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2007 MOU Amdmt #1 FHSMV & SPDCITY OF IJ nbANFORD FLORIDA (SANF'ORD POLICE DEPARTMENT) TRANSMITTAL E O DU T: City Clerk ,: Request for Services The item(s) noted below is/are attached and forwarded to your office for the following action(s): Development Order ❑ Mayor's signature Final Plat (original mylars) ❑ Recording Letter of Credit ❑ Rendering Maintenance Bond ® Safe keeping (Vault) Ordinance ❑ Performance Bond Resolution Amendment No. 1 to MOU between DHSMV and Sanford Police Once completed, please: ❑ Return original ❑ Return copy ® Maintain the fully executed copy on file. Special Instructions: Please advise if you have any questions regarding the above. Thank you! J ani Woo& January 28, 2019 From Date DocuSign Envelope ID: 79142296-E9FC-4AEB-B8A3-AD938A77E169 HSMV No.: 0567-16 AMENDMENT NO. 1 TO THE MEMORANDUM OF UNDERSTANDING BETWEEN THE FLORIDA DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES AND SANFORD POLICE DEPARTMENT THIS AMENDMENT NO. 1, is made to the MEMORANDUM OF UNDERSTANDING (MOU) between the FLORIDA DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES, hereinafter referred to as "Providing Agency" or "Department," and SANFORD POLICE DEPARTMENT, hereinafter referred to as "Requesting Party," collectively referred to as "the Parties," executed on or about 3/1/2016. WHEREAS, the MOU was executed for the purpose of establishing the conditions and limitations under which the Providing Agency agrees to provide electronic access to DAVID information to the Requesting Party; and WHEREAS, as required in the MOU, access to and use of DAVID information shall be in accordance with Chapter 119, Florida Statutes, and the Driver's Privacy Protection Act (DPPA), and may only be disclosed to persons to whom disclosure is authorized under Florida law and federal law; and WHEREAS, in order to ensure that this MOU complies with the requirements of Federal law, the Parties wish to add additional language addressing access to and disclosure of data that may include the deceased date of an individual; and WHEREAS, changes to the MOU are required to be made in writing, in accordance with section Vill. Amendments: and WHEREAS, this Amendment is required to add the additional compliance requirements to the MOU. NOW THEREFORE, in consideration of the mutual benefits to be derived here from, the Parties hereto do hereby amend the MOU as follows: I. Added language is shown herein as underlined. Existing language that was already underlined is shown herein with a double -underline. Ii. The third paragraph of section 111. Legal Authority, is hereby amended as follows: Under this MOU, the Requesting Party will be provided, via remote electronic means, information pertaining to driver licenses and vehicles, including personal information authorized to be released pursuant to Section 119.0712(2), Florida Statutes and DPPA. By executing this MOU, Requesting Party agrees to maintain the confidential and exempt status of any, and all information provided by the Providing Agency pursuant to this agreement and to ensure that any person or entity accessing or utilizing said information shall do so in compliance with Section 119.0712(2), Florida Statutes and DPPA: In Page 1 of 4 DAVID MOU Amendment Adding DMF Data Compliance (New 11/2018) DocuSign Envelope ID: 7914229B-E9FC-4AEB-B8A3-AD938A77E169 HSMV No.: 0567-16 addition, the Requesting Party agrees that insurance policy information shall be utilized pursuant to Section 324.242(2), Florida Statutes. Furthermore, the deceased date of an individual shall only be provided to a Requesting Party that meets the qualifications of 15 CFR §1110.102. Disclosure of the deceased date of an individual, which is not in compliance with 15 CFR §1110.102, is punishable under 15 CFR §1110.200. Additionally, because the Social Security Administration does not guarantee the accuracy of the Death Master File, the Requesting Party is reminded that adverse action should not be taken against any individual without further investigation to verify the death information listed (A notice from the Social Security Administration addressing the foregoing is attached hereto and incorporated herein by reference). III. Section IV. Statement of Wor1c, subsection B., is hereby amended by adding item 14. 14. Access and utilize the deceased date of an individual or other information from the NTIS Limited Access Death Master File, as defined in 15 CFR §1110.2, in conformity with the following requirements: (a) Pursuant to 15 CFR §1110.102, the Requesting Party certifies that its access to DMF information is appropriate because the Requesting Party: (i) has a legitimate fraud prevention interest, or a legitimate business purpose pursuant to a law, governmental rule, regulation, or fiduciary duty; iii) has systems, facilities, and procedures in place to safeguard such information, and experience in maintaining the confidentiality, security, and appropriate use of such information, pursuant to requirements reasonably similar to the requirements of section 61O3(p)(4) of the Internal Revenue Code of 1986; and (iii) agrees to satisfy such similar requirements. (b) Pursuant to 15 CFR §1110.102, the Requesting Party certifies that it will not: (i) disclose DMF information to any person other than a person who meets the requirements of subsection IV. B. 14 (a), above; (ii) disclose DMF information to any person who uses the information for any purpose other than a legitimate fraud prevention interest or a legitimate business purpose pursuant to a law, governmental rule, regulation, or fiduciary duty; (iii) disclose DMF information to any person who further discloses the information to any person other than a person who meets the requirements of subsection IV. B. 14 (a), above; or (!v) use DMF information for any purpose other than a legitimate fraud prevention interest or a legitimate business purpose pursuant to a law, governmental rule, regulation or fiduciary duty. IV. The second paragraph of section V. Safeguarding Information, is hereby amended as follows: Any person who willfully and knowingly violates any of the provisions of this section is guilty of a misdemeanor of the first degree punishable as provided in Sections 119.10 and 775.083, Florida Statutes. In addition, any person who willfully and knowingly discloses any information in violation of DPPA may be subject to criminal sanctions and civil liability. Furthermore, failure to comply with 15.CFR §1110.102 pertaining to the deceased date of an individual may result in penalties of $1,000 for each disclosure or use, up to a maximum of $250,000 in penalties per calendar year, pursuant to 15 CFR §1110.200. Page 2 of 4 DAVID MOU Amendment Adding DMF Data Compliance (New 11/2018) DocuSign Envelope ID: 7914229B-E9FC-4AEB-B8A3-AD938A77E169 HSMV No.: 0567-16 V. Item D., under that part of section V. Safeguarding Information that begins with `The Parties mutually agree to the following:", is hereby amended as follows: D. The Requesting Party shall comply with Rule 74-2, Florida Administrative Code, and with Providing Agency's security policies, and employ adequate security measures to protect Providing Agency's information, applications, data, resources, and services. The applicable Providing Agency security policies shall be made available to Requesting Party. Additionally, with respect to the deceased date of an individual, the Requesting Party shall have systems, facilities, and procedures in place to safeguard such information, and experience in maintaining the confidentiality, security, and appropriate use of such information, pursuant to requirements reasonably similar to the requirements of section 6103(p)(4) of the Internal Revenue Code of 1986 and agrees to satisfy such similar requirements. VI. Section XIII. Certification Information is hereby added to the MOU as follows: Pursuant to IV.B.14(a) above, the Requesting Party certifies that access to DMF information is appropriate based on the following specific purpose (please describe the legitimate purpose): individual to any other person or entity. Yes No If the Requesting Party desires to re -disclose the deceased date of any individual to any other person or entity, the Requesting Party agrees that it will not re -disclose the data received from the Providing Agency, but rather, will contact NTIS at https:Hclassic.ntis.gov/products/ssa-dmf/# to become a Certified Person, as defined by 15 CFR §1110.2. A Requesting Party who is a Certified Person may only disclose the deceased date of an individual pursuant to the Requesting Party's obligations under 15 CFR §1110.102." VII. All other terms and conditions of the original MOU not herein revised shall be and remain the same in full force and effect. REMAINDER OF THIS PAGE INTENTIONALLY LEFT BLANK Page 3 of 4 DAVID MOU Amendment Adding DMF Data Compliance (New 11/2018) DocuSign Envelope ID: 7914229B-E9FC-4AEB-B8A3-AD938A77E169 HSMV No.: 0567-16 IN WITNESS WHEREOF, the undersigned have caused this AMENDMENT to be executed by their authorized officials as of the last date indicated below. For: Sanford Police Title For: Florida Department of Highway Safety and Motor Vehicles: — DocuSigned by: 5ijffffdF9'WAuthorized Official Trey Collins Printed/Typed Name Bureau chief, Purchasing and contracts Title 1/27/2019 Date Page 4 of 4 DAVID MOU Amendment Adding DMF Data Compliance (New 11/2018) Envelope Id: 7914229BE9FC4AEBB8A3AD938A77El69 Subject: DAVID MOU Amendment for Sanford Police Department Source Envelope: Document Pages: 7 Signatures: 5 Certificate Pages: 6 Initials: 0 AutoNav: Enabled Envelopeld Stamping: Enabled Time Zone: (UTC -05:00) Eastern Time (US & Canada) Status: Original 1/10/2019 3:08:36 PM Holder: Deborah Taylor deborahtaylor@flhsmv.gov Status: Completed Envelope Originator: Deborah Taylor 2900 Apalachee Parkway Tallahassee, FL 32399 deborahtaylor@flhsmv.gov IP Address: 204.90.30.1 Location: DocuSign tocu`: secu¢to Signer Events Signature Timestamp Bennett White Completed Sent: 1/10/2019 3:38:03 PM Bennettwhite@flhsmv.gov Viewed: 1/15/2019 11:47:32 AM HSMV - MS Signed: 1/15/2019 11:48:08 AM Security Level: Email, Account Authentication Using IP Address: 204.90.30.1 (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Jaime Briggs JaimeBriggs@flhsmv.gov Contract Administrator HSMV -DAS Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 10/21/2018 9:23:53 AM ID:dceba8fd-c949-48bc-ac36-edd0e38fdb4d Stephanie D. Duhart StephanieDuhart@flhsmv.gov Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 1/17/2019 8:35:52 AM ID:dOcOb0e3-d521-442e-9967-lb782ea3df29 Lisa M. Bassett LisaBassett@flhsmv.gov DAS Chief Executive Officer HSMV-DAS Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign ED—Signed by: Sent: 1/15/2019 11:48:09 AM imtG S Viewed: 1/15/2019 10:03:31 PM 164518DF3A73498- Signed: 1/15/2019 10:03:44 PM Signature Adoption: Pre -selected Style Using IP Address: 174.223.137.217 by: � ' Sent: 1/15/2019 10:03:45 PM ED—Signed , v k�r Viewed: 1/17/2019 8:35:52 AM COIDC538794943A... Signed: 1/17/2019 8:36:20 AM Signature Adoption: Pre -selected Style Using IP Address: 204.90.30.1 oo S1gnedby: Sent: 1/17/2019 8:36:22 AM Viewed: 1/17/2019 9:01:35 AM LSUUI.1021111Signed: 1/17/2019 9:01:53 AM Signature Adoption: Uploaded Signature Image Using IP Address: 204.90.30.1 Signer Events Signature Timestamp by: Trey CollinsSent: 1/17/2019 9:01:55 AM TreyCollins@flhsmv.gov (��Dmuftned f� Viewed: 1/27/2019 5:45:48 PM Bureau Chief, Purchasing and Contracts 784FDF808480— Signed: 1/27/2019 5:46:00 PM HSMV-DAS Security Level: Email, Account Authentication Signature Adoption: Drawn on Device (None) Using IP Address: 98.230.80.70 Signed using mobile Electronic Record and Signature Disclosure: Not Offered via DocuSign IntermediaryDelivery Events Status Timestamp Carbon Copy Events Status Timestamp Jaime Briggs Sent: 1/27/2019 5:46:02 PM Jaime Briggs@flhsmv.g ov ED Contract Administrator HSMV-DAS Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 10/21/2018 9:23:53 AM ID: dceba8fd-c949-48bc-ac36-edd0e38fdb4d Data Listing Unit DataListingUnit@flhsmv.gov COPIED Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Jennie Carpenter COPIED Contracts Specialist HSMV-DAS Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Cecil Smith COPIED �� tw cecil.smith@sanfordfl.gov Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Sent: 1/27/2019 5:46:02 PM Sent: 1/27/2019 5:46:02 PM Sent: 1/27/2019 5:46:03 PM Notary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 1/27/2019 5:46:03 PM Certified Delivered Security Checked 1/27/2019 5:46:03 PM Signing Complete Security Checked 1/27/2019 5:46:03 PM Completed Security Checked 1/27/2019 5:46:03 PM Electronic Record and Signature Disclosure created on: 9/22/2015 2:45:05 PM Parties agreed to: Jaime Briggs, Stephanie D. Duhart, Jaime Briggs ELECTRONIC RECORD AND SIGNATURE DISCLOSURE From time to time, FL Dept HSMV (we, us or Company) may be required by law to provide to you certain written notices or disclosures. Described below are the terms and conditions for providing to you such notices and disclosures electronically through your DocuSign, Inc. (DocuSign) Express user account. Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agree to these terms and conditions, please confirm your agreement by clicking the 'I agree' button at the bottom of this document. Getting paper copies At any time, you may request from us a paper copy of any record provided or made available electronically to you by us. 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By checking the 'I Agree' box, I confirm that: • I can access and read this Electronic CONSENT TO ELECTRONIC RECEIPT OF ELECTRONIC RECORD AND SIGNATURE DISCLOSURES document; and • I can print on paper the disclosure or save or send the disclosure to a place where I can print it, for future reference and access; and • Until or unless I notify FL Dept HSMV as described above, I consent to receive from exclusively through electronic means all notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to me by FL Dept HSMV during the course of my relationship with you. DocuSign Envelope ID: 79142298-E9FC-4AEB-B8A3-AD938A77E169 From: Kynoch. Robert To: Duhart. Ste anis; Collins. Trey: Briggs, Jaime Cc: White, Bennett: Sarvis, Michael; Parramore. Becky Subject; RE: DAVID MOUS Date: Tuesday, December 18, 2018 8:51:07 AM Trey: I delegate my authority to sign the DAVID MOU "death file amendments" to Chief Stephanie Duhart. Thank you. Robert Robert Kynoch Director, Motorist Services Florida Department of Highway Safety and Motor Vehicles 2900 Apalachee Parkway Tallahassee, FL 32399-0500 Telephone 850-617-2600 From: Duhart, Stephanie <StephanieDuhart@flhsrnv,gov> Sent: Tuesday, December 18, 2018 8:36 AM To: Kynoch, Robert <RobertKynoch@flhsmv.gov>; Collins, Trey <TreyCollins@flhsmv.gov>; Briggs, Jaime <JaimeBriggs@flhsmv.gov> ;Cc: White, Bennett <BennettWhite@flhsmv.gov>; Sarvis, Michael <MichaelSarvis@flhsmv.gov>; Parramore, Becky <BeckyParramore @flhsmv.gov> Subject: FW: DAVID MOUS C.'an Ou send Cl€Yl ix3, 5. _ ;�., _... �t,i :Cti n al b-', ; yr ��a:a�l�i.. ;f, .` �' ii f, ;Jt ,QUI :I"H n 1,0 i, , fo ., fJea,,.a 'il"' _n ihe doc .-nen.<, k. uti ! � .. .! 111 [.:e ,; r on ,?Dt,ii.:(�"t'„';'0 .,, S From: Parramore, Becky Sent: Tuesday, December 18, 2018 8:22 AM To: Duhart, Stephanie <StephanieDuhart(@flhsmv.aov>; Briggs, Jaime <JaimeBriges4flhsmv.gov> Cc: Collins, Trey <TreyCollins@flhsmv.gov> 4RI „ ► � DocuSign Envelope ID: 7914229B-E9FC-4AEB-B8A3-AD938A77E169 ]EMII Florida Department of Highway Safety and Motor Vehicles HIGHWAY sAFETYANo MOTOR VEHICLES Contract / Agreement Review DHSMV Contract No.: Contractor Name: Contract Summary: Total Cost 1 Revenue Contract Manager: ❑ New Agreement HSMV-0567-16 Division: Motorist services Date: 1/15/2019 Sanford Police Department Amendment to update Federal Language N/A N/A or No Cost ❑ Term: N/A Deborah Taylor Phone: 850-617-2805 ❑ New Contract (Procurement) Procurement Method: ❑ITB ❑RFP ❑ITN ❑RFQ ❑Single Source ❑Informal Quote ❑Exempt per , Florida Statutes ❑ Not Required ❑ Renewalc❑ Amendment I jaix,c s ❑ Settlement Agreement ❑ New/ Revised Template (1TTUI73<99 Approvals Comments Division Director(s) Signature: Date: D«uSig rieed by: Si natu E .t V. M-yf Date:1/17/2019 Budget--53B794N3A.. Signature: Date: X3 If checked, budgetary review/approval is not required as funds are not expended under this Contract/Agreement. Accounting Signature: Date: )[I If checked, accounting review/approval is not required as funds are not received or obligated under this Contract/Agreement Information Services Signature: Date: kl If checked, ISA review/approval is not required as this Contract/Agreement does not impact informations stems. Legal Signature: Date: $I If checked, legal review/approval is not required as the document is a previously -approved boilerplate Purchasing &Contracts g Pro ram office to verify page information on OocuSigned by: Signatur /'� ��a 1/27/2019 IOB2459... Administrative ervices Currently Vacant Signature: Date: Deputy Executive Director Currently Vacant Signature: Date: )CI If checked, review/approval by Deputy Executive Director is not required as the Contract/Agreement. Chief of Staff / Executive Director Template approved on 11/19/2018 by Signature: Date: Jennifer Langston, Acting Chief of Staff HSMV 95020 (05/2015) DocuSign Envelope ID: 79142298-E9FC-4AEB-B8A3-AD938A77E169 F anM I Florida Department of Highway Safety and Motor Vehicles OP` R HIGHWAY SAFETYAND MOTOR VEHICLES Contract / Agreement Review DHSMV Contract No.: Revised Amendment Division: Motorist services Date: 11/14/2018 Contractor Name: Data Exchange contractors Contract Summary. Amendment to update Federal language Total Cost/ Revenue: N/A Contract Manager: Mike sarvi s ❑ New Agreement ❑ New Contract (Procurement) Procurement Method: ❑ITB ❑RFP ❑Exempt per_ ❑ Renewal ❑ Settlement Agreement Approvals or No Cost ❑ Term: N/A Phone: 617-2586 ❑ITN ❑RFQ ❑Single Source ❑Informal Quote Florida Statutes ❑ Not Required Doc Signed by: ❑ Amendment jaunt, b i/os © New / Revised Template�tgff"7a88 Comments Division Director(s) Dxesig W by: Signatur���"f t., Date:11/15/2018 g0.2EfGA6]PBE466 .. DocuSgeeE bt- n Signatu {� . +/l Date! 1114/2018 Budget Signature: Date: JCI If checked, budgetary reviewlapproval is not required as funds are not expended under this Contract/Agreement. Accounting Signature: Date: gJ If checked, accounting reviewlapproval is not required as funds are not received or obligated under this Contract/Agreement. Information Services Signature: Date: )CI If checked, ISA reviewlapproval is not required as this Contract/Agreement does not impact informations stems. Legal Doi sgnc°tr,: Signatur 5°-4— p s e Date: 11/17/2018 ❑ If checke ,,i€ aP eOM/approval is not required as the document is a previously -approved boilerplate Purchasing & Contracts D« Sign�by Docuspnetl try: Signature '/��d Date: 11/18/2018 4g... Administrative Services Deces�° by: 11/19/2018 Signatur : (hft Date: Deputy ExbbUtM Director Currently Vacant Signature: Date: ® if checked, reviewlapproval by Deputy Executive Director is not required as the Contract/Agreement is either an approved template or does not fall under the Deputy Executive Director's areas of responsibility. Chief of Staff / Executive Director —Sig— by' Signatur{9��,,. Date: 11/19/2018 DC8RCD25JSCaet C.. HSMV 95020 (05/2015)