HomeMy WebLinkAboutAgreement A-16-682 with State of California EDD.pdfST ATE OF CALIFORNIA STANDARD AGREEMENT STD. 213 (Rev 06/03) REGISTRATION NUMBER Agreement No. 16-682 EDD CUSTOMER CODE: E00523 PROJECT/ACTIVITY CODE: 695/090 AGREEMENT NUMBER M7104532 1. This Agreement is entered into between the Agency and the State of California Contractor named below: 2. 3. REQUESTER AGENCY NAME Fresno County Sheriff-Coroner's Office STATE OF CALIFORNIA-CONTRACTOR'S NAME Employment Development Department The term of this Agreement is: The maximum amount of this Agreement is: January 1, 2017 through December 31, 2019 $3,516.00 Three Thousand Five Hundred and Sixteen Dollars and No Cents 4. The parties agree to comply with the terms and conditions of the following exhibits which are by this reference made a part of the Agreement: Exhibit A Scope of Work 2 Pages Attachment A 1 Specifications 4 Pages Exhibit B Budget Detail and Payment Provisions 1 Page Exhibit C* General Terms and Conditions GTC 610 Exhibit D Protection of Confidentiality 3 Pages Attachment 01 Confidentiality Agreement 1 Page Attachment 02 Indemnity Agreement 1 Page Attachment 03 Statement of Responsibility 1 Page Items shown with an Asterisk(*}, are hereby incorporated by reference and made part of this Agreement as if attached hereto. These documents can be viewed at: www.dgs.ca.gov/ols/ResourceslStandardContractLanquaqe.aspx. IN WITNESS WHEREOF, this Agreement has been executed by the parties hereto. STATE OF CALIFORNIA CONTRACTOR California Department of General Services Use Only CONTRACTOR'S NAME (if other than an individual, state whether a corporation. partnership, etc.) Employment Development Department s;Aut~na,r:__ DATE SIGNED(Do not type) l)./11,/16 PRINTED NAME AND TITLE OF PERSON SIGNING ochitl Montano, Manager, Contract Services Group ADDRESS P.O. Box 826880, MIC 62-C Sacramento, CA 94280-0001 AGENCY AGENCY'S NAME Fresno County Board of Supervisors for Fresno County Sheriff-Coroner's Office BY (Authorized Signature) DATE SIGNED(Do not type) fl(~ ~ I ,; -h-L -/:J.-7-IL.o PRINTED NAME AND TITLE OF PERSU!'l SIGNING Ernest Buddy Mendes, Chairman ADDRESS 2881 Tulare Street, Fresno, CA 93721 ATTEST: BERNICE E. SEIDEL, Clerk Board of Supervisors By ~~\SJ\.::Q Q~SbS'1fl Deputy
EDD Agreement No. M7104532 EDD/FCSO Customer Code: E00523 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 Fresno County Sheriff-Coroner's Office, hereinafter referred to as the FCSO. It sets forth the terms and conditions for the release and use of the EDD's confidential information. SCOPE OF WORK I. Purpose The EDD agrees to provide confidential Employer and Client Address information to the FCSO. The FCSO agrees to use the confidential information provided by the EDD for the purpose of furthering investigations of felonies and suspected felonies. II. Legal Authority The EDD shall make this information available to the FCSO pursuant to California Unemployment Insurance Code (CUIC) Section 1095(i). The FCSO shall request and use the specified information in accordance with California Penal Code Section 830.1 and CUIC Section 1095(i). Ill. Contract Representatives 1. The EDD's contact persons are: CONTRACT NEGOTIATIONS, CONFIDENTIALITY, AND TECHNICAL ASSISTANCE Claire Dodson, or Designee Employment Development Department Information Security Office, MIC 33 P.O. Box 826880 Sacramento, CA 94280-0001 Phone: (916) 651-2885 E-mail: Claire.Dodson@edd.ca.gov cc: ISOPrivacyDisclosureUnit@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) 654-7844 E-mail: Erlinda.Matienzo@edd.ca.gov
EXHIBIT A (Standard Agreement) 2. The FCSO contact persons are: CONTRACT NEGOTIATIONS AND ADMINISTRATION AND FISCAL MATTERS Jose Salinas, Lieutenant Fresno County Sheriff-Coroner's Office 2200 Fresno St. Fresno, CA 93721 Phone: 559-600-8029 E-mail: jose.salinas@fresnosheriff.org CONFIDENTIALITY AND DATA SECURITY ASSIGNMENTS Data Security and Integrity: Kai Chakravarthy Internal distribution of the EDD products: Thomas Trester EDD Agreement No. M7104532 EDD/FCSO Customer Code: E00523 Page 2 of 2 3. Either party may make changes to the Contract Representatives information above by giving written notice to the other party. Said changes shall not require an amendment to this Agreement.
SPECIFICATIONS ATTACHMENT A1 (Standard Agreement) EDD Agreement No. M7104532 EDD/FCSO Customer Code: E00523 Page 1 of 4 I. METHODOLOGY: OFFICE OF TECHNOLOGY SERVICES (OTECH) SECURE FILE TRANSFER SERVICE (SFT) 1. The FCSO submits a request for LE 1095(i) Locator Reports under Customer Codes E00523 following the EDD specifications through the Secure File Transfer (SFT) service hosted by the California Office of Technology Services (OTech) 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 retrieves and processes the Social Security Numbers (SSN) submitted by the FCSO. 3. On matching records the EDD produces the data files authorized under this agreement under Customer Code E00523 and submits the data files to the attention of the FCSO through the SFT system. 4. The FCSO retrieves the output data files from the SFT system within twenty (20) days of transfer. 5. On a quarterly basis the EDD invoices the FCSO for all SSN transactions submitted and the cost of the SFT account. I. RESPONSIBILITIES 1. The EDD agrees to: a. Set up a Basic User Account and password under Customer Code E00523 for the FCSO to access the OTech SFT system. b. Assign copies of the OTech SFT Basic User Manual and the EDD Abstract System Customer Instruction Packet to the FCSO to assist the FCSO in the implementation of the SFT process. c. Provide User Account administration to reset password, unlock user account, and/or modify user account. To request User Account support submit an email message to: Claire.Dodson@edd.ca.gov cc: ISOPrivacyDisclosureUnit@edd.ca.gov d. Retrieve the FCSO input file from the SFT temporary file storage repository on a daily basis and run the input file against the EDD databases. e. Provide the FCSO the following Abstract data files for those individuals whose submitted social security numbers match the EDD records: ( 1) LE 1095(i) Locator Report f. Transfer the response data file to the FCSO, through the SFT system under the output DSN: LE 1095(i) Locator Report: em_abs_abs251_sftrpts_abs00523 g. Retain the output data file for a period of twenty (20) calendar days in the SFT temporary file repository. On the 21th day, the data file is automatically deleted. h. Invoice the FCSO on a quarterly basis for all SSN transactions submitted and SFT account cost.
EDD Agreement No. M7104532 EDD/FCSO Cu~omerCode:E00523 2. The FCSO agrees to: ATTACHMENT A1 (Standard Agreement) a. Request only the EDD information specifically authorized under this Agreement. Page 2 of4 b. Establish a new password at first logon to the Basic User Account established under Customer Code E00523 for the FCSO to access the OTech SFT system. c. Follow the following SFT Password Policy syntactical requirements: • The password must contain at least 8 characters. • At least one of the characters must be a number. • At least one of the characters must be a symbol (for example: !@#$%). • At least one of the characters must be an uppercase alpha character. d. Change the Basic User Account password on or before 90 days, after which the account will be locked. A limit of five attempts to enter the password is allowed after which the account will be locked. To request User Account support submit an email message to: Claire.Dodon@edd.ca.gov cc: ISOPrivacyDisclosureUnit@edd.ca.gov e. Create the request for wages file, following the EDD specifications, for felony victims, suspects, missing persons, potential witnesses, or persons for whom a felony arrest warrant has been issued. f. Request the file(s) authorized in this Agreement on an as needed basis during the period specified herein. The number of requests (SSNs) shall not exceed 1,000,000 (one million) SSNs on any daily cycle. Requests exceeding 1,000,000 SSNs will process the first 1,000,000 SSNs only. SSNs in excess of 1,000,000 will be discarded and the FCSO will need to resubmit in a future cycle. g. Upload the request file into the SFT temporary file storage repository, on an as needed basis, under the input DSN: em_abs_abs01 O_absreq_abs00523 h. Retrieve the response data file from the SFT temporary file storage repository within twenty (20) calendar days from submission. On the 21st day, the data file is automatically deleted. i. Delete the retrieved response data file from the SFT temporary file storage repository before submitting a new request. j. Use the EDD information to assist in the investigations of felonies or suspected felonies. k. Comply with the California Unemployment Insurance Code (CUIC) on any matters pertaining to the access, use, and/or release of data under this agreement. Failure to comply with this provision shall be deemed a breach of this agreement and shall be grounds for cancellation of this Agreement. I. Oversee the FCSO staff in their use of confidential information received from the EDD. m. Instruct all the FCSO 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
EDD Agreement No. M7104532 EDD/FCSO Customer Code: E00523 Page 3 of4 ATTACHMENT A1 (Standard Agreement) of this Agreement; (3) the need to adhere to the security and confidentiality provisions outlined in Exhibit D -Protection of Confidentiality Provisions; and (3) the sanctions and penalties against unauthorized use or disclosure found in CUIC Sections 1094 and 2111, the California Civil Code Section 1798.55, and the California Penal Code Section 502. n. Ensure that all FCSO staff assigned to work with the information provided by the EDD have signed the EDD Confidentiality Statement (Attachment 01. Rev 05/14/14). o. Comply with Title 20, Code of Federal Regulations Section 603.9 with respect to any of the EDD confidential information. p. Use the information provided by the EDD only as specifically authorized under this agreement. The Unemployment Insurance Code section 1095(u) prohibits a private collection agency from using any EDD information the FCSO obtains under this Contract. Therefore, nothing in this Contract 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 Contract. q. Dispose of the EDD's confidential information using an approved method of confidential destruction. r. Not release the EDD's confidential information to any other public or private entity without the EDD's prior written consent. s. Cooperate with the EDD's authority to monitor this Agreement in accordance with Exhibit D, Section II, paragraphs (e) and (f). t. Pursuant to 20 C.F.R., Part 603.10(c)(1), if the FCSO 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 the FCSO 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. 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 specific program procedures. b. Not disclose any of the EDD or the FCSO information to any person or agency other than those authorize specifically under this Agreement. c. Cooperate fully and furnish such assistance as may be mutually agreed upon by the parties hereto as being necessary and appropriate for proper performance of this Agreement. 4. Disputes: In the event of a dispute between the EDD and the FCSO over any part of this Agreement, the dispute may be submitted to nonbinding arbitration upon the consent of both the EDD and the FCSO. An election for arbitration pursuant to this provision shall not preclude either party from pursuing any remedy for relief otherwise available.
Ill. ACCURACY ASSESSMENT EDD Agreement No. M7104532 EDD/FCSO Customer Code: E00523 Page 4 of 4 ATTACHMENT A1 (Standard Agreement) 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.
EXHIBITS (Standard Agreement) I. BUDGET DETAIL AND PAYMENT PROVISIONS EDD Agreement No. M7104532 EDD/FCSO Customer Code: E00523 Page 1 of 1 a. The maximum amount of this Agreement shall not exceed Three Thousand Five Hundred Sixteen Dollars and No Cents ($3,516.00). 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 FCSO shall reimburse EDD the total amount due, based on the following product rate structure: • $16.00 per month SFT Account Fee • A $1,500.00 Administrative Fee. The administrative costs for contracting include the costs for development, processing, and maintenance of a contract, which averages $1,500 per contract. For a three year contract, the administrative fee will be charged at a rate of $125 per quarter. These costs are computed in accordance with Sections 8752 and 8752.1 of the State Administrative Manual; and • $2.00 per SSN for each LE 1095(i) Locator Report requested. c. The FCSO shall be charged for the total number of products requested. Each Social Security Number (SSN) submitted will generate 1 LE 1095(i) Locator Report. d. The maximum amount of this Agreement has been computed based on an estimated 60 SSNs per quarter, as follows: .EOE>....Al:tSrrRACT FORMULA GOS.T LE 1095(i) Locator reoort 60 X 2.00 X 12Q $1,440.00 Administrative Fees $1,500.00 SFT Account Fee 16.00 x 12 Months x 3 vrs $576.00 Total for 3-year contract $3,516.00 f. The EDD invoices will reference the EDD Agreement No. M7104532 and Customer Code: E00523; and shall be submitted for payment to: Fresno County Sheriff-Coroner's Office Attn: Business Office 2200 Fresno St. Fresno, CA 93721 g. The FCSO payment must reference EDD Invoice Number, EDD Agreement No. M7104532, and Customer Code: E00523; and be submitted to: Employment Development Department Accounting Section, MIC 70 P.O. Box 826217 Sacramento, CA 94230-6217
EDD Agreement No. M7104532 EDD/FCSO Customer Code: E00523 PROTECTION OF CONFIDENTIALITY EXHIBITD (Standard Agreement) 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. FCSO must therefore, agree to the following security and confidentiality requirements: I. ADMINISTRATIVE SAFEGUARDS a. Adopt policies and procedures to ensure use of the EDD's confidential information solely for purposes specifically authorized under this Agreement that meet the requirements of Title 20, Code of Federal Regulations §603.10. b. Warrant by execution of this Agreement, that no person or selling agency has been employed or retained to solicit or secure this Agreement upon agreement or understanding for a commission, percentage, brokerage, or contingent fee. In the event of a breach or violation of this warranty, the EDD shall have the right to annul this Agreement without liability, in addition to other remedies provided bylaw. c. Warrant and certify that in the performance of this Agreement FCSO 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 §502 (Computer Fraud Act) • Title 5, U.S. Code §552a (Federal Privacy Act Disclosure Restrictions) • Title 42, U.S. Code §503 (Social Security Act) • Title 18, U.S. Code §1905 (Disclosure of Confidential Information) d. Except for state agencies, agree to indemnify the EDD against any loss, cost, damage or liability resulting from violations of these applicable statutes, rules and/or regulations, and Agreement information security requirements. e. Protect the EDD's information against unauthorized access, at all times, in all forms of media. Access and use the information obtained under this Agreement only to the extent necessary to assist in the valid administrative needs of the program receiving such information, and only for the purposes defined in this Agreement. f. Keep all the EDD's confidential information completely confidential. Make this information available to authorized personnel on a "need-to-know" basis and only for the purposes authorized under this Agreement. "Need-to-know" refers to those authorized personnel who need information to perform their official duties in connection with the use of the information authorized by this Agreement. Confidentiality Requirements STD. [Rev 03/08/2016]
EDD Agreement No. M7104532 EDD/FCSO Customer Code: E00523 Page 2 of 3 EXHIBITD (Standard Agreement) g. Notify the EDD Help Desk at (916) 654-1010, immediately upon discovery, that there may have been a breach in security which has or may have resulted in compromise to the confidential information. For purposes of this section, immediately is defined within 24 hours of discovery of the breach. The notification shall be by phone and email. It is not sufficient to simply leave a message. The notification must include a detailed description of the incident (such as time, date, location, and circumstances) and identify responsible personnel (name, title and contact information). The verbal notification shall be followed with an email notification to <lnformationSecurityOffice@edd.ca.gov>. II. MANAGEMENT SAFEGUARDS a. Acknowledge that the confidential information obtained by FCSO under this Agreement remains the property of the EDD. b. Instruct all personnel assigned to work with the information provided under this Agreement regarding the following: • Confidential nature of the EDD information. • Requirements of this Agreement. • Sanctions specified in federal and state unemployment compensation laws and any other relevant statutes against unauthorized disclosure of confidential information provided by the EDD. c. Require that all personnel assigned to work with the information provided by the EDD complete the EDD Confidentiality Agreement (Attachment 01): d. Return the following completed documents to the EDD Contract Services Group: o The EDD Indemnity Agreement (Attachment D2): Required to be completed by the FCSO Chief Financial Officer or authorized Management Representative, unless FCSO is a State Agency. o The EDD Statement of Responsibility Information Security Certification (Attachment D3): Required to be completed by the Information Security Officer or authorized Management Representative. e. Permit the EDD to make on-site inspections to ensure that the terms of this Agreement are being met. Make available to the EDD staff, on request and during on-site reviews, copies of the EDD Confidentiality Agreement (Attachment 01) completed by personnel assigned to work with the EDD's confidential information, and hereby made a part of this Agreement. f. Maintain a system of records sufficient to allow an audit of compliance with the requirements under subsection (d) of this part. Permit the EDD to make on-site inspections to ensure that the requirements of federal and state privacy, confidentiality and unemployment compensation statutes and regulations are being met including but not limited to Social Security Act §1137(a)(5)(B). Ill. USAGE, DUPLICATION, AND REDISCLOSURE SAFEGUARDS a. Use the EDD's confidential information only for purposes specifically authorized under this Agreement. The information is not admissible as evidence in any action or special proceeding except as provided under §1094(b) of the California Unemployment Insurance Code (CUIC). Section 1095(u) of the CUIC does not authorize the use of the EDD's confidential information by any private collection agency. b. Extraction or use of the EDD information for any purpose outside the purposes stated in this Agreement is strictly prohibited. The information obtained under this Agreement shall not be reproduced, published, sold, or released in original or any other form not specifically authorized under this Agreement. Confidentiality Requirements STD. [Rev 03/08/2016]
EDD Agreement No. M7104532 EDD/FCSO Customer Code: E00523 Page 3 of 3 EXHIBITD (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. FCSO 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 FCSO, 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)
~ Employment EDD Development _:--:;;:-~ Department State of California EDD Agreement No. M7104532 EDD/FCSO Customer Code: E00523 ATTACHMENT NO. D2 Paae 1 of 1 EMPLOYMENT DEVELOPMENT DEPARTMENT INDEMNITY AGREEMENT In consideration of access to the EDD information which is personal, sensitive, or confidential, Oscar J. Garcia (Enter name of Chief Financial Officer or authorized Management Representative} agrees to indemnify the EDD against any and all liability costs, damages, attorney fees, and other expenses the EDD may incur by reason of or as a result of any unauthorized use of the personal, sensitive, or confidential information or any violation of the "Confidentiality Agreement" by any and all employees of: County of Fresno (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. (California Unemployment Insurance Code §§ 2111 and 2122). 2. Any person who intentionally discloses information, not otherwise public, which they knew or should have known was obtained from personal information maintained by a state agency, shall be subject to civil action for invasion of privacy by the individual to whom the information pertains. (California Civil Code §1798.53). 3. Any unauthorized access to the EDD computer data, computer systems, or unauthorized use of the EDD data is punishable by a fine or imprisonment in the county jail or both. (California Penal Code §502). I certify that I have read, understand, and agree with the above terms. SIGNED BY REQUESTING ENTITY REPRESENTATIVE Garcia, Oscar J. Print Full Name (last, first, Ml) Auditor-Controller/Treasurer-Tax Collection Print Title County of Fresno Print Name of Requesting Entity Attachment 02 [Rev 051414] //~J-/G Date Signed Enter Name Governmental Sponsor/Entity
.,,,,,,,.-----. E m p I o y m e n t EDD Development ----..::: = Department State of California EDD Agreement No. M7104532 EDD/FCSO Customer Code: E00523 ATTACHMENT NO. D3 Paae 1 of 1 EMPLOYMENT DEVELOPMENT DEPARTMENT STATEMENT OF RESPONSIBILITY INFORMATION SECURITY CERTIFICATION We, the Information Technology Manager and the Sheriffs Administrative Director hereby certify that FCSO has in place the safeguards and security requirements stated in this lnteragency Agreement. We therefore accept responsibility for ensuring compliance with these requirements, as set forth in Exhibit "D" of the EDD Agreement No. M7104532. IT MANAGER SIGNATURE Kai Chakravarthy PRINT NAME OF IT MANAGER Information Technology Manager PRINT TITLE 559-600-8124 TELEPHONE NUMBER ADMINISTRATIVE DIRECTOR SIGNATURE Thomas Trester PRINT NAME Sheriffs Administrative Director PRINT TITLE 559-600-8503 TELEPHONE NUMBER Kal.chakravarthy@fresnosheriff.org Thomas. trester@fresnosheriff.org NOTE: E-MAIL ADDRESS E-MAIL ADDRESS DATE SIGNED DATE SIGNED Return this Information Security Certification to the EDD Contract Manager with the signed copies of the Contract. FOR THE EDD USE ONLY 1. Information Security Certification received by: EDD CONTRACT MANAGER NAME DATE RECEIVED 2. The EDD information asset access approved by: CONTRACT MANAGER OR DISCLOSURE COORDINATOR DATE APPROVED (AFF, EMAIL, ETC.) NOTE: The EDD must have a signed "Information Security Certification" in its possession prior to disclosure of any personal, confidential, or sensitive information to the FCSO. Attachment D3 [Rev 051414]
1 State of California Employment Development Dept. ($3,516) FY 2016-17
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3 REVIEWED & RECOMMENDED
FOR APPROVAL
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MARGARE'r MIMS , Sheriff-Coroner
12 APPROVED AS TO LEGAL FORM:
13 Daniel C. Cederberg , County Counsel
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18 APPROVED AS TO ACCOUNTING FORM:
By :
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Ernest Buddy Mendes , Cha i rman ,
Board of Supervisors
ATTEST:
BERNICE E . SEIDEL, Clerk
Board of Supervisors
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Deputy
Oscar J . Garcia , Auditor-Controllerffreasurer-Tax Collector
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