16-IFB-00669_Sample_Agreement.pdf

STATE OF CALIFORNIA

STANDARD AGREEMENT EXHIBIT 2 – SAMPLE AGREEMENT

STD 213 (Rev 06/03) AGREEMENT NUMBER

16-IFB-00669

REGISTRATION NUMBER

1. This Agreement is entered into between the State Agency and the Contractor named below:

STATE AGENCY'S NAME

California Department of Social Services

CONTRACTOR'S NAME

To Be Determined

2. The term of this Agreement is:

07/01/2016 or upon approval by CDSS, whichever is later through 06/30/2018

3. The maximum amount $TBD of this Agreement is: TBD

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 4 pages

Exhibit B – Budget Detail and Payment Provisions 2 pages

Exhibit C* – General Terms and Conditions GTC - 610

Check mark one item below as Exhibit D:

X Exhibit - D Special Terms and Conditions (Attached hereto as part of this agreement) 3 pages

Exhibit - D* Special Terms and Conditions

Exhibit E – Additional Provisions 2 pages

Exhibit E, Attachment 1 – CDSS Information Security Pre-Cautions/Requirements 2 pages

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/Resources/StandardContractLanguage.aspx

IN WITNESS WHEREOF, this Agreement has been executed by the parties hereto.

CONTRACTOR California Department of General Services Use Only

CONTRACTOR’S NAME (if other than an individual, state whether a corporation, partnership, etc.)

To Be Determined BY (Authorized Signature)

DATE SIGNED(Do not type)

PRINTED NAME AND TITLE OF PERSON SIGNING

ADDRESS

STATE OF CALIFORNIA

AGENCY NAME

California Department of Social Services

BY (Authorized Signature)

DATE SIGNED(Do not type)

PRINTED NAME AND TITLE OF PERSON SIGNING Exempt per:

Deborah Pearce, Chief, Contracts and Purchasing Bureau

ADDRESS

744 P Street, MS 8-14-747, Sacramento, CA 95814 http://www.dgs.ca.gov/ols/Resources/StandardContractLanguage.aspx

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CDSS/TBD

EXHIBIT A

(Standard Agreement)

SCOPE OF WORK

A. Contractor agrees to provide the California Department of Social Services (CDSS) telephone-based interpretation services for staff in the CDSS offices, as described herein:

1. Contractor shall provide telephone-based interpretation services to the following CDSS offices:

• Adoptions Services Bureau Main Office (Index Code: 2521 – PCA Code: 96005)

• Adoptions Services Bureau:

Central Office (Index Code: 2521 – PCA Code: 96005) Arcata Field Office (Index Code: 2523 – PCA Code: 42500/42550) Chico Regional Office (Index Code: 2527 – PCA Code: 42500/42550) Fresno Field Office (Index Code: 2526 – PCA Code: 42500/42550) Monterey Park Regional Office (Index Code: 2525 – PCA Code: 42500) Oakland Regional Office (Index Code: 2524 – PCA Code: 42500) Sacramento Regional Office (Index Code: 2528 – PCA Code: 42500/42550)

• Child and Youth Permanency Branch (Index Code: 2550 – PCA Code: 96550)

• Children’s Services Operations Bureau and Evaluation Branch

(Index Code: 2522 – PCA Code: 96522)

• Civil Rights Bureau (Index Code: 6044 – PCA Code: 96044)

• Disaster and Client Services Bureau (Index Code: 6643 – PCA Code: 45000)

• EFAP and Fraud Collection Review (Index Code: 1281 – PCA Code: 96281)

• Foster Care Ombudsman (Index Code: 2560 – PCA Code: 96007)

• Public Inquiry and Response (Index Code: 6649 – PCA Code: 96649)

• Refugee Programs Bureau (Index Code: 1273 – PCA Code: 96273)

• Security Guard’s Desk, located at 744 P Street (Index Code: 6641 – PCA Code: 96641)

Upon award of contract, Contractor shall use the above Index and PCA codes for office recognition and invoicing services rendered.

2. Contractor shall comply with state and federal laws and regulations that prohibit discriminatory treatment based on any legally protected status, including, but not limited to, sex, race, age, religion, national origin, disability, ethnic origin, etc.

3. Contractor shall perform services at the Contractor’s place of business.

4. Contractor shall provide services on demand 24 hours a day, seven days a week.

5. Contractor shall furnish all labor, materials, equipment and services to administer an 800 toll-free telephone line to provide oral multilingual interpretation (simultaneous and/or consecutive) services in a variety of settings involving spoken communications from one source language to the target language.

6. Contractor shall provide certified, qualified, experienced language professionals to provide interpretation services in the language(s) listed in Exhibit A, Item D.

7. Contractor shall answer all incoming calls within one (1) minute of the call starting to ring.

8. Contractor shall provide an interpreter within two (2) minutes of answering the call.

9. Contractor shall assist CDSS staff to identify the language of a non-English speaking client when necessary.

16-IFB-00669 Page 2 of 4

10. Contractor shall ensure that the person performing the interpretation will conduct themselves in the following manner:

a) Remain neutral in the conversation unless prompted by CDSS staff with additional instructions:

b) Use utmost courtesy when conversing;

c) Respect cultural differences;

d) Refrain from entering into a disagreement; and

e) Treat all conversations as confidential communications. The contractor and the interpreter shall not disclose the names of the parties involved or any part of the conversation without the written consent of the parties involved or unless required by law or regulation.

B. CDSS Responsibilities:

Upon receipt of a call from a non-English speaking client, for which there are no bilingual staff in the office, the CDSS staff person will call Contractor’s toll-free telephone number and 1) identify themselves to Contractor using the applicable Index Code; and 2) ask to be connected to an interpreter who will then interpret the conversation from non-English to the English language and vice versa.

C. The project representatives during the term of this agreement will be:

Name: TBD Address:

Telephone:

E-mail:

Contractor Name: TBD Address:

Telephone:

E-mail:

D. At minimum, the Contractor shall provide translation services for the following languages:

Acholi Afar Afrikaans Akan Akateko Albanian American Sign Language (ASL) Amharic Anuak Apache Arabic - (Juba, Moroccan, Sundanese, Yemeni) Armenian Assamese Azerbaijani

Ashanti Assyrian Badini (Bahdini?)

Bahnar Bajuni Bahasa Bambara Bangla Bantu Barese Basque Bassa Behdini Bemba Belorussian Benaadir Bengali

Berber Bikol Bosnian Bravanese Brunel Bulgarian Burmese

Cambodian (Khmer) Cantonese Catalan Cebuano Chaldean Chaochow Chamorro Chavacano Cherokee

Chin - (Falam, Hakha, Mara, Matu, Senthang, Tedim) Chipewyan Chui Chow Chuukese Cree Creek Creole - (Cape Verdean, French, Haitian, Pidgin, Sierra Leone, W. African) Croatian Czech

16-IFB-00669 Page 3 of 4

Dakota Danish Dari Dewoin Dinka Dutch Dyula Dzongkha

Edo Eritean Eskimo Estonian Ewe

Farsi-Persian Fijian Finnish Flemish Foochow French - (France, Belgium, Switzerland) French Canadian Fula Fulani Fukienese Fuzhou

Ga Gaddang Gaelic - (Irish, Scottish) Galician Garre Gen Georgian German - (Germany, Austria) Gheg Gokana Gorani Greek Guarani Gujarati Gulay

Haitian Creole Hakka - (China, Taiwan) Hassaniyya Hausa Hebrew

Hiligaynon Hindi Hindko Hmong Hokkien Huizhou Hungarian Hunanese

Ibanag Ibo Icelandic Igbo Iiocano Iionggo Indonesian Inuplaq Inukitut Italian

Jakartanese Jamaican Patois Japanese Jarai Javanese Jingpho Jinyu Jula

Kaba Kamba Kajnobal Kannada Karen Kashmiri Kayah Kazakh Kham Khana K’iché Kikuyu Kimiiru Kirghiz Kirundi Koho Korean Kosovan Kpelle Krahn Kreo Krio Kunama Kurdish Kurmanji

Lakota Laotian Latvian Letzeburgesch Liberian Pidgin- English Lingala Lithuanian Luba –Kasai Luganda Luo Lusoga Luxembourgeois

Maay Macedonian Malagasy Malay Malayalan Malinke Maltese Mam Mandarin Mandingo Mandinka Maninka Manobo Marathi Marka Marshallese Maya Mbay Mien Mina Mirpuri Mixteco Mizo Mnong Moldavian Mongolian Mortlockese

Nahuatl Napoletano Navajo Nepali Ngambay Nigerian Norwegian Nuer Nupe Nyanja Nyoro

Ojibway Oriya Oromo

Palauan Pampangan Pangasinan Papgo Papiamento Pashto Patois (Jamaican) Plautdietsch Pohnpei Polish Portuguese - (Brazilian, Cape Verdean) Pothahari Puglise Pulaar Punjabi Putian

Quechua Quichua Q’anjob’al

Rade Rakhine Rohingya Romani, Vlax - (Romania) Romanian Rundi Rwanda Russian

Samoan Sango Seraiki Serbian Serbo-Croation Sesotho Seyup Shanghainese Shona Sichuan Yi Sicilian Sinhala Sinhalese Sindhi Slovak Slovenian Soga Somali

16-IFB-00669 Page 4 of 4

Sonike Sorani Sotho Spanish Sri Lankan Sunda Sundanese Susa Swahili Swati Swedish Sylhetti Szechuan

Tagalog Taiwanese Tajik Tamil Telugu Temne Tibetan Tigre Thai Tigrinya Toishanese Tongan Tooro Trique Tshiluba Tswana Turkish Turkmen Twi Tzotzil

Ukrainian Urdu Uyghur Uzbek

Venda Vietnamese Visayan

Welsh Wodaabe Wolof Wuzhou

Xhosa

Yapese Yiddish Yoruba Yucateco

Yunnanese

Zapoteco Zarma Zyphe Zulu

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EXHIBIT B

BUDGET DETAIL AND PAYMENT PROVISIONS

A. Invoicing and Payment

1. The maximum amount payable under this agreement shall not exceed $TBD. Shown below are the amounts that cannot be exceeded for each of the fiscal year(s):

2016/17 $TBD

2017/18 $TBD

2. For services satisfactorily rendered, and upon receipt and approval of the invoice(s), CDSS agrees to pay the Contractor for said services in accordance with the rate of $TBD per minute.

3. No travel is budgeted for the agreement.

4. Invoices shall include the Agreement Number TBD and the Index Code in accordance with the benefiting program listed in Exhibit A, Section A.1, and shall be submitted in triplicate not more frequently than monthly in arrears to:

Administrative Support Bureau 744 P Street, MS TBD Sacramento, CA 95814

Attn: TBD

Any invoices submitted without the above referenced information may be returned to the Contractor for further re-processing.

B. State Budget Contingency Clause

1. It is mutually agreed that if the Budget Act of the current year and/or any subsequent years covered under this Agreement does not appropriate sufficient funds for the program, this Agreement shall be of no further force and effect. In this event, CDSS shall have no liability to pay any funds whatsoever to Contractor or to furnish any other considerations under this Agreement and Contractor shall not be obligated to perform any provisions of this Agreement.

2. If funding for any fiscal year is reduced or deleted by the Budget Act for purposes of this program, CDSS shall have the option to either cancel this Agreement with no liability occurring to the State, or offer an agreement amendment to Contractor to reflect the reduced amount.

C. For Contract With Federal Funds

1. It is mutually understood between the parties that this Agreement may have been written before ascertaining the availability of Congressional appropriation of funds, for the mutual benefit of both parties, in order to avoid program and fiscal delays which would occur if the Agreement were executed after that determination was made.

2. This Agreement is valid and enforceable only if sufficient funds are made available to the State by the United States Government for the term of this Agreement for the purposes of this program. In addition, this Agreement is subject to any additional restrictions, limitations, or conditions enacted by the Congress or any statute enacted by the Congress which may affect the provisions, terms, or funding of this Agreement in any manner.

16-IFB-00669 Page 2 of 2

EXHIBIT B

3. It is mutually agreed that if the Congress does not appropriate sufficient funds for the program, this Agreement shall be amended to reflect any reduction in funds.

4. CDSS has the option to invalidate the Agreement under the 30-day cancellation clause or to amend the Agreement to reflect any reduction of funds.

D. Prompt Payment Clause

Payment will be made in accordance with, and within the time specified in, Government Code Chapter 4.5, commencing with Section 927.

E. Review

CDSS reserves the right to review service levels and billing procedures as they impact charges against this Agreement.

F. Final Billing

Invoices for services must be received by CDSS within 90 days following each state fiscal year, or 90 days following the end of the contract term, whichever comes first. The final invoice must include the statement “Final Billing.”

G. Nonresident Tax Withholdings

Payments to all nonresidents may be subject to withholding. Nonresident payees performing services in California or receiving rent, lease, or royalty payments from property (real or personal) located in California will have seven percent of their total payments withheld for state income taxes. However, no withholding is required if total payments to the payee are $1,500 or less for the calendar year.

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EXHIBIT D

Rev: 01/25/16

SPECIAL TERMS AND CONDITIONS

A. Dispute Provisions

1. If the Contractor disputes a decision of the State’s designated representative regarding the performance of this Agreement or on other issues for which the representative is authorized by this Agreement to make a binding decision, Contractor shall provide written dispute notice to the State’s representative within 15 calendar days after the date of the action. The written dispute notice shall contain the following information:

a. the decision under dispute;

b. the reason(s) Contractor believes the decision of the State representative to have been in error (if applicable, reference pertinent contract provisions);

c. identification of all documents and substance of all oral communication which support

Contractor’s position; and

d. the dollar amount in dispute, if applicable.

2. Upon receipt of the written dispute notice, the State program management will examine the matter and issue a written decision to the Contractor within 15 calendar days. The decision of the representative shall contain the following information:

a. a description of the dispute;

b. a reference to pertinent contract provisions, if applicable;

c. a statement of the factual areas of agreement or disagreement; and

d. a statement of the representative’s decision with supporting rationale.

3. The decision of the representative shall be final unless, within 30 days from the date of receipt of the representative’s decision, Contractor files with the California Department of Social Services a notice of appeal addressed to:

744 P Street, M.S. 8-14-747 Sacramento, CA 95814 Attention: Chief, Contracts and Purchasing Bureau

Pending resolution of any dispute, Contractor shall diligently continue all contract work and comply with all of the representative’s orders and directions.

B. Termination Without Cause

This Agreement may be terminated without cause by the State upon 30 days written notice to the contractor.

C. Debarment and Suspension

For federally funded agreements, Contractor certifies that to the best of his/her knowledge and belief that he/she and their principals or affiliates or any sub-contractor utilized under this agreement, are not debarred or suspended from federal financial assistance programs and activities nor proposed for debarment, declared ineligible, or voluntarily excluded from participation in covered transactions by any federal department or agency. The Contractor also certifies that it or any of its sub-contractors are not listed with any active exclusions on the System for Award Management (http://www.sam.gov) (Executive Order 12549, 2 CFR Parts 180, 376, 417 and 2336).

http://www.sam.gov/

16-IFB-00669 Page 2 of 3

D. Certification Regarding Lobbying

Applicable to Grants, Subgrants, Cooperative Agreements, and Contracts Exceeding $100,000 in Federal Funds.

1. For Agreements with Contractors who are State entities not under the authority of the Governor, or cities, private firms or agencies which are receiving in excess of $100,000 in federal funds from CDSS to perform services. By signing this Agreement the Contractor certifies that to the best of his or her knowledge and belief, that:

a. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of a Federal contract, the making of a Federal grant, the making of a Federal loan, the entering into of a cooperative agreement, and the extension, continuation, renewal, amendment, or modification of a Federal contract, grant, loan, or cooperative agreement.

b. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress in connection with this Federal Grant or agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying", in accordance with its instructions.

c. The Contractor shall require that the language of this certification be included in the award documents for all covered subawards exceeding $100,000 in Federal funds at all appropriate tiers and that all subrecipients shall certify and disclose accordingly.

2. This certification is a prerequisite for making or entering into this transaction and is imposed by

Section 1352, Title 31, U. S. Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Any person who fails to file the required certification shall be subject to a civil penalty of no less than $10,000 and not more than $100,000 for each such failure.

E. Computer Software Copyrights

Contractor certifies that it has appropriate systems and controls in place to ensure that state funds will not be used in the performance of this contract for the acquisition, operation or maintenance of computer software in violation of copyright laws.

F. OMB Audit

Pursuant to Office of Management and Budget (OMB) audit requirement regulations (2 C.F.R. § 200.501), non-federal entities that expend $750,000 or more in a year in Federal awards from all sources combined shall have a single or program-specific audit conducted for that year in accordance with the provisions of 2 C.F.R. § 200.514 (previously OMB Circular A-133). All OMB audit reports shall meet the report submission requirements established in 2 C.F.R § 200.512 and a copy shall be forwarded to CDSS.

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G. Indirect Costs/Administrative Overhead

For agreements with other governmental entities and public universities, indirect costs are expenses incurred for administrative services such as, but not limited to, accounting; personnel and payroll administration; accounts payable services; general and specialized insurance coverage; compliance and regulatory monitoring; independent audit services; and legal services. Indirect costs are applied to personnel, operating expenses, supplies, equipment, and travel expenses. Per State Contracting Manual, Section 3.06.B, agencies shall assure that all administrative fees are reasonable considering the services being provided. Agencies may only pay overhead charges on the first $25,000 of each subcontract. Any subcontractor receiving $25,000 or more must be clearly identified in the budget display and excluded when the total indirect costs are calculated.

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EXHIBIT E

ADDITIONAL PROVISIONS

A. Contract Term

The anticipated term of the resulting Agreement is July 1, 2016, or date of approval by CDSS, whichever is later, through June 30, 2018. Should performance commence before the contract is approved, such services may be considered voluntary. The State, at its discretion, during the term of the contract may add funds to complete the identified tasks at the originally agreed upon service rate.

B. Insurance Requirements

1. Within 5 days of award of the contract or before work under the contract begins Contractor shall provide evidence of insurance as follows:

a. Commercial General Liability – Contractor shall maintain general liability on an occurrence form with limits not less than $1,000,000 per occurrence for bodily injury and property damage liability combined with a $2,000,000 annual policy aggregate. The policy shall include coverage for liabilities arising out of premises, operations, independent contractors, products, completed operations, personal & advertising injury, and liability assumed under an insured contract. This insurance shall apply separately to each insured against whom claim is made or suit is brought subject to the Contractor’s limit of liability.

The policy must include the State of California, its officers, agents, employees and servants as additional insured, but only with respect to work performed under the contract.

This endorsement must be supplied under form acceptable to the Office of Risk and Insurance Management. In the case of Contractor’s utilization of subcontractors to complete the contracted scope of work, contractor shall include all subcontractors as insureds under Contractor’s insurance or supply evidence of insurance to the State equal to policies, coverages and limits required of Contractor.

b. Automobile Liability – Contractor shall maintain motor vehicle liability with limits not less than $1,000,000 combined single limit per accident. Such insurance shall cover liability arising out of a motor vehicle including owned, hired and non-owned motor vehicles.

The policy must be endorsed to include The State of California, its officers, agents, employees and servants as additional insured, but only with respect to work performed under the contract. The additional insured endorsement is to be provided with the certificate of insurance.

c. Workers’ Compensation and Employers Liability – Contractor shall maintain statutory worker’s compensation and employer’s liability coverage for all its employees who will be engaged in the performance of the Contract. Employer’s liability limits of $1,000,000 are required.

When work is performed on State owned or controlled property the Workers’ Compensation policy shall be endorsed with a waiver of subrogation in favor of the State. The waiver of subrogation endorsement is to be provided with the certificate of insurance.

2. Certificates evidencing Contractor’s insurance coverage shall be filed with CDSS prior to the execution of the Agreement.

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EXHIBIT E

B. General Provisions Applying to All Insurance Polices

1. Coverage Term – Coverage needs to be in force for the complete term of the contract. If insurance expires during the term of the contract, a new certificate must be received by the State at least ten

(10) days prior to the expiration of this insurance. Any new insurance must still comply with the original terms of the contract.

2. Policy Cancellation / Termination & Notice of Non-Renewal – Contractor shall provide to the State within five business days a copy of any notice of Cancellation/Termination or Non-renewal received by contractor for any of the required insurance policies. In the event Contractor fails to keep in effect at all times the specified insurance coverage, the State may, in addition to any other remedies it may have, terminate this Contract upon the occurrence of such event, subject to the provisions of this Contract.

3. Deductible – Contractor is responsible for any deductible or self-insured retention contained within their insurance program.

4. Primary Clause – Any required insurance contained in this contract shall be primary, and not excess or contributory, to any other insurance carried by the State.

5. Insurance Carrier Required Rating – All insurance companies must carry a rating acceptable to the Office of Risk and Insurance Management. If the Contractor is self insured for a portion or all of its insurance, review of financial information including a letter of credit may be required.

6. Endorsements – Any required endorsements requested by the State must be physically attached to all requested certificates of insurance and not substituted by referring to such coverage on the certificate of insurance.

7. Inadequate Insurance – Inadequate or lack of insurance does not negate the contractor’s obligations under the contract.

C. Confidentiality of Data

Contractor and its employees agree to comply with CDSS Information Security Precautions/Requirements as described in Exhibit E – Attachment 1.

D. Execution and Performance

1. Performance shall start not later than 5 days, or on the express date set by the CDSS and the Contractor, after all approvals have been obtained and the agreement is fully executed. Should the contractor fail to commence work at the agreed upon time, the CDSS, upon five (5) days written notice to the Contractor, reserves the right to terminate the agreement. In addition, the Contractor shall be liable to the State for the difference between Contractor’s bid price and the actual cost of performing work by the second lowest bidder or by another contractor.

2. All performance under the agreement shall be completed on or before the termination date of the agreement.

16-IFB-00669 Exhibit E – Attachment 1 CDSS/TBD Page 1 of 2

California Department of Social Services (CDSS)

Information Security Pre-Cautions/Requirements

A. Confidentiality of Data

Please note the following definitions relating to confidential and sensitive information.

• Confidential information is information which identifies an individual (i.e., name, social security number, home/mailing address, telephone number, etc.) and/or entity (i.e., employing unit, etc.) and/or information in the possession of the Department in which the disclosure is limited by contractual agreement (i.e., proprietary information, etc.).

• Sensitive information is information maintained by the Department, which is not confidential by definition, but requires special precautions to protect it from unauthorized access (i.e., financial or operational information). Sensitive information is information in which the disclosure would jeopardize the integrity of CDSS (i.e., CDSS' fiscal resources and operations).

1. All financial, statistical, personal, technical, and other information relating to CDSS operations which are designated confidential or sensitive by CDSS and which may become available to the Contractor as a result of the implementation of this Agreement, shall be protected by the Contractor from unauthorized access, use, and disclosure.

2. Contractor is notified that there are civil and criminal actions that may be invoked for unauthorized disclosure of information from confidential records. (California Penal Code Section 11140-11144, 13301-13303, Civil Code Section 1798, Chapter 709, Statute of 1997 define civil and criminal actions for unauthorized disclosure of information from confidential records.)

3. The Contractor shall:

a. Instruct all employees with access to the CDSS confidential and sensitive information regarding:

(1) the confidential nature of the information, and (2) the sanctions against unauthorized access, use, or disclosure found in the California Civil Code Section 1798.55, and the Penal Code Section 502.

b. Ensure that their employees will not intentionally seek out, read, use, or disclose CDSS confidential or sensitive information.

c. Not disclose any individually identifiable CDSS information to any person.

d. Require that all Contractor's staff or subcontractor and its employees with access to CDSS confidential information sign the CDSS Confidentiality Agreement (See Section B).

e. Immediately notify CDSS within 24 hours of initial detection of any unauthorized access, use, and disclosure of CDSS information. Notification shall be reported by telephone or email to:

Lloyd Indig 916-651-5558 Information Security & Privacy Officer iso@dss.ca.gov California Department of Social Services 744 P Street, M.S. 9-9-70 Sacramento, CA 95814

f. Cooperate in any investigations of information security incidents.

mailto:iso@dss.ca.gov

16-IFB-00669 Exhibit E – Attachment 1 CDSS/TBD Page 2 of 2

B. Confidentiality Agreement

The California Department of Social Services (CDSS) public assistance records and documents are subject to strict confidentiality requirements imposed by State and federal law including California Welfare and Institutions Code sections 10850, California Penal Code section 11167.5, and 45 Code of Federal Regulations.

I acknowledge that unauthorized access, use, or disclosure of CDSS confidential information is a crime.

I agree that unauthorized access, use, or disclosure of CDSS confidential information is grounds for immediate termination of this Contract/Memorandum of Understanding/Agreements with the CDSS and the Contractor may be subject to penalties both civil and criminal.

Contractor:

Employee:

Employee’s Signature:

Title: Date:

Phone: E-Mail Address: