EXHIBIT A (Standard Agreement) AGREEMENT NEGOTIATIONS AND ADMINISTRATION Ken Gominsky, Deputy Chief 60 Civic Center Plaza (M-16) Santa Ana, CA 92702 Phone: 714-245-8040 E-mail: kgominskv(asanta-ana.ora FISCAL MATTERS Patricia Quezada, Police Fiscal Services Supervisor 60 Civic Center Plaza (M-18) Santa Ana, CA 92702 Phone: 714-245-8048 E-mail: aauezadaf')a Santa-ana.org CONFIDENTIALITY AND DATA SECURITY ASSIGNMENTS Data Security and Integrity: Boris Duran Internal distribution of the EDD products: Matt Brown 3. Either party may make changes to the Agreement Representatives information above by giving written notice to the other party. Said changes shall not require an amendment to this Agreement. ATTACHMENT A-1 (Standard Agreement) SPECIFICATIONS 1. METHODOLOGY EDD Agreement No. M0113589 EDD/SAPD Customer Code: E00663 Page 1 of 3 1. The SAPD staff authorized under this Agreement to request the EDD's confidential information completes and submits the EDD forms —"Request for Wage and Claim Information"(DE 8720) for the purpose of investigating felony victims, suspects, missing persons, potential witnesses, or persons for whom a felony arrest warrant has been issued. 2. The EDD will not process or return illegible DE 8720 forms. 3. On matching SSNs, the EDD produces the Abstract System (ABS) reports authorized under this Agreement. 4. On a quarterly basis, the EDD invoices SAPD for all SSN transactions key entered (matched and/or unmatched SSNs). It. RESPONSIBILITIES 1. The EDD agrees to: a. Provide an electronic template of the DE 8720 form for the SAPD to reproduce. b. Provide a PowerPoint "completion instructions" training module to be used by the SAPD to train its staff on how to complete the EDD form and read the ABS reports provided by the EDD. c. Use the SSNs provided by the SAPD on the DE 8720 forms under the assigned Customer Code: E00663, to search the EDD files. On positive matches, the EDD will provide the following EDD ABS reports: (1) Employer Address (DE 4989) (2) Client Address d. Process only the DE 8720 requests that are completed to the EDD's specifications and mailed by the SAPD to the EDD's Document Management Group at: Employment Development Department Document Management Group, MIC 96 P. O. Box 826880 Sacramento, CA 94280.0001 e. Mail the ABS reports to the SAPD staff person assigned responsibility for the internal security, confidentiality, and dissemination of the EDD's confidential information to other SAPD staff: Name and Title: Matt Brown, Commander Agency Name: Santa Ana Police Department Mailing Address: 60 Civic Center Plaza (M-18) Santa Ana, CA 92702 EDD Agreement No. M0113589 EDD/SAPD Customer Code: E00663 Page 2 of 3 ATTACHMENT A-1 (Standard Agreement) f. Monitor and assess the status of the data to ensure that the terms, conditions and disclosure constraints stipulated in this agreement are followed. This compliance review is part of the EDD contract monitoring process. 2. The SAPID agrees to: a. Request only the EDD information specifically authorized under this Agreement. b. Train all SAPID staff authorized to use and request the EDD's confidential information under this Agreement, on the proper completion of the DE 8720. c. Submit all requests under the EDD Customer Code: E00663, and use the preparer code field on the DE 8720 form for internal distribution purposes. d. Request the ABS reports authorized under this Agreement on form DE 8720 on an "as needed" basis. Mail the forms completed to the EDD specifications to: Employment Development Department Document Management Group, MIC 96 P. O. Box 826880 Sacramento, CA 94280-0001 e. Use the specified EDD ABS reports only to SAPID. f. Comply with the UIC on any matters pertaining to the access, use, and/or release of data under this Agreement. Failure to comply with this provision shall be deemed a breach of this Agreement, and shall be grounds for cancellation of this Agreement. g. Oversee the SAPID staff in their use of confidential information received from the EDD. h. Instruct all the SAPID staff with access to the information provided by the EDD under this Agreement regarding the: (1) the confidential nature of the information; (2) the requirements of this Agreement; (3) the need to adhere to the security and confidentiality provisions outlined in Exhibit D — Protection of Confidentiality Provisions; and (4) the sanctions and penalties against unauthorized use or disclosure found in sections 1094 and 2111 of the UIC, section 1798.55 of the California Civil Code and section 502 of the California Penal Code. i. Ensure that all SAPID staff assigned to work with the Information provided by the EDD have signed the EDD Confidentiality Statement (Attachment D1. Rev 072017). j. Comply with section 603.9, Title 20 of the Code of Federal Regulations (CFR) with respect to any of the EDD confidential information. k. Use the Information provided by the EDD only as specifically authorized under this agreement. Section 1095(u) of UIC prohibits a private collection agency from using any of the EDD information the SAPID obtains under this Agreement. Therefore, nothing in this Agreement shall be construed to authorize or permit a private collection agency to use the EDD information for any purpose. Violation of this paragraph will be a basis for terminating the Agreement. 1. Dispose of the EDD's confidential information using an approved method of confidential destruction. m. Not release the EDD's confidential information to any other public or private entity without the EDD's prior written consent. EDD Agreement No. M0113589 EDD/SAPD Customer Code: E00663 Page 3 of 3 ATTACHMENT A-1 (Standard Agreement) n. Cooperate with the EDD's authority to monitor this Agreement in accordance with Exhibit D, Section II, paragraphs (e) and (f). o. Pursuant to federal law, if SAPD fails to comply with any provision of this Agreement, including timely payment of the EDD's costs under this Agreement, this Agreement shall be suspended and no further disclosures will be made until the EDD is satisfied that corrective action has been taken and there will be no further breach. In the absence of prompt and satisfactory corrective action, this Agreement will be cancelled, and SAPID shall surrender to the EDD all confidential information obtained under this Agreement which has not been previously returned to the EDD, and any other information relevant to the Agreement (20 C.F.R., Part 603.10(c)(1)). 3. Joint Responsibilities. Both parties agree to: a. Designate staff to have primary responsibility for program liaison, coordination of activities, and to meet, when necessary, to further redefine speck program procedures. b. Not disclose any of the EDD or the SAPD information to any person or agency other than those authorize specifically under this Agreement. c. Cooperate fully and fumish such assistance as may be mutually agreed upon by the parties hereto as being necessary and appropriate for proper performance of this Agreement. 4. Disputes: In the event of a dispute between the EDD and the SAPD over any part of this Agreement, the dispute may be submitted to nonbinding arbitration upon the consent of both the EDD and the SAPD. An election for arbitration pursuant to this provision shall not preclude either party from pursuing any remedy for relief otherwise available. 111. ACCURACY ASSESSMENT Individual employers and claimants report the information in the EDD's files. Since the EDD is not the originator of the Information disclosed, the EDD cannot guarantee the accuracy of the information. IV. TERMINATION CLAUSE This Agreement may be terminated by either party by giving written notice 30 days prior to the effective date of such termination. EDD Agreement No. M0113589 EDD/SAPD Customer Code: E00663 Page 1 of 2 EXHIBIT B (Standard Agreement) 1. BUDGET DETAIL AND PAYMENT PROVISIONS a. The maximum amount of this Agreement shall not exceed Seven Hundred Forty -Seven Dollars and No Cents ($747.00). b. In consideration of the performance and completion of the foregoing in a satisfactory manner, and upon receipt of a detailed invoice, in triplicate, quarterly in arrears, the SAPD shall reimburse the EDD the total amount due, based on the following product rate structure: Requested Products Rate Structure Lf the cumulative number of requested products per quarter is: Then the cost for Current Data and Archive Wages per requested product shall be: Then the cost for Archive UI/DI Data per requested product shall be: C. The SAPD shall be charged for the total number of products requested. Each SSN submitted may generate 1 to 2 products, depending on the types of ABS reports requested. d. The maximum amount of this Agreement has been computed, based on an estimated 30 SSNs per quarter, as follows: EDD ABSTRACT : FORMULA COST Employer Address DE 4989 1 product 30 x 1.0375 x 12Q $373.50 Client Address 1 product 30 x 1.0375 x 12Q $373.50 Total for 3- ear contract $747.00 e. The EDD Invoices will reference the EDD Agreement No. M0113689 and the EDD customer code E00663; and shall be submitted for payment to: Patricia Quezada, Police Fiscal Services Supervisor Santa Ana Police Department 60 Civic Center Plaza (M-18) Santa Ana, CA 92702 f. The SAPD payments must reference the EDD Invoice Number, the EDD Agreement number M0113689, and the EDD customer code E00663; and be submitted to: Employment Development Department Accounting Section, MIC 70 P.O. Box 826217 Sacramento, CA 94230-6217 EDD Agreement No. M0113589 EDD/SAPD Customer Code: E00863 Page 2 of 2 EXHIBIT B (Standard Agreement) g. Payment will be made in accordance with, and within the time specified in, Title 1, Division 3.6, Part 3, Chapter 4.5 of the Government Code. h. Nothing herein contained shall preclude advance payments, pursuant to Article 1, Chapter 3, Part 1, Division 3, Title 2 of the Government Code of the State of California. EXHIBIT D (Standard Agreement) PROTECTION OF CONFIDENTIALITY EDD Agreement Number: M0113589 EDD/SAPD Customer Codes: E00663 Page 1 of 3 Federal and state confidentiality laws, regulations, and administrative policies classify all the Employment Development Department (EDD) information provided under this Agreement as confidential. The federal and state laws prohibit disclosure of the EDD's confidential Information to the public and mandate its protection against loss and against unauthorized access, use, disclosure, modification, or destruction. SAPD must therefore, agree to the following security and confidentiality requirements: I. ADMINISTRATIVE SAFEGUARDS a. Adopt policies and procedures to ensure use of the EDD's confidential information solely for purposes specifically authorized under this Agreement that meet the requirements of section §603.10, Title 20 of the Code of Federal Regulations. b. Warrant by execution of this Agreement, that no person or selling agency has been employed or retained to solicit or secure this Agreement upon agreement or understanding for a commission, percentage, brokerage, or contingent fee. In the event of a breach or violation of this warranty, the EDD shall have the right to annul this Agreement without liability, in addition to other remedies provided by law. C. Warrant and certify that in the performance of this Agreement SAPD will comply with all applicable statutes, rules and/or regulations, and Agreement information security requirements, including but not limited to the following: • California Unemployment Insurance Code §1094 (Disclosure Prohibitions) • Title 20, Code of Federal Regulations §603.9 and §603.10 (Federal Unemployment Compensation Safeguards and Security Requirements) • California Civil Code §1798, et seq. (Information Practices Act) • California Penal Code §602 (Computer Fraud Act ) • Title 6, U.S. Code §662a (Federal Privacy Act Disclosure Restrictions) • Title 42, U.S. Code §603 (Social Security Act) • Title 18, U.S. Code §1905 (Disclosure of Confidential Information) d. Except for state agencies, agree to Indemnify the EDD against any loss, cost, damage or liability resulting from violations of these applicable statutes, rules and/or regulations, and Agreement information security requirements. e. Protect the EDD's information against unauthorized access, at all times, in all forms of media. Access and use the Information obtained under this Agreement only to the extent necessary to assist in the valid administrative needs of the program receiving such information, and only for the purposes defined in this Agreement. I. Keep all the EDD's confidential information completely confidential. Make this information available to authorized personnel on a "need -to -know" basis and only for the purposes authorized under this Agreement. "Need -to -know" refers to those authorized personnel who need information to perform their official duties in connection with the use of the information authorized by this Agreement. Confidentiality Requirements STD. [Rev 03108/2016) EDD Agreement Number: M0113589 EDD/SAPD Customer Codes: E00663 Page 2 of 3 EXHIBIT D (Standard Agreement) Notify the EDD Information Security Office (ISO) at (916) 654-6231, immediately upon discovery, that there may have been a breach in security which has or may have resulted in compromise to the confidential information. For purposes of this section, immediately is defined within 24 hours of discovery of the breach. The notification shall be by phone and email. It is not sufficient to simply leave a message. The notification must include a detailed description of the incident (such as time, date, location, and circumstances) and identify responsible personnel (name, title and contact information). The verbal notification shall be followed with an email notification to <i nformationSecurityOffice@edd.ca.gov>. II. MANAGEMENT SAFEGUARDS a. Acknowledge that the confidential information obtained by SAPID under this Agreement remains the property of the EDD. b. Instruct all personnel assigned to work with the information provided Linder this Agreement regarding the following: • Confidential nature of the EDD Information. • Requirements of this Agreement. • Sanctions specified in federal and state unemployment compensation laws and any other relevant statutes against unauthorized disclosure of confidential information provided by the EDD. c. Require that all personnel assigned to work with the information provided by the EDD complete the EDD Confidentiality Agreement (Attachment D1): d. Return the following completed documents to the EDD Contract Services Group: o The EDD Indemnity Agreement (Attachment 132): Required to be completed by the SAPD Chief Financial Officer or authorized Management Representative, unless SAPD is a State Agency. a The EDD Statement of Responsibility information Security Certification (Attachment D3): Required to be completed by the Information Security Officer or authorized Management Representative. e. Permit the EDD to make on -site inspections to ensure that the terms of this Agreement are being met. Make available to the EDD staff, on request and during on -site reviews, copies of the EDD Confidentiality Agreement (Attachment D1) completed by personnel assigned to work with the EDD's confidential information, and hereby made a part of this Agreement. f. Maintain a system of records sufficient to allow an audit of compliance with the requirements under subsection (d) of this part. Permit the EDD to make on -site inspections to ensure that the requirements of federal and state privacy, confidentiality and unemployment compensation statutes and regulations are being met including but not limited to Social Security Act §1137(a)(5)(8). III. USAGE, DUPLICATION, AND REDISCLOSURE SAFEGUARDS If a. Use the EDD's confidential information only for purposes specifically authorized under this Agreement. The information is not admissible as evidence in any action or special proceeding except as provided under section §1094(b) of the UIC. Section 1095(u) of the UIC does not authorize the use of the EDD's confidential information by any private collection agency. b. Extraction or use of the EDD information for any purpose outside the purposes stated in this Agreement is strictly prohibited. The information obtained under this Agreement shall not be reproduced, published, sold, or released in original or any other form not specifically authorized under this Agreement. Confidentiality Requirements STD. [Rev 03108/2016] EDD Agreement Number: M0113589 EDD/SAPD Customer Codes: E00663 Page 3 of 3 EXHIBIT D (Standard Agreement) c. Disclosure of any of the EDD information to any person or entity not specifically authorized In this Agreement is strictly prohibited, Personnel assigned to work with the EDD's confidential Information shall not reveal or divulge to any person or entity any of the confidential information provided under this Agreement except as authorized or required by law. IV. PHYSICAL SAFEGUARDS a. Take precautions to ensure that only authorized personnel are given access to physical, electronic and on-line files. Store electronic and hard copy information in a place physically secure from access by unauthorized persons. Process and store information in electronic format, such as magnetic tapes or discs, In such a way that unauthorized persons cannot retrieve the information by means of computer, remote terminal, or other means. b. Secure and maintain any computer systems (network, hardware, and software applications) that will be used in the performance of this Agreement. This includes ensuring that all security patches, upgrades, and anti -virus updates are applied as appropriate to secure data that may be used, transmitted, or stored on such systems in the performance of this Agreement. c. Store all the EDD's confidential documents in a physically secure manner at all times to prevent unauthorized access. d. Store the EDD's confidential electronic records in a secure central computer facility. Where in -use on a shared computer system or any shared data storage system, ensure appropriate information security protections are in place. SAPD shall ensure that appropriate security access controls, storage protections and use restrictions are in place to keep the confidential information in the strictest confidence and shall make the information available to its own personnel on a "need -to -know" basis only. e. Store the EDD's confidential data in encrypted format when recorded on removable electronic storage media, or on mobile computing devices, such as a laptop computer. f. Maintain an audit trail and record data access of authorized users and authorization level of access granted to the EDD's data, based on job function. g. Direct all personnel permitted to use the EDD's data to avoid leaving the data displayed on their computer screens where unauthorized users may view it. Personnel should retrieve computer printouts as soon as they are generated so that the EDD's data is not left unattended In printers where unauthorized personnel may access them. h. Dispose of confidential information obtained from the EDD, and any copies thereof made by SAPD, after the purpose for which the confidential information is disclosed is served. Disposal means return of the confidential information to the EDD or destruction of the information utilizing an approved method of confidential destruction, which includes electronic deletion (following Department of Defense specifications) shredding, burning, or certified or witnessed destruction. Confidentiality Requirements STD. [Rev 03/08/2016] EDDprayment ' 17evclnpmerrl EDD Contract No,M0113589 t7 c p a e t m c n t EDD Customer Code 140.E00663 EDDlSAPD t,fCe oP G t(fornin ATTACHMENT NO,D1 EMPLOYMENT DEVELOPMENT DEPARTMENT CONFIDENTIALITY AGREEMENT Information resources maintained by the State of California Employment Development Department (EDD) and provided to your agency may be confidential or sensitive. Confidential and sensitive Information are not open to the public and require special precautions to protect it from wrongful access, use, disclosure, modification, and destruction. The EDD strictly enforces information security. If you violate these provisions, you may be subject to adminis�tr e, civil. and/orcriminal action. 2 iT i �aA4t/ an employee of Santa Ana Police Department PRInl Yewli RAF — — PNInrYWneFf%4aYEaSlU1 hereby acknowledge that the confidential and/or sensitive records of the Employment Development Depadmentare subject to strict confidentiality requirements imposed by state and federal law include die Unemployment Insurance Code (UIC) §§1094 and 2111, the California Civil Code (CC) §1795 or seq., the California Pen Coda (PC) §502, Titie 5, USC §552a, Code of Federal Regulations, 1*41 20 part 603, and Title 15 USC §1905. acknowledge that my supervisor and/or the Contract's Confidentiality and Data Security Monitor reviewed with me the confidentiality and security IMsu4 requirements, policies, and administrative processes of my organization and of the EDD. acknowledge responsi'l lfty for knowing the classification of the EDD Information I work with and agree to refer questions about the classification of the 11114 EDD Information (public, sensitive, confidential) to the person the Contract assigns responsibility for the security and confidentiality of the EDD's data. acknowledge responsibility for knowing the privacy, confidentiality, and data security taws that apply to the EDD information 1 have been granted access zIIpiW. to by my employer, Including UIC §§1094 and 2111, California Government Cade § 15619, CC § 1798,53, and PC § 502, acknowledge that wrongful access, use, modification, or disclosure of confidential information maybe punishable as a crime and/or result in disciplinary uOTIA4 and/or civil action taken against Pie —including but notlimitedto: reprimand, . suspension without pay, salary reduction, demotion, or dismissal —and/or I lines and penalties resulting from criminal prosecution or civil lawsuits, andlor termination of contract- %f5 acknowledge that wrongful access, ins peclion, use, or disclosure of confidential information for personal gain, curiosity, or any non. business related reason is a crime under slate and federal Imes. Aacknowledge that wrongful access. use, modification, or disclosure of conlldentiat information is grounds for immediate termination of my organization's uano-x Contract with the EDD. _ agree to protect the following types of the EDD confidential and sensitive information: INITA . Wage information . Applicant Information • Employer Information . Proprietary Information • Claimant Information • Operational Information (manuals, guidelines, procedures) • Tax Payer Information hereby agree to protect the EC as infomlalion on either paper or electronic form by: untm4 . Accessing or using the EDD supplied information only as specified in the Contract for the performance of the specific work I am assigned. • Never accessing information for curiosity or personal reasons. • Never showing or discussing sensitive or confidential information to of with anyonewho does not have the need to know. • Placing sensitive or confidential information only in approved locations. • Never removing sensitive Of confidential information from the work silo vllhout authorization. • Following encryption requirements for all personal, sensitive, or confidential information in any portable device or media.. "I certify that I have read and initialed the confidentiality statements above and will abide by them." P ti Full Name (last, first, %It-) Sign re Santa Ana Police Department /C) 9 /q Print Name of Requesting Agency 9610 Signed Check the approprfafe box: Cf1 Employee ❑ Student ❑ Subcontractor ❑ volunteer ❑ Other Explain Attachment D1 (Rev 0720171 r.mpIoymtint Developnreot Dena rI rnent EDD Customer Code No.E00663 EDD/SAPD ATTACHMENT NO. D2 EMPLOYMENT DEVELOPMENT DEPARTMENT INDEMNITY AGREEMENT In consideration of access to the EDD information which is personal, sensitive, or confidential, Santa Ana Police De>) artment (Enter Requesting AgencylEnfily Name) agrees to indemnify the EDD against any and all liability casts, damages, attorney fees, and other expenses the EDD may incur by reason of or as a result of any unauthorized use of the personal, sensitive, or confidential information or any violation of the "Confidentiality Agreement" by any and all employees of: Santa Ana Police De ap rtment (Enter Requesting Agency/Entity Name) This obligation shall be continuous and may not be changed or modified unless agreed to in writing. In addition, I understand that the following penalties may be incurred for any such misuse of the EDD Information: 1. Any individual who has access to returns, reports, or documents maintained by the EDD who fails to protect the confidential information from being published or open to the public may be punished by imprisonment in the county jail for up to one year or a fine of $20,000.00 or both. (Unemployment Insurance Code §§ 2111 and 2122). 2. Any person who intentionally discloses Information, not otherwise public, which they knew or should have known was obtained from personal information maintained by a state agency, shall be subject to civil action for invasion of privacy by the individual to whom the information pertains. (California Civil Code §1798.53). 3. Any unauthorized access to the EDD computer data, computer systems, or unauthorized use of the EDD data is punishable by a fine or imprisonment in the county jail or both. (California Penal Code §502). I certify that I have read, understand, and agree with the above terms. SIGNED BY REQUESTING ENTITY REPRESENTATIVE Kristine Ridge G Print Full Name Signat�� As City Manager �/:we) g Print Title Date Signed Of Santa Ana Police Department Print Name of Requesting Entity Enter Name Governmental SgonsorlEntity Attachment D2 [Rev 0720171 G ui plot mcnt �� I�rvcloprox: nl EDDomerC Code _ •�� U c p a r I nr c n I EDD Customer Code No.E00663 EDDISAPD s 1 ., t 1• r- , i t r r ,. i ATTACHMENT NO. D3 EMPLOYMENT (DEVELOPMENT DEPARTMENT STATEMENT OF RESPONSIBILITY INFORMATION SECURITY CERTIFICATION We, the PDlice Systems Manager and the Commander hereby certify that Santa Ana Police Department has in place the safeguards and security requirements stated in this Interagency Agreement. We therefore accept responsibility for ensuring compliance with these requirements. as set forth in Exhibit "D" of the EDD Contract Dlo. M0113589, —IhIiSGeIi SrGtIAIUR[ ��p C hfANNDER SIGNATURE Boris Duran _ Malt Brown POLICE. SYST@AIS?MNAGERGERCER ,—� PRINTNAMIE. __.___, Police Systems Wlaa er �— Commander NUIT TnLE—_._...._, ,`._._..___. NRINT Tin: --------.------�7Er 245•a23o _.....__ ._..__..____ ____.._ (714) 2rt5.8041 iE6 Et{Dt:E NUt. uER FELEPHOtic tiill,'3ER --� -----�--- bduranBsanta-ana.oro _ inbrown0santa-ana.o E•hlniL AODR&S& EP.fA4 AD7RES aA7E slct,Ea NOTE: Rctuin this Information Security Ceitiricalion to tho EDD Contract Manager vrith lho s7gned copies of the Contract. 1. Information Security Certification received by: -_—EDO CCE:Ta;,f,T fS1J; rR L'.!;i -- DATE _CENED - 2. The EDD information asset access approved by: COFIfE+•1GT AIhtJ:iGER 4R Uf:ifteSURti Gc)ORUItd%.[pR U, [F, faf%RGv"cUf%EF C�4:It F. TC.i NO TE: 'Me EDD must have a signeQ'tnforuratfon Security Certiricatiow in its possession prior to disclosure, orany personal. confidential. or sonsihivo inlornlation to the Santa Ana Police Department Allachment 03 (Rev 0; 20171