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CM-2023-203 - 9/1/2023TEXAS WORKFORCE COMMISSION PERFORMING AGENCY CONTRACT TEXAS WORKFORCE COMMISSION TWC Contract Number I 2923EDE063 TITLE INFORMATION RELEASE CONTRACT Recipient Name City of Round Rock for the benefit of Round Rock Police Department Street Address 2701 N. Mays St Ci L/State/Zip Round Rock, Texas 78665 Telephone Number 1 (512) 218-5524 Contract Period This Contract shall begin on April 1,2024 ("Begin Date") and shall terminate on March 31, 2029 ("End Date"), unless all parties have not executed this Contract before April 1, 2024 in which case the Begin Date will be the date on which the last signature occurs. This Contract may not be renewed or extended. Funding Information The total amount of this Contract will not exceed the sum of $7,500.00 Remarks This Contract is contingent on Recipient's acceptance of and compliance with the terms and conditions of this Contract and any referenced attachments. Summary Information to be provided by TWC will include: • wage records (WR), • unemployment compensation claim benefit data (UI), • employer master file (ER) inquiry. Type of Access: Online access only Number of online users and rate: 1-10 for $1,5001year for five (5) years. Prior contract reference: This contract replaces and supersedes all previous contracts, including 2922PEN026. 60, 2--,1) 2�3 - 2-,�)-? Information Release Contract: February 2022 TWC Contract Number: 2923EDE063 CITY OF ROUND ROCK Page I of 6 TEXAS WORKFORCE COMMISSION PERFORMING AGENCY CONTRACT Signature Authority Each person signing this Contract hereby warrants that he or she has been fully authorized by the respective organization to: • Execute this Contract on 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 Round Rock for the benefit of Round Rock Police Department 7/26/2023 xda&(, 2-5 -3 - John Greytok Date Laurie Hadley bate Senior Adviser to the Executive Director City Manager Information Release Contract: February 2022 TWC Contract Number: 2923EDE063 - CITY OF ROUND ROCK Page 2 of 6 TEXAS WORKFORCE COMMISSION PERFORMING AGENCY CONTRACT TABLE OF CONTENTS General Terms and Conditions Section I Purpose and Legal Authority Section 2 Term, Termination, and Amendment Section 3 Consideration Section 4 Protecting the Confidentiality of TWC Information Section 5 Records and Audit Section 6 Breach of Agreement, Default, and Remedies Section 7 Miscellaneous Attachment A Statement of Work — Project Obligations Attachment B Safeguards for TWC Information Attachment C Texas Workforce Commission User Agreement Attachment D Cover Sheet for Transmitting User Agreement and Training Certificate Attachment E Intenlionally omitted Attachment F Certificate of Destruction for Contractors and Vendors Attachment G Quarter! Self -Assessment Report Exhibit I TWC Data Exchange Request and Safeguard Plan Information Release Contract: February 2022 TWC Contract Number: 2923EDE063 — CITY OF ROUND ROCK Page 3 of 6 TEXAS WORKFORCE COMMISSION PERFORMING AGENCY CONTRACT TEXAS WORKFORCE COMMISSION INFORMATION RELEASE CONTRACT GENERAL TERMS AND CONDITIONS SECTION 1 - Purpose and Legal Authority 1.1 This Contract sets forth the obligations of the Texas Workforce Commission ("Agency") and the Recipient identified on the cover page (each a "Party" and together "the Parties") with respect to Agency's release of confidential data to Recipient. The obligations of the Parties are set forth in detail in Attachment A. 1.2 Subject to certain limitations, the Interlocal Cooperation Act, Texas Government Code, Chapter 791, authorizes Recipient to enter into contracts for services with governmental entities, including state agencies. SECTION 2 - Term, Termination, and Amendment 2.1 This Contract is effective from the Begin Date to the End Date specified on the cover page. 2.2 Either Party may suspend or terminate this Contract at any time, on written notice to the other Party specifying a termination date at least thirty (30) calendar days after the date of the notice. Suspension or termination shall not relieve Recipient of the obligation to pay for all services provided before suspension or termination at the rates specified herein. Recipient shall not be entitled to any refund of the annual subscription fee if access to Agency records is online. 2.3 No modification will be valid unless in writing and signed by both Parties, except for rate revisions made under Section 3.2 of these General Terms and Conditions. SECTION 3 - Consideration 3.1 Recipient shall pay Agency for the services described, and at the rates set forth, in Attachment A. 3.2 Notwithstanding Section 3.1 of these General Terms and Conditions, Agency may unilaterally revise rates upon written notice to Recipient of at least thirty (30) calendar days. SECTION 4 - Protecting the Confidentiality of TWC Information 4.1 "TWC Information" means records maintained by Agency, and records obtained by Recipient from Agency under this Contract, including (1) records and data compilations provided electronically, on paper, or via online access or e-mail, (2) records and data compilations that Recipient has converted into another format or medium (such as handwritten or electronic notes), and (3) records and data compilations incorporated in any manner into Recipient's records, files or data compilations. Information Release Contract: February 2022 TWC Contract Number: 2923EDE063 - CITY OF ROUND ROCK Page 4 of 6 TEXAS WORKFORCE COMMISSION PERFORMING AGENCY CONTRACT 4.2 Recipient shall protect the confidentiality of TWC Information and comply with all statutory, regulatory and contract requirements. Confidentiality is required by Texas Labor Code §§ 301.081 and 301.085, the Social Security Act of 1934, and 20 Code of Federal Regulations (C.F.R.) Part 603. SECTION 5 — Records and Audit Recipient shall keep and maintain complete and accurate records sufficient to allow Agency, the Texas State Auditor's Office, the United States government, and their authorized representatives to determine Recipient's compliance with this Contract. SECTION 6 — Breach of Agreement, Default, and Remedies 6.1 If Recipient or any official, employee, or agent of Recipient fails to comply with any provision of this Contract, including timely payment of Agency's invoices, Agency may suspend services to Recipient (including any data requests being processed) until Agency is satisfied that corrective action has been taken to assure there will be no future breach. 6.2 In the absence of prompt and satisfactory corrective action to cure default and assure future compliance with Contract requirements, Agency shall terminate this Contract immediately and Recipient shall surrender to Agency all TWC Information that has not previously been returned to Agency, and any other records relevant to this Contract. 6.3 Termination of this Contract under Section 6.2 of these General Terms and Conditions will not limit Agency from pursuing penalties under state and federal law for the unauthorized disclosure of TWC Information. 6.4 Agency shall undertake any other action under this Contract or under any law of this State or of the United States, to enforce this Contract and to secure satisfactory corrective action and return of TWC Information. 6.5 Agency shall take other remedial actions permitted under state or federal law to enforce this Contract and 20 C.F.R. Part 603 including seeking damages, penalties, and restitution for all costs incurred by Agency in enforcing this Contract and responding to Recipient's breach. SECTION 7 — Miscellaneous 7.1 Texas Labor Code § 301.085 provides that unemployment compensation records are not "public information" for purposes of the Public Information Act, Texas Government Code, Chapter 552. Recipient shall not release any TWC Information in response to a request made under the Public Information Act or any other law, regulation, or ordinance addressing public access to government records. Information Release Contract: February 2022 TWC Contract Number: 2923EDE063 CITY OF ROUND ROCK Page 5 of 6 TEXAS WORKFORCE COMMISSION PERFORMING AGENCY CONTRACT 7.2 Recipient shall notify Agency within twenty-four (24) hours of the receipt of any subpoena, other judicial request, or request for appearance for testimony upon any matter concerning TWC Information. Federal regulations at 20 C.F.R. § 603.7 dictate the handling of subpoenas for TWC Information. 7.3 This Contract is made in and performed in the State of Texas, and shall be construed, interpreted, and applied in accordance with the laws of the State of Texas, excluding its choice of law rules. Venue of any court action brought directly or indirectly by reason of this Contract shall be in a court of competent jurisdiction in Travis County, Texas. NOTHING IN THIS SECTION SHALL BE CONSTRUED AS A WAIVER OF SOVEREIGN IMMUNITY BY AGENCY. 7.4 Agency's failure to enforce any provision of this Contract does not constitute a waiver of that provision or any other. 7.5 Recipients agrees to indemnify and hold harmless Agency, the State of Texas, and their employees and officials for any loss, damages, judgments, and costs arising or resulting from any acts or omissions or alleged acts or omissions of Recipient or its employees, agents, contractors, and subcontractors, including the inappropriate release or use of TWC Information. 7.6 Recipient shall be responsible and liable for any damages resulting from a breach by Recipient including damages and losses of third parties. Recipient shall reimburse Agency for any costs incurred by Agency in reimbursing third parties damaged by Recipient's breach and costs incurred in attempts by Agency to limit third party losses resulting from Recipient's breach. 7.7 Recipient agrees to accept liability for any damage to Agency's hardware, software, or TWC Information when such damage is caused by the actions of employees, contractors, subcontractors or agents of Recipient, whether or not the individual was an authorized User under this Contract. T8 If any provision of this Contract is held to be unenforceable by a court, this Contract will be construed as if such provision did not exist, and the unenforceability of such provision will not render any other provisions of this Contract unenforceable. 7.9 This Contract is the entire agreement between the Parties. 7.10 The subject headings used in this Contract are for convenience only and are not intended to expand or limit meanings. 7.11 Attachments listed in the Table of Contents are incorporated in their entirety as terms and conditions of this Contract. 7.12 The following provisions survive the expiration or earlier termination of this Contract: Sections 4.2, 5, 6.2, 6.3, 7.1, 7.2, 7.5, 7.6, and 7.7 of these General Terms and Conditions; Sections 3.3.3, 3.3.4, and 3.3.5 of Attachment A; and Attachment B. Remainder of page intentionally left blank. Information Release Contract: February 2022 TWC Contract Number: 2923EDE063 CITY OF ROUND ROCK Page 6 of 6 TEXAS WORKFORCE COMMISSION INFOMRATION RELEASE CONTRACT Attachment A INFORMATION RELEASE CONTRACT BETWEEN TEXAS WORKFORCE COMMISSION AND CITY OF ROUND ROCK FOR THE BENEFIT OF ROUND ROCK POLICE DEPARTMENT STATEMENT OF WORK--- PROJECT OBLIGATIONS SECTION I - - Project Abstract 1.1 Contract Purpose. The purpose of this Contract is to provide Recipient with access to confidential Agency data, to ensure that Recipient will maintain the confidentiality of the data, and to require Recipient to reimburse Agency for costs of providing access at the rates set out in this Contract. 1.2 Authorized Use of TWC Information. Subject to the security and confidentiality provisions of this Contract, Recipient is authorized to use TWC Information, as defined in Attachment B, item 1, solely for the Limited Purpose(s) listed in the Request and Safeguard Plan and associated correspondence which is incorporated into this Contract and marked as Exhibit 1. Recipient warrants that all statements and information in Exhibit 1, Request and Safeguard Plan and associated correspondence true and correct to the best of my knowledge and understands that their organization is bound by the representations in Exhibit 1. Any other use of TWC Information by Recipient is a breach of this Contract. 1.3 References. Section references are to sections of this Attachment A unless otherwise specified. SECTION 2 — Obligations of Agency 2.1 Description of TWC Information Disclosed and Method of Access. Agency agrees to provide access to the TWC information requested and via the method as described in Exhibit 1. 2.2 Availability. Online access will routinely be available Monday through Friday, 8:00 a.m, to 5:00 p.m. Central Time, excluding State holidays, although Agency does not guarantee access during these periods. Agency may terminate or limit access without notice based on business necessity or in the event of an emergency. 2.3 Method of transfer. Agency will transfer TWC Information to Recipient only as specified in the Request and Safeguard Plan or by other methods approved in writing in advance by Agency Chief Information Security Officer or his/her designee. SECTION 3 — Obligations of Recipient 3.1 Online Access. 3.1.1 Direct Oversight of Users. Recipient shall ensure that all individuals with online access through user TWC system log -in accounts ("Users,") are direct Recipient employees. Information Release Contract Attachments- February 2022 TWC Contract Number: 2923EDE063 - CITY OF ROUND ROCK Page l of 13 TEXAS WORKFORCE COMMISSION INFOMRATION RELEASE CONTRACT 3.1.2 Annual Fee and Payment. Recipient shall pay Agency the annual subscription fee applicable to the access identified in Exhibit 1, Request and Safeguard Plan. The annual subscription fee covers the twelve (12) month period that begins on the Begin Date. Payment of the annual subscription fee is due within thirty (30) calendar days of Recipient's execution of this Contract. The annual subscription fee is nonrefundable and will not be prorated in case of early termination of this Contract or suspension of services. If access identified in the Request and Safeguard Plan in Exhibit 1 is for multiple years, the Recipient shall pay Agency the annual subscription fee for each subsequent contract year within thirty (30) calendar days of the beginning of each contract year. If the contracting entity is a city or county, also known as a "local entity", Recipient shall send payment to Texas Workforce Commission, Revenue and Trust Management, P.O. Box 322, Austin, TX 78767-0322. 3.1.3 User Documents. All prospective online Users must execute a Texas Workforce Commission User Agreement ("User Agreement"), Attachment C, and complete online TWC Cybersecurity Awareness Training ("Security Training"). 3.1.4 User Document Submission and Maintenance. Before Agency EAGLE Administration will invite a prospective User, Agency EAGLE Administration must receive from Recipient Contact Person (designated in Exhibit 1, Request and Safeguard Plan) a copy of the completed Texas Workforce Commission User Agreement ("User Agreement"), Attachment C and the Security Training certificate with a completed Transmittal Cover Sheet ("Cover Sheet"), Attachment D. Agency may deny access to any prospective User on security grounds. Recipient must maintain on file all original Training Certificates and User Agreements, which are subject to on -site and desk review audits. 3.1.5 Annual User Renewal. For multi -year, extended, and new contracts continuing, extending, or replacing a prior contract with online access, each year, on the first day of the month following the anniversary of the Begin Date the Recipient Contact Person shall provide new User Agreements and the Security Training certificate. The User Agreements and Security Training certificates shall be submitted with a completed Cover Sheet no earlier than 30 days before the first day following the anniversary of the Begin Date. The User Agreements and Training Certificates shall be executed and dated no more than thirty (30) calendar days before submission. Failure by Recipient Contact Person to timely provide annual User Agreements, shall result in Agency terminating User access. 3.1.6 Notice of User Employment Change. Recipient Contact Person shall notify Agency EAGLE Administration within three (3) calendar days of a User's termination, resignation, or reassignment into a position not requiring access to TWC Information, so that the User's password can be immediately revoked. Failure to provide such notice is a breach of this Contract and may result in immediate suspension of all online access, termination of this Contract, and other penalties provided by law and this Contract. 3.1.7 Monthly Review. For contracts with over twenty-five (25 users), Recipient Contact Person shall review the list of current Users monthly to ensure that the Users have not left employment or changed job duties or otherwise no longer need access. Recipient shall document their process for comparing the current users list with the list of employees needing access. The documentation of the review process should be maintained on file for review by Agency upon request. Information Release Contract Attachments February 2022 TWC Contract Number. 2923EDE063 CITY OF ROUND ROCK Page 2 of 13 TEXAS WORKFORCE COMMISSION INFOMRATION RELEASE CONTRACT 3.1.8 Notice of Suspected Violations. Recipient shall notify Agency of any suspected or confirmed User violation of the confidentiality and security provisions within twenty-four (24) hours of discovery and shall take appropriate corrective action. 3. l .9 Changes to TWC Information Prohibited. Users shall not change or update any TWC Information contained in Agency's computer stored files. Users shall not use any automated system or software to make multiple queries of Agency's computer stored files. 3. l .10 Instructions. Recipient shall be solely responsible for disseminating to Users any instructions provided by Agency regarding navigation of online access to TWC Information. 3.2 Offline Access. If Offline access is selected in Exhibit 1, Request and Safeguard Plan, the provisions of this section apply. 3.2. l Offline Request Submission. For matches of wage records to SSNs, unemployment compensation claim benefit data to SSNs, or employer tax records to EIDs or FEINs, to be performed by Agency staff, Recipient shall submit a completed Request for Texas Workforce Commission Records, Attachment E, with the file of SSNs, EIDs, or FE1Ns to be matched. Recipient shall submit the file electronically in compliance with the Information Technology Department contract listed on Exhibit 1, Request and Safeguard Plan. Agency shall not be responsible for the confidentiality of any information submitted by Recipient. 3.2.2 Offline Rates. Rates for Offline requests are calculated on a per -request basis as specified in Exhibit 1, Request and Safeguard Plan. 3.2.3 Payment. Recipient's payment is due within thirty (30) calendar days of receipt of invoice for information requested Offline. 3.2.4. Tracking of Offline Access. Each quarter, the Recipient shall submit to the Agency Point of Contact a list of the data requests made and data received during the prior quarter including information necessary for identifying each transfer of data, whether a match against Recipient data, a scheduled transfer, or a transfer upon request. The quarterly filing dates are January 15, April 15, July 15, and October 15. 3.3 Additional Requirements. 3.3.1 Security Safeguards. Recipient shall establish, maintain, and comply with security safeguards and procedures to protect the confidentiality of all TWC Information. Recipient shall comply with the requirements in Safeguards for TWC Information, Attachment B. Failure to comply with any requirement of Attachment B is a breach of this Contract. 3.3.2 Suspension. Agency may suspend all services without notice if Agency suspects a violation of the security safeguard provisions in Attachment B. Services will remain suspended until Agency has fully investigated any suspected security violations and is satisfied that resumption of services will not result in security breaches. In the event of an extended suspension of services, Agency will notify Recipient as soon as possible. 3.3.3 Enduring Obligation. Termination or expiration of this Contract will not end Recipient's responsibility to protect the confidentiality of TWC Information remaining in Recipient's Information Release Contract Attachments- February 2022 TWC Contract Number: 2923EDE063 - CITY OF ROUND ROCK Page 3 of 13 TEXAS WORKFORCE COMMISSION INFOMRATION RELEASE CONTRACT possession, under Recipient's control, or held by a third party subject to contract or agreement with Recipient. 3.3.4 Audit. Recipient's security safeguards and procedures, as well as Recipient's access to and use of TWC Information, are subject to monitoring, evaluation, and audit by Agency. 3.3.5 Inspections. Recipient shall cooperate fully with any on -site inspections and monitoring activities of Agency. So that Agency may audit Recipient's compliance with the requirements of state and federal law and this Contract, Recipient shall permit Agency access to all sites containing TWC Information (including sites where data is maintained electronically), and to all workplaces used by personnel who have access to TWC Information. 3.3.6 Self -Assessment Report. Recipient shall submit to Agency a fully executed Quarterly Self - Assessment Reporl, Attachment G, on the next -occurring quarterly filing date after the Begin Date, and on each quarterly filing date for as long as this Contract is in effect. The quarterly filing dates are January 15, April l5, July 15, and October 15. Each report must be completed after the end of the prior calendar quarter and must have been signed within fifteen (15) days preceding submission. Failure by Recipient to submit to Agency a timely Quarterly Self - Assessment Report may result in the following consequences: the first instance of a late Quarterly Self -Assessment Report shall result in a late notice being issued by TWC. A failure by Recipient to timely respond to the first late notice by the time specified in the notice or Recipient receiving a second late notice, may result in TWC terminating the Contract for cause. 3.3.7 Identity Theft Protection. In case of unauthorized disclosure of TWC Information by Recipient, Recipient shall purchase identity theft protection service for all individuals whose information was disclosed without authorization. The protection service shall cover each individual for a two-year period and must include, at a minimum, automatic fraud alerts to the individual. 3.3.8 Si nificant Chan e. Recipient agrees to notify Agency in writing within ten (10) calendar days of any significant change affecting Recipient and Recipient's identity, including but not limited to changes in its ownership or control, name, governing board membership, authority of governing board, officeholders, or vendor identification number. 3.39 Computer Resources. Recipient shall provide and maintain its own computer hardware and software to accomplish the necessary computer communications linkages with Agency. 3.3. l0 Data Source. Agency does not warrant or guarantee the accuracy of TWC Information. TWC Information includes data provided to Agency by third parties, including employers and employees. SECTION 4 --- Contact Persons 4.1 Designation. The Parties designate the primary liaisons as specified in Exhibit 1. Request and Safeguard Plan. Agency Contact Person Contract Management Team Information Release Contract Attachments- February 2022 TWC Contract Number: 2923EDE063 CITY OF ROUND ROCK Page 4 of 13 TEXAS WORKFORCE COMMISSION INFOMRATION RELEASE CONTRACT External Data Exchange Contracts (EDE) Procurement and Contract Services Department Texas Workforce Commission 1117 Trinity Street, Room 342T Austin, TX 78701 Phone: (737) 400-5482 Fax: (512)936-0219 Email: DEContracts twc.texas. ov 4.2 Notice. Any notice required under this Contract must be given to the Recipient's Contact Person specified in Exhibit 1. Request and Safeguard Plan or the Agency Contract Person. 4.3 Notice to Alternate. If Recipient designates an alternate Contact Person in Exhibit 1, Request and Safeguard Plan, written notification by Agency to one (1) of the Recipient Contact Persons will satisfy any notification requirement of this Contract. 4.4 Change. Recipient may request a change in Recipient Contact Person by submitting to Agency Contact Person a written request on organizational letterhead signed by the person who signed this Contract on behalf of Recipient, or by a successor with authority to bind Recipient contractually. The request must include the TWC Contract Number, the name of the person being replaced, and the name of the new Recipient Contact Person, with job title, work address, phone number, and email address. No change in Recipient Contact Person is effective until acknowledged in writing by Agency. 4.5 Communications. Recipient shall include the TWC Contract Number in all communications with Agency. SECTION 5 — Parties Option for Extension and Effect on Other Contracts The Parties agree that this Contract supersedes and replaces all prior contracts, if any, between them for information release or data sharing as specified in Exhibit 1. Request and Safeguard Plan. Remainder of page intentionally left blank. Information Release Contract Attachments- February 2022 TWC Contract Number: 2923EDE063 CITY OF ROUND ROCK Page 5 of 13 TEXAS WORKFORCE COMMISSION INFOMRATION RELEASE CONTRACT Attachment B SAFEGUARDS FOR TWC INFORMATION "Recipient" in this Contract shall maintain sufficient safeguards over all TWC Information to prevent unauthorized access to or disclosure of TWC Information: "TWC Information" means records maintained by Agency (TWC), and records obtained by Recipient from Agency under this Contract, including (1) records and data compilations provided electronically, on paper, or via online access or e-mail, (2) records and data compilations that Recipient has converted into another format or medium (such as handwritten or electronic notes), and (3) records and data compilations incorporated in any manner into Recipient's records, files, or data compilations. 2. Monitorina. Recipient shall monitor its Users' access to and use of TWC Information and shall ensure that TWC Information is used only for the following "Limited Purpose" as set forth in Exhibit 1, Request and Safeguard Plan. Recipient shall also ensure that TWC Information is used only for purposes authorized by law and in compliance with all other provisions of this Contract. 3. Storage. Recipient shall store TWC Information in a place physically secure from access by unauthorized persons. 4. Protection. Recipient shall store and process TWC Information, including that maintained in electronic format, such as magnetic tapes or discs, in such a way that unauthorized persons cannot obtain TWC Information by any means. 5. Access. Recipient shall undertake precautions to ensure that only authorized personnel are given access to TWC Information stored in computer systems. 6. Instruction. Recipient shall instruct all personnel having access to TWC Information about all confidentiality requirements including the requirements of 20 C.F.R. Part 603 as well as the sanctions specified in this Contract and under slate and federal law for unauthorized disclosure of TWC Information. Recipient acknowledges that all personnel who will have access to TWC Information have been instructed as required. Disposal. Recipient shall dispose of TWC Information and any copies thereof after the Limited Purpose(s) is achieved, except for TWC Information possessed by any court. Disposal means return of TWC Information to Agency or destruction of TWC Information, as directed by Agency. Disposal includes deletion of personal identifiers in lieu of destruction. In any case, Recipient shall dispose of all TWC Information within thirty (30) calendar days after the termination, cancellation, or expiration of this Contract, in accordance with Attachment F, Certificate of Destruction for Contractors and Vendors, which is attached to this Contract and incorporated for all purposes. 8. System. Recipient shall establish and maintain a system sufficient to allow an audit of compliance with the requirements of this Attachment S and the other provisions of this Contract. 9. No Disclosure or Release. Recipient shall not disclose or release any TWC Information other than as permitted in this Contract, without prior written consent of Agency. 10. Unauthorized Disclosure. It is a breach of this Contract to disclose TWC Information orally, electronically, in written or printed form, or in any other manner without the prior written consent of Agency: 10.1 to any contract employee of Recipient or any individual not employed by Recipient; 10.2 to another government entity, including a law enforcement entity; 10.3 to Recipient employees who do not have a need to use TWC Information for the Limited Purpose. Information Release Contract Attachments - February 2022 TWC Contract Number: 2923EDE063 — CITY OF ROUND ROCK Page 6 of 13 TEXAS WORKFORCE COMMISSION INFOMRATION RELEASE CONTRACT 1 l . Authorized Disclosure. TWC Information may only be disclosed: 11.1 to employees under the direct hiring -and -firing control of Recipient who have a need to use the TWC Information for the Limited Purpose(s); and 11.2 in a criminal judicial proceeding if the TWC Information is introduced in court as a sealed record with access limited to the prosecutor, defendant, judge, and jury. 12. Security Violation. Recipient shall monitor access of Users and shall notify Agency within twenty-four (24) hours if a security violation of this Contract is detected, or if Recipient suspects that the security or integrity of TWC Information has or may have been compromised in any way. 13. Format, TWC Information is subject to the requirements of this Contract even if the TWC Information is converted by Recipient into another format or medium, or incorporated in any manner into Recipient's records, flies, or data compilations. 14. Access Limited. Recipient shall limit access to TWC Information to its employees who need access to achieve the Limited Purpose. 15. Mobile Device and Removal. Recipient shall not place TWC Information on mobile, remote, or portable storage devices, or remove storage media from Recipient's facility, without the prior written authorization of Agency. 16. Public Information Act. Under Texas Labor Code § 301.085, TWC Information is not "public information" for purposes of the Public Information Act, Texas Government Code, Chapter 552. Recipient shall not release any TWC Information in response to a request made under the Public Information Act or under any other law, regulation, or ordinance addressing public access to government records. 17. Subpoena. Recipient shall notify Agency within twenty-four (24) hours of the receipt of any subpoena, other judicial request, or request for appearance for testimony upon any matter concerning TWC Information. Federal regulations dictate the handling of subpoenas for TWC Information. Recipient shall comply with the requirements of 20 C.F.R. § 603.7 in responding to any subpoena, other judicial request, or request for appearance for testimony upon any matter concerning TWC Information. 18. Federal Regulation. Recipient shall comply with all requirements of Safeguards for TWC Information as required by 20 CFR Part 603 and this Contract relating to safeguarding TWC Information and ensuring its confidentiality. 19. Unauthorized Lookup. A User shall not access TWC Information listed under the User's SSN or the SSN of a co- worker, family member, or friend. 20. Screening - Online Users. Recipient shall screen potential Users and seek online access only for employees that Recipient has determined pose no threat to the security of TWC Information. 21. Screening All Handlers. Recipient shall permit access to TWC Information only to employees that Recipient has determined pose no threat to the security of TWC Information. 22. Internet. Recipient shall not transmit any TWC Information over the Internet unless it is encrypted using at least 256-bit AES encryption and the current FIPS 140 series encryption standards. 23. Screen Dump. Recipient's security guidelines shall ensure that any screen dump or other extraction of TWC Information will be protected from unauthorized use or disclosure. 24. No Transfer. Recipient shall not transfer the authority or ability to access or maintain TWC Information under this Contract to any other person or entity. Information Release Contract Attachments February 2022 TWC Contract Number: 2923EDE063 - CITY OF ROUND ROCK Page 7 of 13 TEXAS WORKFORCE COMMISSION INFOMRATION RELEASE CONTRACT Attachment C TEXAS WORKFORCE COMMISSION USER AGREEMENT (User's Printed Name) (User's Social Security Number) (User's work phone number) (Print User's work street address) (Print User's employer) (Print User's work email) acknowledge that I will be assigned a personal User ID and password to gain access to the Texas Workforce Commission (TWC) computer system. Under no circumstances will t allow my User ID or password to be used by any other individual, nor will I use one belonging to anyone else. As an online User with access to confidential TWC data ("TWC Information"), I understand that I will be held personally accountable for my actions and for any activity performed under my User ID. I understand that the use of TWC Information is limited to the following "Limited Purpose(s)" only: to assist in criminal investigations; to assist in locating defendants, witnesses, and fugitives in criminal cases; to assist in locating persons with outstanding warrants and to assist in locating probation absconders. I understand that TWC maintains a record of the individuals and employers whose TWC Information I gain access to, and that I am not allowed access to TWC Information about any individual or employer except as necessary for the Limited Purpose(s). I understand that I am not allowed access to TWC Information about myself. I will not enter any unauthorized data or make any changes to data. I will not disclose any TWC Information orally, electronically, in written or printed form, or in any other manner without prior written authorization from TWC. I will not disclose any TWC Information to other governmental entities, including law enforcement entities. I understand that under Texas Labor Code §301.085, all TWC Information I obtain under this User Agreement is confidential and that it is a criminal offense to solicit, disclose, receive or use, or to authorize, permit, participate in, or acquiesce in another person's use of TWC Information that reveals: (1) identifying information regarding any individual or past or present employer; or (2) information that foreseeably could be combined with other publicly available information to reveal identifying information regarding any individual or past or present employer. This offense is punishable by as much as a year in jail, a fine up to $4,000, or both. understand that under Texas Penal Code §33.02(a), it is a criminal offense to knowingly access a computer, computer network, or computer system without the effective consent of the owner. Depending on the circumstances, the offense is punishable by confinement in jail for up to 180 days or up to 99 years or life in prison, a fine of up to $2,000 or up to $10,000, or both. 1 have read and had explained to me the confidentiality and security requirements of 20 C.F.R. § 603.9 and of my employer's contract with TWC. I understand and agree to abide by these requirements. I understand that if I violate any of these requirements or any provision of this User Agreement, 1 will jeopardize my employer's contract with TWC. Signature of User Date signed Supervisor Approval.• I have instructed the User listed above about all confidentiality requirements applicable to TWC Information obtained under the contract with TWC, including the requirements of 20 C.F.R. § 603.9 and the sanctions specified in the Contract and in state law for unauthorized disclosure of TWC Information. Signature of Supervisor Printed Name Date signed Approval of Contract Signatory or Contact Person named in Contract: Signature of Contract Signatory or Recipient Contact Person Printed Name Date signed All fields on this User Agreement are required. Employer must retain signed original and give a copy to User. Employer must send copy of executed User Agreement to TWC EAGLE Administration as specified on the required Cover Sheet, Attach meni D to this Contract. An incomplete User Agreement will be rejected. Information Release Contract Attachments February 2022 TWC Contract Number. 2923EDE063 - CITY OF ROUND ROCK Page 8 of I TEXAS WORKFORCE COMMISSION INFOMRATION RELEASE CONTRACT Attachment D TRANSMITTAL COVER SHEET FOR NEW USER AGREEMENTS AND TRAINING CERTIFICATES AND EXISTING USER TRAINING CERTIFICATES To: EAGLE Administration via email to: EAGLEsupgort(c-)twc.texas.Qov (Document must be scanned and encrypted before sending) via fax to: 512-463-6394 Number of pages including cover sheet: _ via mail to: EAGLE Administration Texas Workforce Commission 101 East 151h Street, Room 0108 Austin, TX 78778-0001 From: _ (Recipient Contact Person) (Recipient Contact Person email) Re: User Agreement(s) and Training Certificate(s) attached Instructions: • User Agreement and Training Certificate must be submitted together for each individual. Only one cover sheet is required if submitting documents for more than one User at the same time. For questions regarding the User Agreement, please email EAGLEsupport Qt we. texas. Roy Note: An incomplete User Agreement will be rejected Information Release Contract Attachments- February 2022 TWC Contract Number: 2923EDE063 CITY OF ROUND ROCK Page 9 of 13 TEXAS WORKFORCE COMMISSION INFOMRATION RELEASE CONTRACT Texas Workforce Commission Attachment F Certificate of Destruction for Contractors and Vendors Hard copy and electronic media must be sanitized prior to disposal or release for reuse. The TWC tracks, documents, and verifies media sanitization and disposal actions. The media must be protected and controlled by authorized personnel during transport outside of controlled areas. Approved methods for media sanitization are listed in the NIST Special Publication 800-88, Guidelines for Media Sanitization. http://csrc.nist.aovlpublicationslnistpubs/800-88INISTSPBO0-88 with-enata.pdf Contact Name Title Company Name and Address Phone You may attach an inventory of the media if needed for bulk media disposition or destruction. Media Type Media Title / Document Name HARD COPY I I ELECTRONIC Media Description (Paper, Microfilm, Computer Media, Tapes, etc.) Dates of Records Document I Record Tracking Number TWC Item Number Make / Model Serial Number CLEAR Who Completed? Who Verified? Item Sanitization PURGE Phone Phone DESTROY DATE Completed Sanitization Method and/or Product Used Final Disposition of Media Reused Internally Destruction / Disposal Reused Externally _ Returned to Manufacturer Other Comments: If any TWC Data is retained, indicate the type of storage media, physical locations(s), and any planned destruction date. Description of TWC Data Retained and Retention Requirements: Proposed method of destruction for TWC approval: Type of storage media? Physical location? Planned destruction date? Within five (5) days of destruction or purging, provide the TWC with a signed statement containing the date of clearing, purging or destruction, description of TWC data Geared, purged or destroyed and the method(s) used. Authorized approval has been received for the destruction of media identified above and has met all TWC Records Retention Schedule requirements including state, federal and/or internal audit requirements and is not pending any open records requests. Records Destroyed by: Records Destruction Verified by: Signature Date Signature Date Be sure to enter name and contact Info for who completed the data destruction and who verified data destruction in the fields above - Send the signed Certificate of Destruction to: TWC: Information Security Office, Rm. 0330A, 101 E. 15th Street, Austin, TX 78778-0001 GP Revised: 09-02.15 Information Release Contract Attachments February 2022 TWC Contract Number: 2923EDE063 CITY OF ROUND ROCK Page 10 of 13 TEXAS WORKFORCE COMMISSION INFOMRATION RELEASE CONTRACT Texas Workforce Commission Certificate of Destruction for Contractors and Vendors INSTRUCTIONS FOR CERTIFICATE OF DESTRUCTION Attachment F Hard copy and electronic media must be sanitized prior to disposal or release for reuse. The TWC tracks, documents, and verifies media sanitization and disposal actions. The media must be protected and controlled by authorized personnel during transport outside of controlled areas. Approved methods for media sanitization are listed in the NIST Special Publication 800-88. Guidelines for Media Sanitization, htti):Ilcsrc.nist.gov/publications/nistoubs/800-88/NISTSP800-88 with-errata.pdf IRS Publication 1075 directs us to the FISMA requirements and NIST guidelines for sanitization and disposition of media used for federal tax information (FTI). These guidelines are also required for sensitive or confidential information that may include personally identifiab.e information (Pit) or protected health information (PHI). NIST 800-88, Appendix A contains a matrix of media with minimum recommended santtizat on techniques for clearing, purging, or destroying various media types. This appendix is to be used with the decision flowchart provided ;n NIST 800-88, Section 5. There are two primary types of media in common use: • Hard Copy Hard copy media is physical representations of information. Paper printouts, printer and facsimile ribbons, drums, and platens are all examples of hard copy media. Electronic for soft copy). Electronic media are the bits and bytes contained in hard drives, random access memory (RAM), read-only memory (ROM), disks. memory devices, phones, mobile computing devices, networking equipment, and many other types I sted in NIST SP 800 88, Appendix A. 1. For media being reused within your organization, use the CLEAR procedure for the appropriate type of media. Then validate the media is cleared and document the media status and disposition. 2. For media to be reused outside your organization or if leaving your organization for any reason, use the PURGE procedure for the appropriate type of media. Then validate the media is purged and document the media status and disposition. Note that some PURGE techniques such as degaussing will typically render the media (such as a hard drive) permanently unusable. 3. For media that will not be reused, use the DESTRUCTION procedure for the appropriate type of media. Then validate the media is destroyed and document the media status and disposition. 4 For media that has been damaged (i.e., crashed drive) and cannot be reused use the DESTRUCTION procedure for the appropriate type of media. Then validate the media is destroyed and document the media status and disposition. 5. If immediate purging of all data storage components is not possible, data remaining in any storage component will be protected to prevent unauthorized disclosures Within twenty (20) business days of contract expiration or termination, provide TWC with a signed statement detailing the nature of TWC data retained type of storage media, physical location, planned destruction date, and the proposed methods of destruction for TWC approval. 6 Send the signed Certificate of Destruction to: Texas Workforce Commission Information Security Office Room 0330A 101 E. 151h Street Austin, TX 78778-0001 FAX to 512-463-3062 or send as an email attachment to: cisoO,twc.texas.aov Final Distribution of Original to Chief Information Security Officer Copy to: 1. Your Company Records Management Liaison - or - Information Security Officer Certificate 2. TWC Contract Manager GP Revised: 09-02- Information Release Contract Attachments February 2022 TWC Contract Number: 2923EDE063 CITY OF ROUND ROCK Page I 1 of 13 TEXAS WORKFORCE COMMISSION INFOMRATION RELEASE CONTRACT Attachment G QUARTERLY SELF -ASSESSMENT REPORT Failure to submit this report by due date can result in termination of all access to TWC Information. The period covered is -Year: Quarter ❑ Q1, ❑ Q2, ❑ Q3, ❑ Q4 The entity receiving TWC Information under TWC Contract ("Recipient") confirms it is in compliance with the requirements of the Contract and the Safeguards for TWC Information (Attachment B of the Contract), during the previous period, to include the following: 1. Recipient used the disclosed TWC Information only for purposes authorized by law and Yes: _ No: consistent with the Limited Purpose set forth in Exhibit L Request and Safeguard Plan of the Contract. 2. Recipient stored the disclosed TWC Information in a place physically secure from access by Yes: _ No: unauthorized persons. This includes hard copies of the information. 3. Recipient stored and processed disclosed TWC Information maintained in electronic format Yes: No: outside of the recipient computer systems in such a way that unauthorized persons cannot obtain the TWC Information by any means. 4. Recipient took precautions to ensure that only authorized personnel were given access to Yes: No: disclosed TWC Information that is stored in recipient's computer systems. 5. Recipient has instructed all personnel having access to the disclosed TWC Information about Yes: _ No: confidentiality requirements, the requirements of 20 C.F.R. § 603.9 found in Safeguardsfor TWC Information (Attachment B), and the sanctions specified in State law for unauthorized disclosure. (Each violation is a Class A Misdemeanor, punishable by a fine of $4,000, a year in }ail, or both). 6. Recipient adhered to confidentiality requirements and procedures that are consistent with and Yes: _ No: meet the requirements of the TWC Contract. 7. Recipient agreed to report any infraction(s) of these requirements and procedures to TWC Yes: No: fully and promptly. 8. Recipient disposed of disclosed TWC Information, and any copies thereof made by Recipient, Yes: No: after the purpose for which the TWC Information was disclosed, is served, or as required by court order. (Disposal means return of the TWC Information to TWC or destruction of the TWC Information, as directed by TWC. Disposal includes deletion of personal identifiers in lieu of destruction.) 9. Recipient ensured that the disclosed TWC information is not retained with personal identifiers Yes: No: for longer than such period of time as TWC deems appropriate. 10. Recipient maintained a system sufficient to allow an audit of compliance with the Yes: _ No: requirements of 20 C.F.R. § 603.9 found in Safeguards for TWC Information (Attachment B) and the TWC Contract. Information Release Contract Attachments- February 2022 TWC Contract Number: 2923EDE063 CITY OF ROUND ROCK Page 12 of 13 TEXAS WORKFORCE COMMISSION INFOMRATION RELEASE CONTRACT 11. Attached is a description of the system referred to in Item 10. Recipient ensured that any Yes: No: copies of any logs sent to TWC do not contain Sensitive PI1. Remember to secure originals containing PII. 12. Recipient maintained as a minimum, the encryption requirements of FIPS 140-2 and encrypt Yes: No: the data at the minimum of 256-bit AES encryption. 13. Annual Renewal of Contract User Agreement and training certifications per the Contract Yes: No: terms are on file and copies have been submitted to EAGLEsupportatwc.texas. gov. 14. All users have completed the training within the previous 12 months. Yes: No: 15. Do you re -disclose to other entities under Section 6, Redisclosure Authorization, Roles and Responsibility, of Attachment A of the contract? Yes: No: If yes, Receiving Agency ensures that contract personnel are held to the same standard of processing, training, and protecting information as Recipient Agency employees who have a need Yes: No: to use the TWC information for the Limited Purpose. By signature hereon, the Contract signatory or the entity's internal auditor certifies that: All statements and information submitted in response to this Quarterly Self -Assessment Report are current, accurate, and complete. Signature Date Printed Name and Title Return this Report to: External Data Sharing Contracts Manager I Procurement and Contract Services Department Texas Workforce Commission j 1 1 l7 Trinity Street, Room 342T I Austin, Texas 78701 Email: SelfAssessmentReports a,twc.texas.Rov Fax: 512-936-021 Information Release Contract Attachments February 2022 TWC Contract Number: 2923EDE063 - CITY OF ROUND ROCK Page 13 of 13 Exhibit 1. TWC Data Exchange Request and Safeguard Plan All statements and information on this form and associated correspondence relating to the Request and Security Plan (RSP) are incorporated by reference into the data exchange Contract with TWC as Exhibit 1. Recipient agrees to {provide written notice to TWC of any changes to the responses contained in this RSP during the Contract term immediately but no later than three (3) calendar days from the date of change. Email changes to DEcontracts0twc.texas.xov. After review and approval by TWC, the notice of changes shall be incorporated by reference into the Contract under Exhibit 1. Any changes to the responses requested by Recipient and accepted by TWC in this Exhibit 1 shall amend the corresponding information in the GTC and A-H. This document is confidential under Texas Government Code regarding infrastructure security and shall be redacted from release in response to a request for information or documents. Contact TWC upon such a request. 1. ILegal name of requesting governmental I City of Round Rock / Round Rock Police Department entitv/Responsible Financial Partv 2. 1 Entity Tax IDq 74-6017485 3. Street Address — Line 1 2701 N Mays St 4. Street Address — Line 2 5. City, State, Zip Round Rock, TX 78665 6. INew request or renewal of an existing contract? 7.—TType of entity and authority to contract 8. 1 Legal Purpose(s) for requesting information (Check all that apply) 9 Requested length of contract term New request Extension of existing agreement Previous/Current Contract q: 2922PEN026 ❑ There are other contracts between TWC, and the party not affected by this Contract, which, are as follows: Texas Local Government Code, Chapter 791, Interlocal Cooperation Act (e.g., cities, counties) ❑ Texas Government Code, Chapter 771, Interagency Cooperation Act (e.g„ state agency) ❑ Federal Agency Authority ❑ if state a enc -please--s LciN authority - ® to assist in criminal investigations ® to assist in locating defendants, witnesses, and fugitives in criminal cases ® to assist in locating persons with outstanding warrants ® to assist in locating probation absconders ❑ to assist in determining eligibility for public assistance/services ❑ other: please specify: (language will be inserted into contract) U 1 year 2 years 3 years 4 years 5 years lRenewal Option up to a total of S years combined) Texas Workforce Commission I Nov 2022 10. Requested start date 11. Information requested (Check the data being requested) 12. E Method of receiving data For federal entities only: to correspond with start of fiscal year starting: j ®Wage Records (WR): Wage Detail Inquiry: View wage information for an individual. Coworker Search: View wages reported by an employer. ®UI Benefits and Claimant Info (UI): Personal information: View demographic information for an individual. Claims: View unemployment insurance claim information. Payments: View unemployment insurance payment info. Employer Search: Search employers by name or address. ® Employer Records (ER) Em to er Master File: Search Employer Master File and view state unemployment tax information. ® Online access: Contractor access for lookup by SSN through a password -protected log -in account. Number of individuals needing access accounts: 01-10 (The subscription rate is $1,500 per year.) ❑11-25 (The subscription rate is $2,000 per year.) 026-50 (The subscription rate is $3,500 per year.) ❑Specify other quantity Please confirm that the number of Users given access is and will be limited to the minimum number necessary to accomplish the Limited Purpose(s). ® Yes ❑ No Online Access for Over 25 User Accounts: *If the request is for more than 25 user accounts, please indicate the reason the volume of access accounts is necessary (check all that apply): There is/are: ❑ a high volume of daily/weekly inquiries require the requested volume of use accounts ❑ other reason(s) for the volume of access accounts: ❑ Offline access: Offline Method of Transfer and Frequency: (Check applicable options) ❑ Ongoing: Scheduled computer matching against file of SSNs or tax account numbers submitted by Requestor periodically. Frequency of ongoing scheduled requests: []Nightly []Weekly ❑ Bi-Weekly ❑ Monthly ❑Quarterly [:]Annually ❑Other —specify: Texas Workforce Commission I Nov 2022 [] Non-scheduled - Upon Request: Ad hoc request for non- scheduled matches or data files. ❑ One-time request for large quantity of records. ❑ One-time request for one or a few records (less than 100 matches of SSNS or <5 TWC Employer ID or FEIN). Submit request to open.records@twc.texas.gov or fax request to 512-463-2990 or the open records portal at httos://twc.xovaa.us/WEBAPP/ rs/(Slraibfua2yv4rbj2wrzlu c3se))/su porthome.as x. Specify the particular data elements for the information requested in question 11. E.g., name, address, wage benefit amount, employer name, telephone number, etc. 1. If other specific data elements are requested, provide a data format. Offllne Data Elements Requested: Data elements to be submitted to TWC for the resulting matched data: ❑ SSN — Social Security Number Data available from TWC available for SSN matches from the UI Wane Records: Name: last, first, middle initial NAILS Quarter Wages were earned Quarterly Wages Employer Name Employer Address Employer Zip Employer contract Employer Telephone Employer Tax Account Number Instructions for submitting SSN-Ul Wage Record Match Requests: Filename and format will be provided by and coordinated with the TWC developer upon receipt of Attachment E. REQUEST FOR TEXAS WORKFORCE COMMISSION RECORDS File transmission shall be protected using TWC Secure FTP and encrypted using at least 256-bit encryption. ❑ TWC Employer ID Number (EIN) Texas Workforce Commission I Nov 2022 13 Data available from TWC available for EIN matches from the Employer Tax Master File: Name: last, first, middle initial Social Security Number Quarterly Wages Employer Name Employer Address Employer Zip Employer contact Employer Telephone Employer Tax Account Number Instructions for submitting Texas EIDs or FEINs: (follow the same pattern as for SSNs): Format sample: 123456789 Send seed file via secure file transfer to Agency's secure portal, currently GoAnywhere — https://mft.twc.state.tx.us/webcllent/Lo in.xhtmi (prior account establishment required) ❑ Federal Employer ID Number (FEIN) Same as Texas Employer ID information Volume/quantity of offline records requested per submission and associated rates: Estimated number of individuals in which sensitive personally identifiable information requested at any one time: ❑ 1-999: $250 ❑ 1,000— 14,999:$300 ❑ 15,000—19,999: $375 ❑ 20,000 — 24,999: $500 ❑ 25,000 -Above: $1,000 Hourly rate for programming of a new request or modification of an existing job: $48.81. De -identification: If submitting SSNs to TWC, also include a unique identifier. For enhanced security, the return file will not include SSNs but instead will include only the unique identifier where feasible. How will data be viewed? 1) W We will ONLY view screen information. w �� Select one of the three options. (Respond to #14-19, check "N/A" to #20 and #21.) 2) ❑ We will use electronic copies of screen prints (PDF), or ❑ We will transfer data into an electronic record. (Respond to #14-20, check "N/A" to #21.) Texas Workforce Commission I Nov 2022 T 14 Will non -employees be provided access to the data? Express written contract language authorizing data exchange with non - employees is required for re- distribution of information accessed. 15. Will the data you are requesting be disclosed to any other entity? Express written contract language authorizing data exchange with non - employees is required for re- distribution of information accessed. 16. What access control methods will you use for access to the TWC information? 17. How does your organization assess your security posture? How frequently are these assessments conducted? 18.0 it Are background checks performed on 18.1 19 20. employees who will access information? When are background checks performed? How will you have an auditable trail? How will you encrypt the data at rest.) (Ex: Once transferred to a database or other electronic system) When will data destruction occur? 3)_0We will use paper copies of screen prints, or ❑ We will transfer information into paper records format. (Respond to ##14-19 and f#21, check "N/A" to ##20) Only direct employees will be provided access. ❑ Persons who are not employees may/will be provided access. Please specify those that apply: ❑ Data Center Operators ❑ Other Governmental Contractors: Please specify: Yes - Specify: -0 Texas State Requirements under Title 1, Part 10, TAC Sec. 202, or comparable standards ❑ National Institute of Secure Technology (NIST) or comparable standards ❑ IRS Publication 1075 or comparable standards Vulnerability testing Frequency: ❑ Penetration testing Frequency: ® Audits testing Frequency: Weekly C ber Hygiene Assessment by CISA and we complete the GIS Audit and stay in compliance with those standards. ❑ Other — Please specify: Frequency: Yes, background checks are performed (go to 18.1). ❑ No, background checks are not performed If No background checks are performed, state what type of records checks are being performed: Pre -employment ❑ Periodic checks during employment ❑ N/A I will keep a worksheet that includes at a minimum, the person making the inquiry, the reason for the inquiry, identifying information regarding the case or claim for which the inquiry was made, and the date the inquiry was made. rl Other, If Other specify: _ Lj Please specify: ® N/A — We do not keep data at rest. [Consistent with Texas State Libraries and Archives Commission (state records retention laws) ❑ Consistent with other standards: Please specify: ® N/A - We do not retain data. Texas Workforce Commission E Nov 2022 22.7P21 of Contact Name daily mattes) Rick White 23.of Contact Title Plannin Manager 512-218-SS24 24.of Contact Phone 25. of Contact E-mail rwhite@roundrocktexas.v 2701 N Mays St, Round Rock TX 78665 26. 1 Point of Contact Address 27. Alternate Point of Contact Name and Title If different from Point of Contact Laurie Hadley 4 City Manager 512-218-5400 1hAdlekgRroundrocktexas.goy 221 E Main, Ste 221, Round Rock, TX 78664 28. Alternate Point of Contact Phone 29. Alternate Point of Contact E-mail 30. Alternate Point of Contact Address 31. Signatory Name 32. Signatory Title 33. Signatory Phone Number 34. Signatory E-mail 35. Signatory Address 36. Data Technology Contact Name Megan Tschoerner _ 512-218-5451 mtschoerner@roundrocktexas.gov 37. Data Technology Contact Phone 38. Data Technology Contact E-mail 39. Invoice Recipient Name Rick White 512-218-SS24 40. Invoice Recipient Phone Number 41. Invoice Recipient Title Plannin Manager r roundr ktexas. ov 42, Invoice Recipient E-mail 43. Invoice Recipient Address If different from Point of Contact — Same Address All statements and information on this form and associated correspondence relating to the Request and Safeguard Plan are incorporated by reference into the data exchange Contract with TWC as Exhibit 1. The original Exhibit 1 and contract must be signed by the Contract Signatory. The person signing is authorized by Recipient to bind their organization to the terms of the contract. signation For Subsequent Submissions: By checking here, the contract signatory approves the Recipient Point of Contact as their designee for s bmission of subsequent updates to the Request for Safeguard Plan and requests for renewals for purposes of extending the duration and associated amount. I'el 7. 26-z3 Contract Signatory or desi ee Date Laurie Hadley/City Manager Printed Name/Title For questions on how to complete this request form, contact DEContracts@twc.texas.com Texas Workforce Commission I Nov 2022