Artifical Intelligence Use.pdf
PDF 188 KB Posted
- Attached to
- Traffic Data Services WIM/CCS State and local contract opportunity
- Solicitation number
- 5400029091
- Issued by
- Richland County, South Carolina
About this file
This is an Artificial Intelligence Use Disclosure Questionnaire for state and local contract opportunities in South Carolina, specifically related to Traffic Data Services WIM/CCS. The questionnaire establishes mandatory disclosure requirements for contractors proposing solutions that incorporate artificial intelligence, machine learning, generative AI, or algorithmic decision-making capabilities. Contractors must complete all applicable sections detailing their AI implementation, including the specific functions and purposes, types and sources of AI models, training methodologies, datasets used, data protection measures, transparency and explainability features, known limitations and bias risks, ongoing monitoring and governance protocols, and future AI updates. The form requires contractor certification that all disclosures are accurate, complete, and made in good faith, with authorization required by a company representative.
The questionnaire mandates that contractors provide comprehensive documentation across ten sections, with particular emphasis on data protection, model explainability, and compliance oversight. Key requirements include disclosure of all AI/ML/GenAI models used, complete identification of training datasets and their origins, confirmation that agency data will not be repurposed or added to training corpora, and detailed safeguards for any personally identifiable information, protected health information, or sensitive data processed by the AI systems. Contractors must identify known model limitations, bias risks, and accuracy constraints along with corresponding mitigation strategies, establish ongoing monitoring procedures including performance checks and drift detection, and acknowledge the requirement to notify the agency at least 60 days in advance of any new AI capabilities, model updates, or material changes to data sources. The questionnaire applies to all contractors responding to the Traffic Data Services WIM/CCS opportunity regardless of whether AI is ultimately incorporated into their proposed solution.
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Text version
ARTIFICIAL INTELLIGENCE USE DISCLOSURE QUESTIONNAIRE
Artificial Intelligence Use Disclosure Questionnaire Page 1 of 3
SECTION 1 - GENERAL INFORMATION
Contractor: Date:
Solicitation/Job Order:
Primary Contact: Title:
Email: Phone:
Does the proposed solution use any form of AI, ML, GenAI, or algorithmic decision-making?
If “No,” skip to Section 10 (Certification) Yes: ⃣ No: ⃣
SECTION 2 – FUNCTION AND PURPOSE OF AI
Describe all areas where AI will be incorporated into the solution:
(Include specific business processes, workflows, features, evaluation modules, automation functions, and decision points.)
Purpose of AI functionality (check all that apply):
⃣ Data analysis / classification ⃣ Predictive analytics ⃣ Natural language processing
⃣ Image / video analytics ⃣ Recommender systems ⃣ Automated decision-making
⃣ Workflow automation ⃣ Other (describe):
SECTION 3 - TYPE & SOURCE OF AI MODELS
Identify the source of AI technology used (check all that apply):
⃣ Developed in-house by Contractor ⃣ Provided by a third party
⃣ Open-source model(s) ⃣ Commercial model(s)
List all AI/ML/GenAI models used within the solution:
Model Name Version Source/Vendor Licensing Open-Source (Y/N)
Artificial Intelligence Use Disclosure Questionnaire Page 2 of 3
SECTION 4 - MODEL TRAINING & DATA SOURCES
Describe how each AI model was trained, including:
(training methodology, whether pre-trained or proprietary, any fine-tuning applied for the proposed solution.)
List ALL datasets used for model training:
Dataset Name Origin Ownership Public/Private Synthetic Data Used?
Did you use Agency data to train, fine-tune, or improve any model?
If “Yes,” provide written documentation of Agency’s express authorization (required). Yes: ⃣ No: ⃣
SECTION 5 - DATA USAGE & PROTECTIONS
Describe the data inputs used by AI within the solution (types of data, source, ownership):
Does the AI process any form of PII, PHI, or sensitive information? If yes, describe safeguards: Yes: ⃣ No: ⃣
Describe how data is stored, transmitted, anonymized, or protected during AI processing:
Confirm that Agency data will not be shared, repurposed, or added to any training corpus:
⃣ Confirmed ⃣ Not Confirmed (explain)
SECTION 6 - TRANSPARENCY & EXPLAINABILITY
To what extent can the AI model’s decisions be explained or audited?
⃣ Full explainability ⃣ Partial explainability ⃣ Limited explainability ⃣ No explainability
Describe available explainability or audit features, including logs, model outputs, rationale, or traceability:
Artificial Intelligence Use Disclosure Questionnaire Page 3 of 3
SECTION 7 - LIMITATIONS, RISKS & BIASES
Identify any known limitations, bias risks, accuracy constraints, or edge cases associated with the AI model(s):
Describe mitigation plans, bias testing methods, or risk management processes:
SECTION 8 - ONGOING AI MONITORING & GOVERNANCE
Describe your ongoing monitoring approach, including performance checks, drift detection, retraining, patching, and compliance with laws/policies:
Identify who is responsible for AI governance and oversight:
SECTION 9 - FUTURE AI UPDATES OR CHANGES
Contractor must notify the Agency at least 60 days in advance of:
(Introduction of any new AI capabilities, updates to existing models, material changes to data sources or usage)
⃣ Acknowledged ⃣ Not acknowledged (explain)
SECTION 10 - CONTRACTOR CERTIFICATION
By signing below, the Contractor certifies that all disclosures provided in this attachment are accurate, complete, and made in good faith. The Contractor further certifies compliance with all requirements outlined in the Agency’s AI Use Disclosure Requirements.
AUTHORIZED REPRESENTATIVE
LEGAL COMPANY NAME:
SIGNATURE:
PRINTED NAME:
TITLE:
DATE:
| SECTION 1 - GENERAL INFORMATION |
| SECTION 2 – FUNCTION AND PURPOSE OF AI |
| SECTION 3 - TYPE & SOURCE OF AI MODELS |
| SECTION 4 - MODEL TRAINING & DATA SOURCES |
| SECTION 5 - DATA USAGE & PROTECTIONS |
| SECTION 6 - TRANSPARENCY & EXPLAINABILITY |
| SECTION 7 - LIMITATIONS, RISKS & BIASES |
| SECTION 8 - ONGOING AI MONITORING & GOVERNANCE |
| SECTION 9 - FUTURE AI UPDATES OR CHANGES |
| SECTION 10 - CONTRACTOR CERTIFICATION |
| AUTHORIZED REPRESENTATIVE |
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