DPS Outsourcing Agreement Certification .pdf
PDF 115 KB Posted
- Solicitation number
- HHS0016791v2
- Issued by
- Texas
About this file
This is a certification form from the Texas Department of Public Safety establishing security and management control standards for non-criminal justice agencies utilizing criminal history record information. The document serves as a binding agreement for contractor employees and representatives who require access to sensitive criminal justice information through the CJ/S Security Policy and Texas Government Code Chapter 411. The certification requires authorized personnel to acknowledge the restrictions on criminal history record information access, recognize that such data is limited solely to contracted purposes, and understand the administrative and criminal penalties associated with unauthorized access, misuse, or improper dissemination of information. Signatories must provide personal identification details including name, date of birth, state ID or driver's license information, sex, and race, along with signatures from both the contractor employee and contractor representative with corresponding dates.
The certification establishes strict liability standards for information misuse, including accessing the system without authorization, exceeding granted authorization, accessing for improper purposes, or using information obtained through the contract for purposes beyond those specified in the agreement. The document emphasizes that penalties for such violations extend beyond compensatory considerations and may include employment suspension or termination and prosecution under state and federal law. This certification form is directly applicable to the HHSC Region 03 document shredding and disposal services contract, as the selected contractor must handle confidential documents containing protected health information and potentially criminal justice information, requiring CJIS certification and compliance with federal security standards including IRS Publication 1075 and HIPAA Privacy Rules. All contractor personnel with access to sensitive materials must execute this certification as a condition of contract performance.
View the file
Other files
Show all 11
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
TEXAS DEPARTMENT OF PUBLIC SAFETY
NON-CRIMINAL JUSTICE AGENCY
SECURITY and MANAGEMENT CONTROL OUTSOURCING STANDARD for NON-CHANNELERS
CERTIFICATION
I hereby certify that I am familiar with the contents of (1) the Security and Management Control Outsourcing Standard for Non-Channelers; (2) the CJ/S Security Policy; and (3) Texas Government Code Chapter 411, and agree to be bound by their provisions.
I recognize that criminal history record information and related data, by its very nature, is sensitive and has potential for great harm if misused. I acknowledge that: access to criminal history record information and related data is therefore limited to the purpose(s) for which an Authorized Recipient has entered into the contract incorporating this Security and Management Control Outsourcing Standard for Non-Channelers. I understand that misuse of the system by, among other things:
accessing it without authorization; accessing it by exceeding authorization; accessing it for an improper purpose; using, disseminating or re-disseminating information received as a result of this contract for a purpose other than that envisioned by the contract, may subject me to administrative and criminal penalties. I understand that accessing the system for an appropriate purpose and then using, disseminating or re-disseminating the information received for another purpose other than execution of the contract also constitutes misuse. I further understand that the occurrence of misuse does not depend upon whether or not I receive additional compensation for such authorized activity.
Such exposure for misuse includes, but is not limited to, suspension or loss of employment and prosecution for state and federal crimes.
Click or tap here to enter text.
Signature of Contractor Employee Date
Printed or Typed Contractor Employee Name
Sex: Click or tap here to enter text. Race: Click or tap here to enter text.
DOB: Click or tap here to enter text.
State ID or DL: Click or tap here to enter text.
Signature of Contractor Representative Date
Printed or Typed Name of Contractor Representative
Organization and Representative’s Title
| NON-CRIMINAL JUSTICE AGENCY |
| NON-CRIMINAL JUSTICE AGENCY |
File details come from the government source that posted it. Updated .