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Home My WebLink About2015-142 Contract - General Information Services f Contract for Back round Screening Services f CITY OF CONSULTANT: General Information Services, Inc. (GIS) ASHLAND CONTACT: Marinell Harper, Senior Vice President of Sales 20 East Main Street Ashland, Oregon 97520 ADDRESS: 917 Chapin Road, Chapin, SC 29036 Telephone: 541/488-6002 Fax: 541/488-5311 TELEPHONE: 888-333-5696 FAX: 803-932-2306 DATE AGREEMENT PREPARED: January 29, 2015 EMAIL: mharper@geninfo.com BEGINNING DATE: March 1, 2015 COMPLETION DATE: See Additional Terms COMPENSATION: Fee schedule is attached as Exhibit C and GIS proposal is attached as Exhibit E. SERVICES TO BE PROVIDED: BACKGROUND SCREENING SERVICES to be performed as requested and specified by City staff, City's RFP attached as Exhibit D and GIS proposal attached as Exhibit E. GIS agreement is attached as Exhibit F. ADDITIONAL TERMS: Contract may be extended annually for three additional years for a maximum term of five (5) years. V-4, , In the event of conflicts or discrepancies among the contract documents, the City of Ashland Contract for Personal Services will be primary and take precedence, and any exhibits or ancillary contracts or agreements having redundant or contrary provisions will be subordinate to and interpreted in a manner that will not conflict with the said primary City of Ashland Contract. FINDINGS: Pursuant to AMC 2.50.120, after reasonable inquiry and evaluation, the undersigned Department Head finds and determines that: (1) the services to be acquired are personal services; (2) the City does not have adequate personnel nor resources to perform the services; (3) the statement of work represents the department's plan for utilization of such personal services; (4) the undersigned consultant has specialized experience, education, training and capability sufficient to perform the quality, quantity and type of work requested in the scope of work within the time and financial constraints provided; (5) the consultant's proposal will best serve the needs of the City; and (6) the compensation negotiated herein is fair and reasonable. NOW THEREFORE, in consideration of the mutual covenants contained herein the CITY AND CONSULTANT AGREE as follows: 1. Findings / Recitations. The findings and recitations set forth above are true and correct and are incorporated herein by this reference. 2. All Costs by Consultant: Consultant shall, at its own risk and expense, perform the personal services described above and, unless otherwise specified, furnish all labor, equipment and materials required for the proper performance of such service. 3. Qualified Work: Consultant has represented, and by entering into this contract now represents, that all personnel assigned to the work required under this contract are fully qualified to perform the service to which they will be assigned in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of Oregon, are so registered, licensed and bonded. 4. Completion Date: Consultant shall start performing the service under this contract by the beginning date indicated above and complete the service by the completion date indicated above. ('t\4 L-, 5. Compensation: City shall pay Consultant for service performed, includin osts and`~xpenses, the sum specified above. Payments shall be made within 30 days of the date of the invoic . Should the contract be prematurely terminated, payments will be made for work completed o date of termination. 6. Ownership of Documents: All documents prepared by Consultant pursuant to this contract shall be the property of City. 7. Statutory Requirements: ORS 279C.505, 279C.515, 279C.520 and 279C.530 are made part of this contract. 8. Living Wage Requirements: If the amount of this contract is $20,142.20 or more, Consultant is required to comply with chapter 3.12 of the Ashland Municipal Code by paying a living wage, as defined in this chapter, to all employees performing work under this contract and to any Subcontractor who performs 50% or more of the service work under this contract. Consultant is also required to post the notice attached hereto as Exhibit B predominantly in areas where it will be seen by all employees. 9. Indemnification: Consultant agrees to defend, indemnify and save City, its officers, employees and agents harmless from any and all losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from injury to any person (including injury resulting in death), or damage (including loss or destruction) to property, of whatsoever nature arising out of or incident to the performance of this contract b Consultant (including but not Contract for Personal Services, Revised 07/08/2014, Page 1 of 5 limited to, Consulta; is employees, agents, and others designated by Consultant to perform work or services attendant to this contract). Consultant shall not be held responsible for any losses, expenses, claims, subrogations, actions, costs, judgments, or other damages, directly, solely, and proximately caused by the negligence of City. 10-. Termination: a. Mutual Consent. This contract may be terminated at any time by mutual consent of both parties. b. City's Convenience. This contract may be terminated at any time by City upon 30 days' notice in writing and delivered by certified mail or in person. C. For Cause. City may terminate or modify this contract, in whole or in part, effective upon delivery of written notice to Consultant, or at such later date as may be established by City under any of the following conditions: i. If City funding from federal, state, county or other sources is not obtained and continued at levels sufficient to allow for the purchase of the indicated quantity of services; ii. If federal or state regulations or guidelines are modified, changed, or interpreted in such a way that the services are no longer allowable or appropriate for purchase under this contract or are no longer eligible for the funding proposed for payments authorized by this contract; or iii. If any license or certificate required by law or regulation to be held by Consultant to provide the services required by this contract is for any reason denied, revoked, suspended, or not renewed. d. For Default or Breach. i. Either City or Consultant may terminate this contract in the event of a breach of the contract by the other. Prior to such termination the party seeking termination shall give to the other party written notice of the breach and intent to terminate. If the party committing the breach has not entirely cured the breach within 15 days of the date of the notice, or within such other period as the party giving the notice may authorize or require, then the contract may be terminated at any time thereafter by a written notice of termination by the party giving notice. ii. Time is of the essence for Consultant's performance of each and every obligation and duty under this contract. City by written notice to Consultant of default or breach may at any time terminate the whole or any part of this contract if Consultant fails to provide services called for by this contract within the time specified herein or in any extension thereof. iii. The rights and remedies of City provided in this subsection (d) are not exclusive and are in addition to any other rights and remedies provided by law or under this contract. e. Obligation/Liability of Parties. Termination or modification of this contract pursuant to subsections a, b, or c above shall be without prejudice to any obligations or liabilities of either party already accrued prior to such termination or modification. However, upon receiving a notice of termination (regardless whether such notice is given pursuant to subsections a, b, c or d of this section, Consultant shall immediately cease all activities under this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination, Consultant shall deliver to City all contract documents, information, works-in-progress and other property that are or would be deliverables had the contract been completed. City shall pay Consultant for work performed prior to the termination date if such work was performed in accordance with the Contract. 11. Inciependent Contractor Status: Consultant is an independent contractor and not an employee of the City. Consultant shall have the complete responsibility for the performance of this contract. Consultant shall provide workers' compensation coverage as required in ORS Ch 656 for all persons employed to perform work pursuant to this contract. Consultant is a subject employer that will comply with ORS 656.017. 12. Assignment and Subcontracts: Consultant shall not assign this contract or subcontract any portion of the work without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be void. Consultant shall be fully responsible for the acts or omissions of any assigns or Subcontractors and of all persons employed by them, and the approval by City of any assignment or subcontract shall not create any contractual relation between the assignee or subcontractor and City. 13. Default. The Consultant shall be in default of this agreement if Consultant: commits any material breach or default of any covenant, warranty, certification, or obligation it owes under the Contract; its QRF status pursuant to the QRF Rules or loses any license, certificate or certification that is required to perform the Services or to qualify as a QRF if consultant has qualified as a QRF for this agreement; institutes an action for relief in bankruptcy or has instituted against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing business on a regular basis of the type identified in its obligations under the Contract; or attempts to assign rights in, or delegate duties under, the Contract. 14. Insurance. Consultant shall at its own expense provide the following insurance: a. Worker's Compensation insurance in compliance with ORS 656.017, which requires subject employers to provide Oregon workers' compensation coverage for all their subject workers b. Professional Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, $1,000,000, $2,000,000 or Not Applicable for each claim, incident or occurrence. This is to cover damages caused by error, omission or negligent acts related to the professional services to be provided under this contract. C. General Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,000, $500,000, $1,000,000, 2 000 000 or Not Applicable for each occurrence for Bodily Injury and Property Contract for Personal Services, Revised 07/08/2014, Page 2 of 5 Damage. It shall,include contractual liability coverage for the indemnity provided under this contract. d. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than Enter one: $200,,h00, $560,000, $1,000,000, or Not Applicable for each accident for Bodily Injury and Property Damage, including coverage for owned, hired or non-owned vehicles, as applicable. e. Notice of cancellation or change. There shall be no cancellation, material change, reduction of limits or intent not to renew the insurance coverage(s) without 30 days' written notice from the Consultant or its insurer(s) to the City. f. Additional Insured/Certificates of Insurance. Consultant shall name The City of Ashland, Oregon, and its elected officials, officers and employees as Additional Insureds on any insurance policies required herein but only with respect to Consultant's services to be provided under this Contract. The consultant's insurance is primary and non-contributory. As evidence of the insurance coverages required by this Contract, the Consultant shall furnish acceptable insurance certificates prior to commencing work under this contract. The certificate will specify all of the parties who are Additional Insureds. Insuring companies or entities are subject to the City's acceptance. If requested, complete copies of insurance policies; trust agreements, etc. shall be provided to the City. The Consultant shall be financially responsible for all pertinent deductibles, self-insured retentions and/or self- insurance. 15. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws of the State of Oregon without resort to any jurisdiction's conflict of laws, rules or doctrines. Any claim, action, suit or proceeding (collectively, "the claim") between the City (and/or any other or department of the State of Oregon) and the Consultant that arises from or relates to this contract shall be brought and conducted solely and exclusively within the Circuit Court of Jackson County for the State of Oregon. If, however, the claim must be brought in a federal forum, then it shall be brought and conducted solely and exclusively within the United States District Court for the District of Oregon filed in Jackson County, Oregon. Consultant, by the signature herein of its authorized representative, hereby consents to the in personam jurisdiction of said courts. In no event shall this section be construed as a waiver by City of any form of defense or immunity, based on the Eleventh Amendment to the United States Constitution, or otherwise, from any claim or from the jurisdiction. 16. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER, CONSENT, MODIFICATION OR CHANGE, IF MADE, SHALL BE EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR THE SPECIFIC PURPOSE GIVEN. THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR REPRESENTATIONS, ORAL OR WRITTEN, NOT SPECIFIED HEREIN REGARDING THIS CONTRACT. CONSULTANT, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT HE/SHE HAS READ THIS CONTRACT, UNDERSTANDS IT, AND AGREES TO BE BOUND BY ITS TERMS AND CONDITIONS. 17. Nonappropriations Clause. Funds Available and Authorized: City has sufficient funds currently available and authorized for expenditure to finance the costs of this contract within the City's fiscal year budget. Consultant understands and agrees that City's payment of amounts under this contract attributable to work performed after the iast day of the current fiscal year is contingent on City appropriations, or other expenditure authority sufficient to allow City in the exercise of its reasonable administrative discretion, to continue to make payments under this contract. In the event City has insufficient appropriations, limitations or other expenditure authority, City may terminate this contract without penalty or liability to City, effective upon the delivery of written notice to Consultant, with no further liability to Consultant. Certification. Co ultant shall sign the certification attached hereto as Exhibit A and herein incorporated b reference. Consultant: City-of Ashland 4 By By _ Signature Department Head r Print Name Print Name Title Date W-9 One copy of a W-9 is to be submitted with the signed contract. Purchase Order No. Contract for Personal Services, Revised 07/08/2014, Page 3 of 5 EXHIBIT A CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perjury, certifies that (a) the number shown on the attached W-9 form is its correct taxpayer ID (or is waiting for the number to be issued to it and (b) Contractor is not subject to backup withholding because (i) it is exempt from backup withholding or (ii) it has not been notified by the Internal Revenue Service (IRS) that it is subject to backup withholding as a result of a failure to report all interest or dividends, or (iii) the IRS has notified it that it is no longer subject to backup withholding. Contractor further represents and warrants to City that (a) it has the power and authority to enter into and perform the work, (b) the Contract, when executed and delivered, shall be a valid and binding obligation of Contractor enforceable in accordance with its terms, (c) the work under the Contract shall be performed in accordance with the highest professional standards, and (d) Contractor is qualified, professionally competent and duly licensed to perform the work. Contractor also certifies under penalty of perjury that its business is not in violation of any Oregon tax laws, and it is a corporation authorized to act on behalf of the entity designated above and authorized to do business in Oregon or is an independent Contractor as defined in the contract documents, and has checked four or more of the following criteria: (1) 1 carry out the labor or services at a location separate from my residence or is in a specific portion of my residence, set aside as the location of the business. (2) Commercial advertising or business cards or a trade association membership are purchased for the business. (3) Telephone listing is used for the business separate from the personal residence listing. (4) Labor or services are performed only pursuant to written contracts. V (5) Labor or services are performed for two or more different persons within a period of one year. (6) 1 assume financial responsibility for defective workmanship or for service not provided as evidenced by the ownership of performance bonds, warranties, errors and omission insurance or liability insurance relating to the labor or services to be provided. Contractor (Date) ~ r Contract for Personal Services, Revised 07/08/2014, Page 4 of 5 CITY OF ASHLAND, OREGON EXHIBIT B City of Ashland LIVING WAGE per hour effective June 30, 2014 !LA (Increases annually every June 30 by the Consumer Price Index) portion of business of their 401 K and IRS eligible _ employer, if the employer has cafeteria plans (including ten or more employees, and childcare) benefits to the has received financial amount of wages received by assistance for the project or the employee. For all hours worked under a business from the City of service contract between their Ashland in excess of Note: "Employee" does not employer and the City of $20,142.20. include temporary or part-time Ashland if the contract employees hired for less than exceeds $20,142.20 or more. If their employer is the City of 1040 hours in any twelve- Ashland including the Parks month period. For more r For all hours worked in a and Recreation Department. details on applicability of this month if the employee spends policy, please see Ashland 50% or more of the In calculating the living wage, Municipal Code Section employee's time in that month employers may add the value 3.12.020, working on a project or of health care, retirement, 1'For additional information: Call the Ashland City Administrator's office at 541-488-6002 or write to the City Administrator, City Hall, 20 East Main Street, Ashland, OR 97520 or visit the city's website at www.ashland.or.us. Notice to Employers: This notice must be posted predominantly in areas where it can be seen by all employees. CITY OF ASHLAND ~ A t Contract for Personal Services, Revised 07/08/2014, Page 5 of 5 Background Screening Services PROPOSED FEE SCHEDULE Item Services to be Performed Unit Unit Price I Address Profile - Verification Social Security Each S 1.00 2 Criminal History Search (County - United Each S 6.50 States) or (Statewide where applicable) Criminal History Search All new hires 3 (International /Canada /where applicable) are subject Each S Varies by Country to screening 4 Civil History Items 1-6. Each S 12.50 5 Federal Criminal History Each S 6.00 6 Registered Nationwide Sex Offender Search Each S 1.50 *Package price does not include International Criminal History Search. PACKAGE PRICE Please refer to Exhibit 6 - GIs International Services Pricing. $ 27.50 (for items 1-6, if available) PACKAGE PRICE - Volume Price Break Quantity (for items 1-6, if available) N/A S N/A 7 Driving History in Current Licensed State Each S 3.75 (State requested ) 8 Credit Report (Employment) Screening Each S4.00 Employment Date Verification: Items 7-13 9 (Hire date and termination dates only) cons rered Each S7.00 # Requested: 1_ 2_ 3_ individually Employment Reference Comprehensive with based on 10 what is Each S 8.00 narrative: # Requested: 1_2 _ 3 applicable Education / Academic Verification for a specific 11 (Degree claimed / Year) employment Each S8.00 position. 12 DOT 49: (For Commercial Drivers) Each S 12.00 13 Health Care Integrity: (OIG/HHS) Each S 3.00 PACKAGE PRICE S 45.75 (for items 7-13, if available) PACKAGE PRICE - Volume Price Break Quantity S N/A (for items 7-13, if available) N/A Package price does not include International Criminal History Search. Please refer to Exhibit 6 - GIS International PACKAGE PRICE -Items 1-13, if available Services Pricing. S 73.25 PACKAGE PRICE - Volume Price Break Quantity S N/A ( for items 1-13, if available) N/A 14 Basic Background Check Includes item Ws: FLAT FEE S 15.00 1, 2, 5, 6 (Each) Prices will be guaranteed for a minimum of (24) months. 1 es / No if `•no°, provide date (Circle one) Please note: In addition to the required Proposed Fee Schedule, proposers map include additional packages and pricing options for consideration by the City. RFP - Background Screening Services, Page 3 of 3, 11/7/2014 zl `OL Loo) ADDENDUM TO CITY OF ASHLAND CONTRACT FOR BACKGROUND SCREENING SERVICES This Addendum is made and attached to a contract for background screening services of selected persons, between the City of Ashland ("City") and General Information Services. Inc. ("GIS" or "Consultant"). Recitals: A. The City and GIS are entering into a "City of Ashland Contract for Background Screening Services" (further referred to in this addendum as "the agreement"). B. The parties desire to change the agreement to conform the standard GIS terms and conditions with the City's standard Personal Services Agreement. City and Consultant agree to change the agreement in the following manner: 1. Change Section 2. All Costs by Consultant, to add: "Despite the previous sentence, in addition to the prices on the fee schedule, Customer shall pay GIS amounts that allow GIS to recover all fees (without markup) that third-party information sources charge GIS for access to information needed to perform the Services (such as county court fees)." 2. Change Section 5. Compensation, first sentence, to delete "the sum specified above" and substitute" at the prices set out on the fee schedule." 3. Change Section 5. Compensation, third sentence, to read: "Should the contract be prematurely terminated, payments will be made for work completed to the date of termination." 4. Change Section 6. Ownership of Documents, title and text to read: "Ownership of Documents and Work Product. GIS owns all Work Product." 5. Change Section 9. Indemnification, to read: "Consultant shall pay the reasonable, out-of-pocket cost of investigating, defending, negotiating, and paying claims by a non- governmental third party (other than a party's affiliate) against City and its representatives, officers, directors and employees from any loss or claim made by third parties, that proximately arise from the negligence or breach of the contract of Consultant or Consultant's employees or subcontractors in performing the work called for in this contract. If the loss or claim arises from both parties' actions and each party's action is a breach of this contract or a failure to use reasonable care, , except as limited under the Oregon Tort Claim Act and the Oregon Constitution as applied to the City, the loss or claim shall be borne by each in proportion to the degree of negligence or other fault attributable to each. Consultant's and City's obligations under this paragraph shall survive the termination of this contract." 6. Change Section 12, Assignment and Subcontracts, to read: "Consultant may use third-party information sources such as courts, other governmental entities, consumer 1- CITY OF ASHLAND, ADDENDUM TO CONTRACT FOR PERSONAL SERVICES-GIS, Inc. reporting agencies, universities, and former employers or other entities to obtain or verify information supporting its Work Product. Consultant shall not, however, assign this contract or subcontract its obligation to create the final Work Product for City's use without written consent of City. Any attempted assignment or subcontract said obligation without written consent of City shall be void. Consultant shall be fully responsible for the acts or omissions of any assigns of subcontractors and of all contractual relation between the assignee or subcontractor and City." 7. Adopt Exhibit F, except Terms and Conditions, Sections 1 - 2; 5; 10, 13, 14, 15; 17 - 20. 8. Except as modified above the terms of the agreement shall remain in full force and effect. GIS: ' CITY OF ASHLAND: BY BY Department Head Its L Date DATE l 7 1`~ Purchase Order # Acct. No.: (For City purposes only) 2- CITY OF ASHLAND, ADDENDUM TO CONTRACT FOR PERSONAL SERVICES-GIS, Inc. 1 ® DATE(MM/DD/(YYY) AC40R " CERTIFICATE OF LIABILITY INSURANCE 1/29/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Michelle Goodwin NAME: Keenan Suggs PHONE (803)799-5533 FAC A/C No. Ext), A No;(803)771-0166 1330 Lady Street A,MRIE :mgoodwin@keenansuggs.com INSURERS AFFORDING COVERAGE NAIC # Columbia SC 29201 INSURER A:Travelers Insurance CO INSURED INSURERS Catlin Insurance Company General Information Services, Inc. INSURERC:Federal Insurance Company INSURER D AS en Specialty Insurance Co _ P. 0. Box 353 INSURER E : Chapin SC 29036 INSURER F: COVERAGES CERTIFICATE NUMBER:14-15 & 15-16 E&O GIs REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE INSR UVVVD BR POLICY NUMBER MM/DD/YYY MM DDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 DAMAGE TO RENTED S 300,000 X COMMERCIAL GENERAL LIABfLITY PREMI ES Ea occurrence A CLAIMS-MADE ❑X OCCUR X X 63001)353070TIL14 4/6/2014 4/6/2015 MED EXP (Any one person) S 10 , 000 X Contrctual Liability dd'1 Insured & Waiver PERSONAL& ADV INJURY $ N/A Status only applies per GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER ritten contract PRODUCTS - COMP/OP AGG S 2,000,000 X POLICY PRO LCC S AUTOMOBILE LIABILITY !Ea aocdeDtsINGLE OMIT $ 1 000,000 ANY AUTO AOD38082214CAG 4/6/2014 4/6/2015 BODILY INJURY (Per person) $ A ALL OWNED SCHEDULED dd' 1 Insured & Waiver BODILY INJURY (Per accident) S X X AUTOS X NAUTOS ON OWNED Status only applies per PROPERTY DAMAGE S HIRED AUTOS AUTOS Per accident written contract S Uninsured motorist combined 1,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 15,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ _ 15,000,000 DED X RETENTIONS 10,000 UPOD657852TIL14 4/6/2014 4/6/2015 $ A WORKERS COMPENSATION X OD66088114 4/6/2014 /6/2015 X WCSTATU- OTH- AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER,IEXECUTIVE YIN diver only applies per E.L. EACH ACCIDENT S 1,000,000 OFFICER/MEMBER EXCLUDED? N / p' ritten contract (Mandatory in NH) E. L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT S 1,000,000 B Errors & Omissions PQ7502220115 1/19/2015 1/19/2016 Limit $2,500,000 D Errors & Omissions RAF54815 1/19/2015 1/19/2016 Limit $2,500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ashland ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Kariann Olson Purchasing Representative AUTHORIZED REPRESENTATIVE 90 N. Mountain Avenue Ashland, OR 97520 Darren Foy/MSG S7 ACORD 25 (2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. I NS025 i5mi M51 M + Thn Ar npn nnmo nnrf Innn nra runic+oraii mnrkc of A( npn COMMENTS/REMARKS Prof Errors & Omissions 2nd Layer MPL022214, 1/19/2015 - 1/19/2016 - $5,000,000 Prof Errors & Omissions 3rd Layer QPL0043650, 1/19/2015 - 1/29/2016 - $5,000,000 Prof Errors & Omissions 4th Layer SPL005811200, 1/19/2015 - 1/19/201.6 - $5,000,000 Cyber Errors & Omissions lst Layer 027780023, 1/19/2015 - 1/19/2016 - $10,000,000 Cyber Errors & Omissions 2nd Layer MAN783179012015, 1/19/2015 - 1/19/2016 - $10,000,000 OFREMARH COPYRIGHT 2000, AMS SERVICES INC. CITY OF ASHLAND Request for Proposal BACKGROUND SCREENING SERVICES Release date: November 7, 2014 Requested by: Kari Olson Purchasing Representative City of Ashland 90 N. Mountain Avenue Ashland, OR 97520 Tel: 541-488-5354 Fax 541-488-5320 Kari.olson,,'&ashland.or.us Proposals are due prior to: 2:00 Pm (PSI'), Thursday. December 4. 2014 Project Name: BACKGROUND SCREENING SERVICE Additional requirements and information: Proposals may be faxed, emailed or hand delivered. Proposers shall submit their proposal on their company letterhead. Informal email proposals and/or late proposals will not be accepted. Terms or discounts which are conditioned upon payment within a certain time will not be considered for purposes of comparison of proposals. The successful proposer will be required to enter into a contract with the City for the services and provide insurance certificates in their own name for General Liability, Professional Liability, Automobile, and Workers' Compensation. Subcontracting will not be permitted. The City's intent is to enter into a two (2) year agreement for these services with the option to renew the agreement annually for up to three additional years for a maximum term of five (5) years. SCOPE OF SERVICES Background Screening Services for Applicants The City is requesting proposals from qualified firms that can provide accurate and timely pre-employment background screening and reporting for applicants. The City would like to consider any available background screening packages being offered, including web-based online ordering services, and the costs associated with these types of services. Proposers are being asked to submit a proposal that includes detailed information on the background screening packages offered by their company, including web-based online services, and all of the costs associated with these services. Firm prices will be required for a minimum of 24 months. The successful contractor will be required to provide accurate tracking and reports and resolve open-ended cases or cases involving misinformation to the City's satisfaction. Contractor shall be responsible for the professional quality and technical accuracy of the services furnished by Contractor and without additional compensation will correct or revise errors or deficiencies per accepted criteria and/or requirements. Contractor will ensure their employees are sufficiently trained, qualified and screened to ensure background screening information remains confidential and customer service remains at the highest level. Contractor will agree to hold confidential information in strict confidence. Contractor will provide the City with the results of the background screening services requested within the processing time agreed to by the contractor and the City. Contractor shall notify, via postal mail and email, the designated City contact when results are available for review Two adverse Action Letters - When applicable, the Contractor shall create two (2) Adverse Action letters per Fair Credit Reporting Act (FORA) requirements. The first letter, accompanying a copy of the record the City received, must be sent to the Individual informing him/her they have 5-days to request any correction. The second letter must ow" RFl - Background Screening Services, Page 1 of 3. 11/7/2014 ILA be swnt 5 business days later indicating case closure and denial of employment resulting from the lack of request of an appeal Proposals contents: 1. Proposer shall provide Company information (address, telephone, fax, website address) and contact information (address, telephone, fax, and email address) for an authorized representative of the company who if required, can provide the City with additional information. 2. Proposer shall demonstrate experience and knowledge in the field of Criminal, Educational, Driver License and Financial background services. Minimum five years verifiable experience. 3. Proposer shall confirm an independent database will be available to serve as a repository for background check results and be readily available to the City for a minimum of one (1) year. 4. If the proposer is currently providing web-based services, the Proposer shall confirm that the database will be easily accessible by the City via the internet and that the City will be able to submit background check requests and view results of those checks via the internet. 5. Proposer shall provide unit prices as requested for the specified services on the attached Proposed Fee Schedule. In addition to the required Proposed Fee Schedule, proposers may include additional packages and pricing options for consideration by the City. 6. Proposer shall provide a list of their available screening packages they are able to offer, including web- based online ordering services, and the costs associated with the proposed services. 7. Proposer shall agree to the City's contract terms and conditions in the attached contract and/or provide a copy of their services contract. Proposals must be received prior to 2:00 PNI (PST), Thursdav, December 4, 2014. Late proposals will not be considered. If you have any questions and/or need additional information, please email your questions to Kari Olson at kari.olson~c-tlashland.or.us. Thank you. Kari Olson Purchasing Representative City of Ashland 90 N. Mountain Avenue Ashland, OR 97520 Tel 541-488-5354 Fax 541-488-5320 Kari.olson aashland.or.us Method of Award. In accordance with AMC 2.50.120(C), personal services selection criteria shall include: I. Specialised experience in the type of work to be performed; 2. Capacity and capability to perform the work, including anv specialised services within the time limitations for the work: 3. Educational and professional record, including past record of performance on contracts with governmental agencies and private parties with respect to cost control, quality of work, ability, to meet schedules, and contract administration where applicable, 4. Availability to perform the assignment and familiarity with the area in which the specific work is located, including knowledge of designing or techniques peculiar to it, where applicable; 5. Cost of lire services; and 6. Any, other factors relevant to the particular contract. ]it accordance with ORS 279B.070, Intermediate procurement (4) If a contract is awarded, the contracting agency, shall award the contract to the offeror whose quote or proposal will best serve the interests of the contracting agency, taking into account price as well as considerations including, but not limited to, experience, expertise, product functionality, suitability for a particular purpose and contractor responsibility under ORS 279B.110. RFP - Background Screening Services, Page 2 of 3, 11/7/2014 Background Screening Services PROPOSED FEE SCHEDULE Item Services to be Performed Unit Unit Price I Address Profile - Verification Social Security Each S 2 Criminal History Search (County - United Each S States) or (Statewide where applicable) Criminal History Search All new hires 3 International / Canada / where a licable) are subject Each S ( pP to screening 4 Civil History Items 1-6. Each S 5 Federal Criminal History Each S 6 Registered Nationwide Sex Offender Search Each S PACKAGE PRICE S (for items 1-6, if available) PACKAGE PRICE - Volume Price Break Quantity S (for items 1-6, if available) 7 Driving History in Current Licensed State Each S (State requested ) 8 Credit Report (Employment) Screening Each S Employment Date Verification: Items 7-13 9 (Hire date and termination dates only) consiare dered Each S # Requested: 1 2 3 individually Employment Reference Comprehensive with based on 10 narrative: # Requested: 1 2 3 what is Each S - applicable Education / Academic Verification for a specific I I (Degree claimed / Year) employment Each S position. 12 DOT 49: (For Commercial Drivers) Each S 13 Health Care Integrity: (OIG/HHS) Each S PACKAGE PRICE S (for items 7-13. if available) PACKAGE PRICE - Volume Price Break _Quantity S (for items 7-13, if available) PACKAGE PRICE - Items 1-13, if available S PACKAGE PRICE - Volume Price Break Quantity S ( for items I-13, if available) 14 Basic Background Check Includes item Ws: FLAT FEE S (Each) Prices will be guaranteed for a minimum of (24) months. 1 es / \o If "no", provide date (Circle one) Please note: In addition to the required Proposed Fee Schedule, proposers maN include additional packages and pricing options for consideration by the City. RFP - Background Screening Services. Page 3 of 3, 11/7/2014 Kari Olson From: Kari Olson [kari.olson@ashland. or,usj Sent: Wednesday, November 19, 2014 11:48 AM To: 'Kari Olson'; 'Lisa Holder; jason.holt@adp.com; eronsenberg@advrep.com; biinfo@backgroundinv.com; robertk@castlebranch.com; tposey@corpsecure.com; cris.inc@comcast.net; jlopez@frasco.com; mharper@geninfo.com; hbrowning@openonline.com; amankoski@pre-employ.com; jon@publicsafetytesting.com; 'Tyson Poso'; 'Robert Keller; 'Ryan Holman'; 'Erika Prizzi' Cc: 'Kari Olson' Subject: RE: RFP - Background Screening Services "ADDENDUM #3"' ADDENDUM #3 Question: Must each page of the proposal be printed on company letterhead, or will a cover letter on letterhead suffice? Answer: Proposals are required to be submitted on proposer's letterhead. Cover fetter on letterhead will suffice. Complete proposal may be emailed as an attachment. Question: Does the City of Ashland require an executed contract? Answer: No, an executed contract is not required to be submitted with proposal. The City intends to execute a single contract with the successful proposer. uestion: Is a Certificate of insurance to be provided with the proposal or upon award of contract? Answer: A certificate of insurance is required to be submitted with the proposal. The successful proposer will be required to add the City of Ashland as the endorsed and additional insured. Question: Is Exhibit A to be submitted with the proposal or upon award of contract? Answer: If you are referring to the contract as Exhibit A, the answer is "no", proposers are not required to include a copy of the solicitation or contract with their proposal. This solicitation is being processed as an Intermediate Procurement, not a formal Competitive Sealed Proposal. Question: Are vendors required to acknowledge receipt of addenda? If so how? Answer: No, this solicitation is being processed as an Intermediate Procurement, not a formal Competitive Sealed Proposal. Question: Does the City of Ashland require adverse actions letters to be sent automatically based on criteria set forth by the City, or will the City supply the successful vendor with a list of applicants requiring adverse action letters? Answer: The City will send out the letters and would appreciate the vendor providing a letter template for the City to use. i Question:' In reference to question 6, scope of services, our company offers hundreds of background screening products and services. Therefore, is it permissible to price Only those products and services we believe will best serve the City? Answer: In addition to the fees being requested on page 3 of the RFP, proposers are encouraged and welcome to include any additional products and services, including pricing, for the City to consider. Question: Would the City of Ashland like to see a sample of our client acknowledgments form, which requires clients to read and acknowledge receipt of FTC-mandated and FCRA documents? Answer: Yes Please note: Questions are due prior to 5:00 PM (PST) today. Have a nice afternoon! Thank you. Kariann Olson Purchasing Representative City of Ashland 90 N. Mountain Avenue Ashland, OR 97520 Tel: 541.488.5354 Fax: 541.488.5320 TTY: 800.735.2900 kari.olson@ashland.or.us Visit the City's web site at: www.ashland.or.us This email transmission is official business of the City of Ashland, and it is subject to Oregon Public Records law for disclosure and retention. If you have received this message in error, please contact me at (541) 488-5354. Thank you. From: Kari Olson [mailto:kari.olson@ashland.or.us] Sent: Tuesday, November 18, 2014 2:42 PM To: 'Kari Olson'; 'Lisa Holder'; jason.holt@adp.com; eronsenberg@advrep.com; biinfo@backgroundinv.com; robertk@castlebranch.com; tposey@corpsecure.com; cris.inc@comcast.net; jlopez@frasco.com; mharper@geninfo.com; hbrowning@openonline.com; amankoski@pre-employ.com; jon@publicsafetytesting.com; Tyson Poso'; 'Robert Keller; 'Ryan Holman'; 'Erika Prizzi' Cc: 'Kari Olson' Subject: RE: RFP - Background Screening Services *ADDENDUM #2* ADDENDUM #2 Question: On the Proposed Fee Schedule, is item 5 Federal Criminal History referring to an individual federal district for federal level crimes, or does it refer to a general nationwide criminal history database? Answer: We are looking for the nationwide criminal history database search. 2 Have a nice afternoon! Thank ycu. Kariann Kariann Olson Purchasing Representative City of Ashland 90 N. Mountain Avenue Ashland, OR 97520 Tel: 541.488.5354 Fax: 541.488.5320 TTY: 800.735.2900 kari.olsonPashland.or.us Visit the City's web site at: www.ashland.or.us This email transmission is official business of the City of Ashland, and it is subject to Oregon Public Records law for disclosure and retention. if you have received this message in error, please contact me at (541) 488-5354. Thank you. From: Kari Olson [main o:kari.olsonCa~ashland.or.usj Sent: Thursday, November 13, 2014 5:22 PM To: 'Kari Olson'; 'Lisa Holder'; ja os n holt ado com; eronsenberg~aadvrep.com; biinfoCdbackgroundinv.com; robertk(@castlebranch.com; tposey@cornsecure.com; cri .inc@comcast.net; jlopez0frasco.com; mharperLa4eninfo.com; hbrowninq@openonline.com; amankoski@pre-employ.com; jon@publicsafe estinq com; Tyson Poso; 'Robert Keller' Cc: 'Kari Olson' Subject: RE: RFP - Background Screening Services *ADDENDUM #1* ADDENDUM #1 Question: What is the approximate number of background investigations you would anticipate ordering in 2015. Answer: To date the City has requested approximately 100 during the calendar year 2014. The City is anticipating a much higher volume as they consider adding background screening for all volunteers. If the City is able to secure reasonable fees, the City will likely double or even triple the number of background screenings conducted. Additional information: A request was made for a copy of the 2012 Evaluation Summary, which I have attached. If you have additional questions and/or requests for information, please email me. Thank you. Kariann Kariann Olson Purchasing Representative City of Ashland 90 N. Mountain Avenue Ashland, OR 97520 Tel: 541.488.5354 Pax: 541.4S8.5320 TTY: 800.735.2900 3 ka ri.olson@ashIand.or.us Visit the City's web site at: www.ashland.or.us This email transmission is official business of the City of Ashland, and it is subject to Oregon Public Records law for disclosure and retention, if you have received this message in error, please contact me at (541) 488-5354. Thank you. From: Kari Olson [mailto:kari.olson(&ashland.or.us] Sent: Friday, November 07, 2014 3:23 PM To: 'Lisa Holder'; jaaon.holt.@a adp.com; eronsenberq@advrep.com; biinfa backgroundinv.com; robertkOcastlebranch.com; tp, Qsey corpsecure.com; cris.incftcomcast.net; ilopez0frasco.com; mhar er geninfo.com; hbrowning0 openonline.com; amankoski pre-employ.com; ioncftublicsafet_y-testinq.com Cc: 'Kari Olson' Subject: RFP - Background Screening Services *Due date 2:00 PM (PST), Thursday, December 4, 2014* Hello, The City of Ashland is now accepting proposals for BACKGROUND SCREENING SERVICES. The Request for Proposal (RFP) is attached for your review and consideration. Proposals are due prior to 2:00 PM (PST) Thursday, December 4, 2014. If you have any questions and/or need additional: information, I will be the sole point of contact for this solicitation. Questions and/or requests for additional information, will need to be requested by 5.00 PM Wednesday November 19, 2014 (prior to Thanksgiving week). If I receive questions and/or requests for additional information, the questions and answers will be provided to each of the prospective proposers in the form of a written addendum. *IF YOU COULD PLEASE CONFIRM RECEIPT OF THIS RFP VIA EMAIL, IT WOULD BE GREATLY APPRECIATED.* Have a nice afternoon! Thank you. Kariann Kariann Olson Purchasing Representative City of Ashland 90 N. Mountain Avenue Ashland, OR 97520 Tel: 541.488.5354 Fax: 541.488.5320 TTY: 800.735.2900 kari.olson(a)ashland.or.us Visit the City's web site at: www.ashland.or.us This email transmission is official business of the City of Ashland, and it is subject to Oregon Public Records law for disclosure and retention. If you have received this message in error, please contact me at (541) 488-5354. Thank you. 4 The Pinnacle o Hire Knowtedoe. GIS Response to City of Ashland Request for Proposal CITY OF ASHLAND December 4'~, 2014 Submitted by:' MarineU Harper I Sr. Vice President/Sales Email: mharper@geninfo.com office: 800.369.3640 ext. 4012 cell: 214.457.9856 ;xi'F December 4, 2014 Kariann Olson, Purchasing Representative City of Ashland 90 N. Mountain Avenue Ashland, OR 97520 Dear Ms. Olson: On behalf of our CEO, Raymond Conrad, I would like to thank you for the opportunity to submit our response to City of Ashland's Request for Proposal. We strongly believe this response will show you why GIS has been the leading provider of workforce risk management solutions for 48 years and continues to see impressive growth of our product line, client base, and industry standing. We have put together a response for City of Ashland that details how our level of technology and employment screening expertise will improve the return on investment and the effectiveness of your screening program. We believe we can provide City of Ashland with a screening program that works to mitigate risk and maintain compliance without disrupting existing processes. As you review our response we would like to point out a few key differentiators that make GIS standout such as: • Dedicated Account Management • Customized Management Reporting • Regulatory Compliance • Non-Employee Screening - Vendor/Contractor and Volunteer Screening Program We look forward to continuing our conversation with City of Ashland and ultimately hope to be chosen to provide the highest level of service found anywhere. Our clients have given us continuous recognition throughout the years, and our longevity and retention rates are a testament to GIS' mission. Please feel free to contact me with any additional questions. We look forward to having the opportunity to continue showing the difference working with a true program partner can bring to your workforce management program. Sincerely, Marine[[ Harper, Senior Vice President of Sales General Information Services, Inc. Office: (800) 369-3640 Ext: 4012 Cell: (214) 457-9856 Email: mharper@geninfo.com General Information Services, Inc. (GIS) R C ' Table of Contents Introduction ...........................................................................................................................................................................4 How We Measure Success as an Organization ...........................................................................................................7 Solution Overview ..............................................................................................................................................................8 Background Screening Services .......................................................................................................................................9 Federal and State Compliance Services 23 Online System for Ordering Background Checks 25 Background Check Integration Expertise ....................................................................................................................30 Implementing Your Account 32 What You Can Expect Beyond Implementation (Our Very Important Differentiators) 34 Dedicated Account Management 34 Initial and Ongoing Training 34 Customized Management Reporting .......................................................................................................................34 The Most Current Regulatory Update Information and Guidance 34 Disputes Resolution Service for Your Applicants 35 System Customization/Viewing Rights/Hierarchy Changes ...............................................................................35 Background Check Adjudication and Score Change Process Management ...................................................36 Protection of Your Personal Information 36 Conclusion 36 General Information Services, Inc. (GIS) RFIQ... Introduction GIS has been helping companies of all sizes and in all industries mitigate risk and hire smarter since 1966. Our solutions were designed to help employers revolutionize their hiring processes in ways which translate to a real return on investment. We have focused on developing solutions which reduce the need and costs to engage multiple vendors. All of the following services fall beneath our umbrella of expertise: • Full-service Background Screening with Adverse Action and Disputes Resolution • Comprehensive International Screening background screening with data privacy guidance • Federal and State level guidance with regard to legislative requirements • Fingerprint scheduling and facilitator services • Substance Abuse scheduling, testing and reporting • Medical and Wellness scheduling and testing services • Industry specific package design and technology • Business / due diligence screening services • Vend or/Contra ctor/VoIunteer screening • Talent Acquisition with applicant tracking and onboarding • Ongoing Criminal Monitoring Service • Ongoing Credential and License Expiration Monitoring • 1-9 and E-Verify automation tools to keep you 100% compliant 0 Tax credits and Incentives to help you document and collect on state and federal tax credits General Information Services, Inc. (GIS)*~~ GIS' headquarters are located just outside the capital city of Columbia, South Carolina in Chapin. Our headquarters campus is the site of the majority of our operations, and is serviced by the majority of our 675+ employees. Over 15% of our employees are classified as IT and development personnel and they do work onsite at our locations. We have multiple account managers and maintain additional sales offices located throughout the country to meet the needs of our nationwide client base. GIS also provides services from our Western Operations Center in Dallas, Texas. This office helps facilitate account management and workflow of employment, professional licenses, education, and other standard background screening to service the nationwide locations of our clients. The Dallas operation center also serves as our redundant site should an emergency situation ever occur at our Chapin headquarters. SAFEIIr1RBOR Now, We are a company that is rich in diversity of our expertise when it comes to client relations, program compliance, technology, and security. Although we offer a wider scope of organically developed products and services than our peers in the industry, we do not offshore or outsource any part of the development or support processes involved with providing our full range of services. All of our development, operations and client support are handled by employees who are directly employed by GIS at our two locations in the United States. Our no off-shoring rule is one that envelopes your entire program with the added security of knowing that you are getting exceptional products and services without creating a vulnerability when it comes to the personally identifiable information that you (or your end-users) are responsible for keeping safe from exposure. As a result of our no offshoring policy and security protocols, GIS has never had a data breach in the entire history of our company. GIS is also a founding and accredited member of the National Association of Professional Background Screeners (NAPBS) and achieved accreditation status in May 2012. The NAPBS was started in 2003 by leaders in the background screening industry to help establish and promote ethical business standards and practices, to promote FCRA compliance, to foster awareness of issues related to consumer protection and privacy, to advocate our industry needs to legislators and to provide an education forum for NAPBS members. Since the creation of NAPBS, membership has gone from a handful of background screening industry members to over 900. In recent years the NAPBS decided to establish a Background Screening Agency Accreditation Program (BSAAP). As of October 2014, there are less than 55 accredited organizations meaning less than 6% of all background screening companies are NAPBS-accredited. The accreditation program was established to ensure that employment background screening companies follow high standards in dealing with background checks and personal data. To be accredited, background screening companies have to voluntarily apply for accreditation. After applying, the background screening company f~ General Information Services, Inc. (GIS) 0r,Ci,.,.,:, C must meet or exceed the expectations of a rigorous onsite audit, conducted by an independent auditing firm, of its policies and procedures in six critical areas: • Consumer protection • Legal compliance • Client education • Product standards • Service standards • General business practice In addition, we are also a Safe Harbor member in accordance with all requirements to meet the European "adequacy" standard for privacy protection. As a Safe Harbor member, GIS complies with the seven safe harbor principles of Notice, Choice, Onward Transfer, Security, Data Integrity, Access, and Enforcement. General Information Services, Inc.'s (GIS) company information is as follows: Address: 917 Chapin Road Chapin, South Carolina 29036 Telephone: 1.888.333.5696 Fax: 1.803.932.2306 Website: The contact information for the GIS representative is: Marinell Harper, Senior Vice President of Sales Office: (800) 369-3640 Ext: 4012 Cell: (214) 457-9856 Email: General Information Services, Inc. (GIS) F s a How We Measure Success as an Organization Any organization with the right technology and a competent sales force can achieve success through gaining new clients but we firmly believe that the true measure of an organization's success in all areas of operation beyond the sale (implementations, training, customer support, and technical support) is best shown through how well they keep the clients they already have. GIS uses Key Performance Indicators to measure our success and to identify areas needing improvement: • UPTIME: Our system has 99.9% availability with a scheduled maintenance window of four hours per month. This window occurs in non-peak production hours and typically only causes intermittent loss of availability in the maintenance window due to our extensive use of redundancy and load balancing technologies. • ACCURACY: We conducted over 19.5 million screenings in 2013 and our error rate was 0.016%. This metric was derived from the total disputes researched that resulted in a change compared to total background screening components processed. • TIMELINESS: GIS' approach to staying competitive with regard to time service is to be both high tech and high touch; we use a combination of internal process automation efficiencies and hands on management to ensure timely turnaround for our clients. • GOVERNANCE: One of GIS' core competencies is our customer-focused account management philosophy. As we believe in true partnerships with organizations versus mere vendor-and-client interaction, we will work with you from day one of the relationship to ensure that your voice is heard and your screening program matches your organization's unique goals and objectives. We have dedicated account teams, direct access to executive management and after-hours support, all to ensure we operate with a genuine sense of urgency. This has led to our 97% client retention rate. General Information Services, Inc. (GIS) RF44~!ff, Solution Overview GIS is a leading provider of comprehensive background screening solutions, processing over 19 million screening components annually. Our platforms and services are the result of our emphasis on technological innovation and client feedback, and they feature industry-best practices and processes. We also deploy customized workflows and account-specific guidelines to ensure your screening program matches your organization's specific goals and objectives. The major factors in determining which background screening program is right for you are heavily based upon: • What group of people you will be running background checks on? • What the purpose is for running background checks on these individuals? • What (if any) other platforms you may need to have integrated with your GIS background screening program? GIS' proprietary web-based screening technology for submission and retrieval of background reports offers a single-point solution for all your screening needs plus consolidated reporting, twenty-four hours a day, seven days a week access and real-time status updates. This enables you to make informed decisions faster. Furthermore, this web-based solution does not require the installation of any software. Our clients access this system directly online or via integrations with ATS', HRIS' or other third-party platforms. GIS has previously integrated our background screening solutions with a wide range of third-parties in a variety of different methods. The platform is HR-XML certified, which means we are often able to integrate with other platforms which use HR-XML standards with relative ease. Additionally, through our strategic drug screening partner (eScreen) and the single-sign on integration we have with them, we provide drug screening results as part of the completed background report. 777, General Information Services, Inc. (GIS) ~tf Background Screening Services We provide the full spectrum of screening services, including international background screening and verifications in any country where it is legal to obtain information for employment screening purposes. We have the coverage and depth to exceed the needs of any organization, regardless of workforce, location, size, or organizational structure. We will also work with you to offer the best-fit submission and reporting method for your organization, whether it is through our online system, fax, batch interface, IVR, or integration with your ATS, HRIS or home-grown system. Criminal Background Investigative Procedures Our criminal screening solutions give you the confidence and resources needed to protect your organization from financial and reputation risks associated with negligent hiring, internal theft and unsafe working environments. When a record is located, GIS will provide you the following information in an easy to read format: • Level of the record • How the record was verified (name, address information, DOB, and/or DL • Case number • Offense • Disposition and disposition date (where applicable) GIS can provide criminal history reports on a county, state and federal level. Our standard for these reports is to search directly in the court records for the locations where the felony convictions are maintained, thus obtaining the most recent criminal information available. If misdemeanors are maintained in the same index, GIS will automatically report those as well. If misdemeanors are required but indexed separately from the felony convictions, GIS will also search the court location that maintains the misdemeanors. GIS will search the courthouses based on the applicants current and previous residential, work history and/or education history addresses over the period of time you specify and report information available for the past seven years for each address, unless you desire that we go back further. The addresses searched are based on the client criteria: whether they want work history/education history locations, current and/or previous, as well as whether GIS should develop names from additional services available (i.e. Name and Address History, Trace and Credit Report). VeriCourt GIS has developed automated online court interface search technology to allow the instant ordering of county criminal searches in over 1,100 jurisdictions, which significantly speeds time service of these searches and positively impacts the quality of these searches as well. Our VeriCourt technology is not database search technology; it provides real-time direct access to criminal history records using an online interface with the courthouses and jurisdictions that have the capability to provide online access to their records information. General Information Services, Inc. (GIS) RF011ffV~1_ By developing the technology to automate searches of online court interfaces, it eliminates a number of errors that are common with other background screening companies. Common errors such as searching the wrong jurisdiction, misspellings caused by additional data entry, flipping the middle name and last name and, switching numbers in the date of birth are now a thing of the past. Where there is no online access due to limitations at the jurisdiction level, we send one of our more than 800 researchers on the ground to the appropriate courthouses to conduct the investigation in person. It is also important to note that whether a record is retrieved via our VeriCourt search process or via one of our court researchers that physically accessed the record in the court house, ALL of these reports are reviewed by an individual in our quality assurance department. GIS is currently the only major background screening provider that does a quality assurance review of every report, rather than a random selection of reports that have been processed. We also use the services of our nationwide network of over 800 court researchers to complete physical research and verification of court records in areas that are not accessible via an interface or in areas where we believe a physical search will be a higher quality search (e.g. if our automated interfaces will not access all of the years of data we need to research, we would typically opt to send one of our court researchers to physically conduct the search on site). We solicit the assistance of additional and back-up researchers in high volume areas in order to allow for timely completion of multiple reports. One of the key factors in our ability to establish relationships with court systems is our longevity and integrity in the industry. We use field researchers on a contractor basis to maximize flexibility. On site searches are performed by court researchers who research name and provided identifiers via a public access terminal, ledger books, microfiche, name card file or a combination of the above to fulfill a search of at least seven years. Criminal History-County Level 1 hour - 3 business days As one of the most accurate source for uncovering criminal records, county criminal searches return information from the courthouse records in which the conviction is recorded. If a felony or misdemeanor charge exists for an individual, a county criminal search is where the record is most likely to be filed. Our network of field researchers physically research courthouse records in county seat courthouses across the United States. County criminal searches go back a minimum of seven years and include felonies and misdemeanors where applicable. Criminal History-Statewide Level Varies due to state court limitations A statewide search will yield information for all counties in a given state, as long as the state's repository is being updated on a regular basis. This type of search is helpful if you want to sweep the entire state looking for any criminal history information that is available regardless of where an individual has lived or worked. However, some states aggregate all of their county criminal records into a "statewide repository." If available publicly, these repositories can be searched for statewide criminal history information but escalation rate of records up from the county level is sometimes quite slow. Therefore, in our opinion, the General Information Services, Inc. (GIS) F L use of the state level criminal history search should not preclude the use of a county-level search since statewide searches may sometimes fail to return all of the information that is available. Criminal History-Federal Level 1 hour - 3 business days A federal criminal search is conducted in a federal courthouse in much the same way as a county criminal history. Crimes reported in a federal criminal record include only those offenses that are violations of federal law (and therefore federally prosecuted) as opposed to local and state law. Each state has at least one US District Court, while others are divided into as many as four. Federal violations will generally not appear in either a county or statewide criminal check. Offenses can include kidnapping, drug trafficking, interstate transportation of stolen goods, bank robbery, and embezzlement. GIS has online court interfaces installed for all federal courts, allowing us to access information related to federal level crimes faster. KwikScreen National Criminal Conviction Database Instant for Clears, 1 hour - 3 business days for Hits KwikScreen is an exclusive offering of GIS and contains more than 500 million criminal records from 1,080 sources at all jurisdictional levels, which makes it the largest database of its kind in this industry. Along with checking criminal history records at the county, state and federal levels, KwikScreen also includes sex offender information from all states, and the largest list of. national security sources available. Clients with a strong desire to exercise deep diligence in screening their prospective employees for criminal history information will typically utilize KwikScreen in conjunction with a county criminal check. To control the cost associated with running two criminal history checks, KwikScreen and the county check can be configured within our system to run progressively so that a standalone county criminal check is only ordered if KwikScreen does not return a hit. Clients who wish to cast the widest net for information but also remain cognizant of cost are often in favor of the progressive screening approach. In the continued effort to provide the most comprehensive national criminal database in existence, we actively seek and collect all our data ourselves rather than purchasing the data as many of our competitors do. The Data Acquisition Department is dedicated to a four to five day turnaround time with our data. That means that within five days of receiving a data file from a source, our KwikScreen-dedicated IT team has loaded, tested and updated the data in our criminal records database. Because of this turnaround, new information is available up to 75% faster, providing you the most updated resources possible. We also continue to implement risk mitigation processes into our daily procedures, to ensure that any expunged or sealed records are removed from our database. Please reference the KwikScreen seven year growth chart below: General Information Services, Inc. (GIS) c Number of Records (Millions) 2008 2009 2010 2011 2012 k' 2013 2014 0 100 200 300 400 500 NOTE: Per the FCRA, all hits found in KwikScreen are validated at the source. Ongoing Criminal Monitoring through KwikScreen Instant for Clears, 1 hour - 3 business days for hits This service can only be performed on current employees who have been screened through KwikScreen previously. GIS will automatically conduct a KwikScreen search on your employees and only report back to you if there is a change in criminal conviction status. In the event there is a new "hit" found on the employee, GIS will conduct a jurisdiction validation to ensure the record does belong to the individual and to comply with FCRA and other regulatory guidelines. You are only charged for the validation of the hit and any applicable pass thru fees associated with its validation. Our ongoing criminal monitoring helps our clients track ongoing developments, keeping their workforce safe from criminal activity. This search requires that your employees sign an evergreen authorization, allowing you to screen them on an ongoing basis. Sex Offender Registries (National) Instant for Clears, 1 hour - 3 business days for hits This search is provided as part of our KwikScreen National Criminal Database solution or it can also be ordered as a standalone search. For the state of Nevada, which has disallowed the use of their state sex offender registry database for employment screening purposes, GIS' dedicated data acquisition team has developed sources at the county level to acquire data on sex offenders within that state. In addition, GIS has created a special Year of Birth search mechanism to acquire data from sources that only provide information in this format. Details in the report include: identifiers, registered addresses, aliases, case numbers, charge(s), conviction details, and period of incarceration. -71 General Information Services, Inc. (GIS) - ~m Other Searches Included in KwikScreen Along with over 500 million criminal conviction records found at the county, state, federal levels, and sex offender registry information. KwikScreen also includes 1 02 national security searches which include (but are not limited to) Terrorism Watch lists, Interpol, OFAC Specially Designated Nationals List, OIG (Health and Human Services Exclusion List), United Nations Consolidated Sanctions list, and various others lists related to the US departments of Commerce, Labor, State, and Treasury. Upon execution of a Non- Disclosure Agreement, GIS can provide you a full list of the sources included in our proprietary KwikScreen search. Substance Abuse Testing and Wellness Services 8-15 minute negatives, 2-5 days for positives As an important component of an effective employee screening program, GIS offers a single-source background screening and drug testing program. We can integrate with an organization's current drug testing provider or customize a program through one of our preferred vendors, providing cost-effective solutions that best fit your needs. We offer national coverage in convenient drug testing locations, comprehensive SAMHSA-certified laboratory testing, MRO review of all positives, simplified invoicing, paperless chain of custody, and multi-panel options. We also offer DOT compliant programs. The MRO appeal process allows any donor to challenge a positive result. The donor will be required to pay for the second test of the specimen. Upon receipt of the payment the MRO will submit the specimen for a second test to another SAMHSA certified laboratory. The donor will not be able to provide a second specimen; all additional testing will be done with the original specimen provided. In some states, such as Maine, the donor is allowed to ask the collection facility to split the specimen before shipping. Fingerprinting Federal submittal - same day, state - varies. We can provide multiple options to include LiveScanning, ink-rolled/wet fingerprinting and utilization of third-party occupational health networks. This includes entire program management including importing processes to such as adjudication, applicant pre-registration, scheduling, fingerprint disposition perfection and more. Additionally, GIS is capable of assisting with state fingerprint requirements. As a non-channeler we have partnered with Accurate Biometrics, Cogent, Daon, and MorphoTrust to provide total services where allowed by state and federal law. International Background Screening Time Service Varies Greatly by Country GIS has an International Screening division which specializes in the extensive country-specific requirements of screening applicants outside the United States. We provide the full spectrum of available background screening services in all countries where the data can be legally obtained for employment screening purposes. Much like our domestic capabilities, GIS' International Division provides web-based order and retrieval of background screening results for international searches. Below are the various international screening products we offer. • International Criminal History Search General Information Services, Inc. (GIS) RF1 for Cftr, C • International GlobalWatch Limited Criminal Search • International Education Verification • International Employment Verification • International Professional License / Credential Verification • International Reference Check • International Negative Press/Media Search • International Passport Verification • International MVR / Driver Abstract • International Credit Report • International Civil History • International Bankruptcy Check • International BUSINESS Civil History • International BUSINESS Bankruptcy • International BUSINESS Credit History • International BUSINESS Affiliations Search • International BUSINESS Government Affiliations Search • International BUSINESS Registration Search • International BUSINESS Sanctions/ Regulatory Search Our International Screenings Division is managed centrally from our headquarters location in South Carolina. GIS' International Screening Department has a team of experts in the areas of conducting background searches, due diligence investigations, document verification, and employment and contractor screening. Our experts utilize a multitude of media, legal publications, employment law, and privacy subscriptions to stay abreast of changes in the data privacy sector around the world. Additionally, we have vendors in strategic global locations, which help keep us up to date on cultural and legal changes in the areas where they are located and service. GIS maintains compliance with country-specific regulations/laws with regular review of any updates of related legislation that may impact the application of the laws. GIS utilizes various legal compliance resources to assist with data privacy/protection laws in each country. GIS regularly monitors new and emerging country legislative activity where data protection/privacy laws are not yet in place. In addition, we partner with NAPBS international members to form strategic partnerships to assist with regional global presence to assist GIS with local country data privacy regulations and/or new legislation that may impact day to day operations and processing of personal information across international borders. GIS also invested in a special tool called DataGuidance, which aggregates an incredible amount of information and analysis on laws across the globe governing employers. DataGuidance features whitepapers written by attorneys who practice in the countries represented in DataGuidance. These whitepapers not only explain the purpose of the laws but they also explore the application of the laws given the role of the reader (i.e. employers or employer processors such as GIS) Beyond the special analysis by their panel of expert attorneys, DataGuidance also provides news alerts that are relevant to specific laws, specific countries and any known penalties experienced by employers who have failed to comply with regulations. It is our experience that foreign employment laws inspire just as many General Information Services, Inc. (GIS) Rff-~, interpretations as U.S. employment laws, so it is helpful to have access to expert opinions and analysis from abroad when we are advising our clients on the permissibility of employment screening restrictions. GIS modifies our processes related to information collected and authorization forms used per country when legislative activity related to data protection and privacy occurs. We ensure that these changes are reflected in the standard operating procedure documents used to manage day-to-day activities related to providing background screening results to our clients. In addition we have developed proprietary tools which aggregate important legislative information, and present it to our clients in an easily understood manner. For instance, for clients with global background screening concerns, we developed our International Screening Resource System (ISRS). ISRS features information on important legislation and required forms for processing background checks, all searchable via an interactive world map: http://www.gis-internationaiscreening.com/Default.aspx vltull% IM ill, s aFf F-..,.;.e t• tier ~ T~so-. Isis s I As ......r ...i...a a«,.1..-+ y . ~ lpwAfy W •t~~dR IuY^'.M tlxJlit~tSi'pgWYlBSSi0ai- t i - ,w r All Social Security Number Validation Instant Results SSN Validation searches the Social Security Administration (SSA) database to identify any irregularities that may exist in association with the SSN provided. Validation of an SSN enables employers to identify whether a Social Security Number exists within the SSA database and if the SSN is still valid and not found in the SSAs Death Master Index File. The year and state of issuance are also identified by this search. If the date of birth is provided, GIS can verify SSN accuracy based on the year of issuance. Our system can assign a score for client adjudication to any SSN irregularities. Examples of this include an SSN reported as not having been issued (which may indicate the applicant supplied an incorrect SSN), or that the SSN is reported as owned by a deceased person (listed on the SSA Death Master Index). `T General Information Services, Inc. (GIS),~ Credit History Report Instant Results Using an individual's name, Social Security Number and residential address, we will return all names and addresses found to be associated with the SSN and will include highest credit extended, past due amount, credit limit, average monthly payment information, balance, and percentage of available credit. A summary of public records is also provided and may include civil suits, judgments, bankruptcies, tax liens, and collection amounts. Our system can assign a score for client adjudication to a credit report based upon criteria that we work with you to define during account set up. Additionally, point values can optionally be assigned to relevant criteria with the total "score" determining the decision. Please reference the following examples: • Tax lien(s) outstanding within range $N and $N • Tax lien(s) totaling $N or more, and presently outstanding • Child support payments totaling $N or more • Collections totaling $N or more • N or more collection accounts • Garnishment on earnings within last N years(s) totaling $N or more • Garnishment on earnings within last N year(s) • Outstanding civil judgments totaling $N or more • Past due balances totaling $N or more • Revolving Debt Available not greater than N% • Total of charge off amounts $N or higher • Applicant SSN does not match SSN on file • Applicant name and name on file do not match • Applicant address does not match last known address on file • Applicant credit report indicates existing medical payments or collections • Applicant credit report lists two or more medical transactions • Applicant credit report indicates medical-related civil judgment • No credit information found on applicant GIS monitors all state specific regulations which apply to both our employer clients and us as a Credit Reporting Agency (CRA). Where a state limits the use of such information, our system includes special validation rules which prevent the reporting of credit information for employment purposes where it is not legal to do so. Civil Suits and Judgments-County 3-5 business days Civil history records provide information about claims, suits and judgments filed by individuals or corporations against other private parties or corporations at the county level. Examples of findings include divorce, product liability suits, violations of civil rights, judgments, nonpayment of goods, and other similar cases. Services, General Information f. Civil Suits and Judgments-Federal 2-3 business days Federal civil records are searched at an appropriate US District Court. Cases are typically related to interstate commerce, violation of civil rights, issues involving the Federal government, financial institutions, etc. 100% of Federal Districts currently have docket records accessible electronically. Bankruptcy Reports 1 -2 business days A search for any bankruptcy associated with an applicant that is recorded in the specific US District Court. Information returned may include: case or file number, date filed, type of bankruptcy (Chapter 11, Chapter 7, etc.), discharge date, and name(s) listed as petitioners. Workers Compensation Incidents Varies by state availability GIS can research a state's repository for information (where available) to include name, date and types of injury. In addition, many states also provide additional information ranging from the case/claim number to specific insurance information including name of insurance carrier and payment methods. Motor Vehicle Record Reports Instant in 40 States The GIS MVR search can help you identify applicants with a history of reckless behavior, driving while intoxicated and may indicate individuals with substance abuse and other behavioral problems. GIS covers driving records in fifty states plus Washington D.C., providing instant results in forty states. A motor vehicle history for the state in which the individual holds a license is necessary for those who drive company vehicles or for those who drive their own vehicles on company business. States differ in the information provided, but the average history is available for three to seven years. GIS provides all variations of driver history including CDL, Non-CDL and CDLIS. Non-CDL driver's licenses, we provide the following information in the report: • Name searched • State searched • Demographic information as provided from the DL (to include sex, weight, height, DOB, hair color, eye color, etc.) • License information (to include license class and class description, issue date, expiration date, status (valid, invalid), and any applicable restrictions) • Miscellaneous and state-specific information (license status, license class, description, and whether the applicant had a previous license) RAP General Information Services, Inc. (GIS) ~F F i • Driving Record Information (will list any violations or suspensions to include date issue happened and date of conviction, the, violation/suspension code, description, and the number of points against their license) For CDL driver's licenses, we provide the following information in the report: • Licensee name • License state • License number • Issue date • Expiration date • License status • Any accidents or violations (to include type, violation suspension date, conviction date, violation/suspension code, number of points against the license, and vioIation/suspension description) • Miscellaneous and state specific information (to include name, DOB, license number, CDL class, issue date, expiration date, and any special clearances, issuances, or restrictions) CDLIS, Commercial Driver's License Information System Report CDLIS allows employers and their agents to comply with FMCSA requirements by searching within the "Commercial Driver's License Information System" for any prior licenses, current CDL and up to three prior licenses held by said individual. This service provides users with: • Present Jurisdictional State and Driver's License Number • Name • DOB • Social Security Number Match • Up to three Previously held CDL Numbers • AKA Information Mandated by the Commercial Motor Vehicles Safety Act (CMVSA) of 1986, CDLIS supports the issuance of commercial driver licenses (CDLs) by the jurisdictions, and assists jurisdictions in meeting the goals of the basic tenet "that each driver, nationwide, have only one driver license and one record" through the exchange of commercial driver information between jurisdictions. Whether or not the CDL reports show previous driver's license information is dependent on the state. In the event the state does provide previous driver's license information, the details are disclosed in the background investigation report provided by GIS. We can flag CDL MVRs with less than five years driving history, as we maintain an updated list that discloses the number of years a driving abstract/history is available for that state. We can also work directly with the state or with our TPA to request information from additional years in some states where extended histories are needed by the client. General Information Services, Inc. (GIS),.-,.. • NOTE: GIS also has the capability to accept large batch requests for annual MVR report requests. This service provides our clients with large fleets of vehicles and drivers with the ability to reduce risk to their organization and others by consistent monitoring of their driver employee population. Results can be provided as they become available or via batch file when all are complete. Driver Qualification File (DFQ) Tool According to DOT regulations, each motor carrier must maintain a Driver Qualification File for every driver it employs. Staying on top of updates and renewals can be a tedious and time-consuming task, making GIS' DQF component a valuable resource for achieving compliance. We save our clients time and money by transitioning them from traditional paper-based filing systems and Access databases to a web-based electronic file management system. The Platform is completely customizable, allowing client users to define what types of forms they want to manage and how long each form should be retained. Forms can be added, tracked and manipulated with ease. The system can send reminders to designated client users that renewal deadlines are approaching and will even verify the updated credentials. By helping you track license and renewal reminders, GIS' Pangea for Transportation platform is the ideal system to streamline your process and boost your compliance. GIS' Driver Qualification File features: • Automated notification to you or to your employees of approaching renewal deadlines • Configurable time frames for the notification and the reminder notifications • Secure, online submission of updated license information • Capability to upload credential documents • Quick turnaround on verification for updated information • Dedicated account manager and follow up processes to ensure compliance is achieved Educational Verification 1 -3 business days GIS will confirm an individual's education by contacting the appropriate institution(s) in order to verify dates of attendance, degree(s) received and if any honors were attached to the degree. If the school uses a third-party administrator to manage graduate information, GIS will work with the appropriate third- party data administrator to acquire the information needed to verify an individual's education history. If the school uses a third-party administrator to manage graduate information, GIS will work with the appropriate third-party data administrator to acquire the information needed to verify an individual's education history. We will communicate with your applicants to clarify or obtain missing information to speed the process and provide time stamped status notes in the system to let you know how verifications are progressing. General Information Services, Inc. (GIS),Rf ~forg Employment Verifications 1-3 business days Employment Verification is a check of previous employers' records during an individual's employment tenure. Information obtained via interview includes, but is not limited to, dates of employment, job position, reason for leaving, and eligibility for rehire. GIS also provides in depth DOT compliant checks of previous employer's records and conducts interviews with past supervisors/co-workers to obtain a comprehensive evaluation of work tenure, work history, capabilities, and driving history. GIS can also work with you to customize a specific question set to use in the interview, or can provide you with a standard question base already utilized by our verifications team. For Non-DOT Employment Verifications we will return the following information on the report: • Employment Dates • Position Held • Ending Salary • Reason for Leaving • Eligible for Rehire • Answers to any client specified questions For DOT Employment Verifications we will return the following information on the report: • Did the employee have an alcohol test with a result of 0.04 or higher? • Did the employee have a verified positive drug test? • Did the employee refuse to be tested? • Any other violations of DOT drug and alcohol testing regulations? • Did the previous employer report a drug and alcohol rule violation? • If positive answer to these questions, return-to-duty process completed by employee? • Answers to any client specified questions Professional/Personal Reference Check 1-3 business days We can contact business and personal references, confirming personal qualities such as dependability, integrity, character, and work ethic. Developed References may be obtained and used to cover periods of unemployment, self-employment, travel etc., which cannot be verified by other means. GIS' standard series of questions are customized to meet client question requirements. tic..... - - ~s.. ~ . - ~.la..~:~'. T 7'q 77, v, a. k n- _4 c c 4 am. General Information Services, Inc. (GIS)~W ~w. X t ~ 1 !l r . X X III X X X X X Cl 1111,11111! X X X X wr X Y~ 14 'r X jr X X R 1511 X X r r $s€, X X X . X Professional License Verification 1 -3 business days Based on the information provided by the applicant, we contact the appropriate licensing agencies and verify the type of certification, date of issuance, expiration if applicable, as well as comments, honors or actions related to the certification. Ongoing Credential and License Expiration Monitoring GIS can also check your employee's credentials on an ongoing basis. Once an employee is hired, their licensing documentation and the expiration date is supplied to GIS. When the expiration date approaches, the employee receives an email reminding them to renew their license/credentials. Once the credentials have been renewed, the new document and expiration date are submitted and a GIS researcher verifies the renewal. Additionally, because GIS monitors this on an ongoing basis, we will be able to inform you if any employee credentials have expired. There is a minimal monthly fee associated with this service in addition to the fee for the license verification. We manage this entire process through a proprietary technology which we developed to help our friends in the insurance and healthcare industries, however, Credential Management is a valuable tool for employers in any industry where keeping up with license or special credentials is necessary. Non-Employee Screening, VendorSAFE More than ever, businesses are using outside contractors and vendors to handle staffing flexibility issues. While it's easy to ensure that your vendors are running background checks, it's nearly impossible to ensure that the checks they are performing are up to your standards and come from a reputable background screening company. GIS offers a web-based platform that is specifically designed for companies that use a network of non- employee workers that represent the company. You simply work with us to design the screening program X7 r r * a; General Information Services, Inc. (GIS) c you want to implement and your vendors and contractors can then pay for their own background checks via credit card. This provides you with elevated compliance with no money out of pocket. Benefits of GIS' Non-Employee Background Screening Program: • Sponsoring companies incur no cost! • Screening packages can mimic the sponsor's company current screening packages that are used for full time employees. • Solution is 100% compliant with current background screening practices, reducing the sponsor company's liability. • Protects companies reputations by ensuring the affiliates that are representing the sponsoring companies are screened appropriately. • Program has no implementation charge and can be available in two weeks with sponsoring companies branding. • Account registration is fast, with vendors receiving a promo code that provides them with the sponsor company's pricing. Non-Employee Screening Program Features: • Customized landing page, branded to represent the sponsor company • 247 online access for request reviewing results • Client relations experts that provide support to sponsoring companies and vendors. • Certifications of Completion so that the sponsoring company will be able to ensure that an individual has undergone the required background checks. Pricing Information Please refer to for GIS' pricing. Additionally, please reference the following documents for applicable pass through fees and information: • For pricing on GIS' international screening services, please refer to General Information Services, Inc. (GIS) RF4.or C5 4 Federal and State Compliance Services Adverse Action Services GIs' systems and service have been designed to ensure total regulatory compliance. We take specific measures to comply with the FCRA as well as state consumer reporting legislation for all fifty states through our initial implementation procedures and through ongoing monitoring efforts. Where states limit the use of certain information for employment purposes, GIs' system is configured to prevent the reporting of such information. We have a full-service adverse action service we offer to handle the entire adverse action process for your organization. The diagram below illustrates the workflow associated with management of the adverse action process: Adverse GIs Reporter Alien Eerier concludes n, }yAn case Pre-Adve.se Action Le*e. GIs CIA reviews and or _ finalizes results #1 T Case to Client HR for review and grades in system assigned Individualized Assessment Program Individualized assessments are an optional add-on to our adverse action program and a nice GIs differentiator. The individualized assessment service is available for any client that has an employment screening program. Based on EEOC guidance every employer that does employment screening should have an individualized assessment program/process in place. We are one of a few companies with a service designed to help them comply with this portion of EEOC guidance. The EEOC's new guidance has suggested that employers need to think about what they can do for applicants that do not dispute the findings at all but want to explain why they should be hired anyway. By adding our Individualized Assessment Program to an adverse-action notices program, GIs' clients can give applicants a structured way to give that statement and the clients can have additional documentation for their own compliance purposes. Through our program, the employer can ask a variety of pre-established questions concerning any criminal offenses or they can simply offer the option of an open ended statement regarding the record and why the applicant should still be considered for the position in question. General Information Services, Using the Individualized Assessment Program does not lengthen your time to hire because applicants are notified within the pre-adverse-action notice and must provide their statements within the same timeframe they are given to dispute findings. To find out more about the EEOC's recent guidance, we suggest looking over the entire guidance closely and attending a GIS webinar on the subject. Managing Legislative Information In addition we have developed proprietary tools which aggregate important legislative information, and present it to our clients in an easily understood manner. For instance, for clients who wish to proactively seek information on US laws & regulations, we provide a special website we developed called backgroundscreeningregulations.com. This tool will endow your organization with an enhanced capability to maintain compliance in your hiring processes across all states. We also provide our clients with access to this valuable tool so they can use it as a quick reference for state-specific background screening questions, all searchable via an interactive world map. For more information about backgroundscreening regulations please reference the link below: htt s: backgroundscreeningregulations.com/ >i K«< 'tat* D*t_cttalll I S i4i f M w n.. - . ........ems-.. NO 3 Op AWOr F ~ 6 -R_.. 10 dim VIINEEPP" V°c General Information Services, Inc. (GIS) fL117K C Online System for Ordering Background Checks Our web-based platform provides a single-point solution for all your background screening, drug testing and fingerprinting needs. While we do follow strict standards to ensure compliance with the federal, state and global laws regarding privacy and the use of consumer data for employment screening purposes, our system design is not constrictive. We know that you have varying concerns and needs at your corporate, divisional or field location levels. We are here to help you protect your business from risk but we also feel obligated to ensure that our solution helps to simplify and improve user experience at all levels of your organization. Therefore, we offer a variety of submission options for you to consider: Your managers can enter applicant information directly online Your applicants can enter their own information using our applicant entry portal Your managers and your applicants can use our Pangea System We can integrate with your existing ATS/HRIS or other homegrown systems Your vendors can order and pay for their own screenings using our VendorSAFE portal We even offer IVR and Fax orders for any locations you have with no internet access. At a glance, here are a few quick benefits of our background check ordering system: No special software or hardware is needed; just an Internet browser We pre-configure the system with your approved packages and scoring criteria We can, where legal, automatically generate an initial score based on your criteria. The system documents all decisions related to scoring and the changing of scores Real-time results delivery; plus status notes from our reporters in the system Automatic generation of Adverse Action letters, including state specific notices Accommodating Multiple Users Our system is designed to accommodate any number of users. In fact, for larger national accounts, we have set up users for over 14,000 locations across the nation. Each user is assigned a unique user ID and password. During the implementation of your account, we will have training sessions on the system and can add as many users as needed. GIS will add new users to your account at any time and also provide training for new users on an ad hoc basis. Receiving Your Order When a background investigation is initiated via our online ordering system, our system automatically generates a unique case number and assigns it to the request. When the process of entering the request is complete, the user is notified on-screen that it was successfully submitted and the unique case number is provided. You can then use that case number for tracking the request at any time in the process. Score Reporting The platform features automatic scoring notifications where legal. We also have the capability to change the naming conventions to meet client needs. We will provide a score on each component of the background report and also on the report as a whole. Prior to implementation of your account, we will Information General x- r provide you with a template listing crimes and asking for your adjudication criteria. This will be done for each job class that involves significantly different risks. Your GIS implementation consultant ensures that your decision criterion is documented on your Customer Information Form (CIF). 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Pass j E c,•,Pass Pass E / do 5 R 1I Progressive Screening Functionality Progressive Screening allows our clients more control over the total cost of screenings ordered by arranging individual package components in tiers. We progress through the package in stages, the first of which typically includes instant searches which could be considered "red flags" according to your hiring criteria if adverse results are returned. Many clients include products such as the SSN Validation, Credit History and National Criminal Database in their first tier. If any of these receive an initial score of review or defer, then screenings arranged in your second tier are not ordered for that applicant. Provided the candidate does not receive an adverse decision in the first tier of screenings, then screenings in the second tier are ordered. Second tier screenings are typically those screenings requiring more in depth investigation such as drug screening and employment and education verifications. General Information Services, Inc. (GIS),RF. C Quality Review When all aspects of the investigation are complete, our Quality Assurance (QA) team then reviews the report. Every report that includes a hit is checked by our QA specialists for accuracy, completeness, and compliance with your investigative parameters. You are only notified that the report is ready to viewed after QA has reviewed it and deemed it acceptable based on the agreed upon standards. Results Delivery We will determine how you prefer to be notified when a report is complete prior to implementation. Most clients opt to receive an e-mail notification that includes basic information to identify the applicant as well as an overall score or hiring disposition. Additionally, we can include a link to the detailed report online. If you require notification of results in a different way, we will do our best to accommodate your request as long as it does not deviate from security principles established to ensure data privacy. Viewing Rights As part of your account set-up, we establish the number and division of sub-accounts you desire, enabling each user to be assigned a specific sub-account related to their location. GIS enables you to identify the level of viewing rights each of your users will have. This limits each person's ability to view reports to what they have authorization to see. Managers may view only reports that they have requested or all background requests from a certain department or location. You may also allow "super user" accounts, which provide access to see any report requested regardless of position, department or location. GIS can also establish security levels at any point in between. Documenting Decisions Reports which receive an initial score of "review" (per your approved adjudication criteria) will need to be reviewed by someone within your organization. All review cases can be sent to a regional office or wherever you need them to go. The person who reviews the report is responsible adjudicating the score based upon your own internal standards for making these decisions. Our system will record the history of the decision for you in case you ever need to look back to see how your organization arrived at the final score decision. User Access to Personal Information Our system can also allow certain users to order background reports and receive an email notification of a hiring decision but prevent them from being able to view the details of completed reports. Many companies are opting for this approach for field offices as an additional way of protecting the confidentiality of an applicant's information. We can also suppress or truncate date-of-birth and social security numbers in the reports you receive as an additional measure to protect personal information. Management Reporting Our system can provide you with twenty-four hours a day, seven days a week access to special reporting to help you manage your background screening program. For instance, we can provide you with an order summary that can be queried in a number of ways by the system user. Order summaries can be retrieved according to parameters that include: Applicant Info (Name, SSN) Requester Info (Name) Client Specified Reference (i.e. location or division numbers, cost-codes, etc.) General Information Services, Inc. (GIS) RJF1P f, . C Case/Work Order Number Dates Requested or Completed Within Time Range Reports Pending Final Decision Unviewed, Completed Background Reports Pending progressive ordering decision Complete, Incomplete or Supplement Pending Status Scoring (Pass, Review, Defer or Review, and Defer) Plus a variety of report sorting options GIS understands that each of our clients has specific program initiatives and organizational goals which will require even more specialized reporting. So we do provide customized reporting for you at no additional cost. In fact, we provide targeted information to analyze virtually any aspect of your screening practices by location, group of locations or all locations. Just tell us what type of reporting you need and we will set you up on a schedule to receive your customized management report on a regular basis. NOTE: GIS has begun the process of building advanced graphical data analytics into our background screening system. Our full data warehouse is being examined to determine what data will be available to pull in these reports and how the reports will display. This new reporting rr ii capability will soon be implemented on our model ft~fatttttt~ttt~ftlt~i~ftlft environment with full availability to clients coming soon thereafter. We firmly believe this new capability will take an area where we believe we have room for improvement and will elevate our capabilities in this area to be the best reporting available in the entire background screening industry. We believe the data we have available that will power this new offering is the highest quality in our industry, so our clients can know that this new reporting not only looks amazing but communicates amazing information as well. Some of the graphics shown to the right are examples of the kind of graphical business analytics we will be able to provide. Please note that these are in the early stages of construction, but by looking ` . at these capabilities, you can imagine this reporting ~h will be yet another game changer GIS brings to the background screening marketplace. Business Reviews Meetings GIS also understands that in addition to management reporting from the system and any customized reports, you will likely need in depth analysis of our performance as it relates to your background General Information Services, Inc. (GIS) IRFF ' C. a.a screening program. Our business review reporting is designed to answer the tough questions about our relationship: How have we performed as your provider? Have we met time service commitments? How much money have you really saved by using our services? What do you need to be doing to strengthen your program so that it is more efficient and offers you the best protection from risk? Your dedicated account team will provide the answers to these questions and more during your business review meeting. We offer quarterly or annual business review meetings; depending on your schedule, one or the other may work best for you. Just let us know what you prefer and we will make sure that we provide you with whatever information you need, right when you need it. 2,OO Monthly Completed Cases 12000 1911 j 1669 I 16061 i lc ,1455 _ 1481 11509 405 '1468 3467 .1493 1227 1270 11429ll X42 1143 1095 1181 -2012 10DO -.-2013 ? 807 i 3 500 0i--,--•--r- I Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Year • Quarter Quarter Quanef Total I 2012 3,220 4,085 3,990 5,073 16,368 Turnaround Times 2013 4,288 4302 n/a n/a 8,590 3 11 1.9 11 1.9 i 2.0 - 1.8 1.6 1.7 1.7 1.8 1.6 1.8 1,6 1.8 1.8 1.7 1.8 1.5 15 1.0 ■ 2012 i I n 2013 g D.0 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec GIS eLink Ordering Option GIS created eLink, an applicant entry option within our online ordering system that allows for recruiters to send an email link to an applicant. Upon receipt of the email invitation, the applicant will be able create a login and password to enter our system. Once logged into GIS' secure online application, the applicant will enter the required information such as name, DOB, address, SSN to complete the background check and electronically sign a release form using their mouse. All release forms are stored electronically within our online ordering system. For a demonstration of our el-ink option please reference the following link: httR://www.geninfo.com/d/`--elinkdemo.g-M General Information Services, Inc. (GIS) a.a Background Check Integration Expertise GIS is known for and has a long history of providing customized solutions for our clients to ensure operations are as efficient and effective as possible. Our systems were designed with the flexibility to integrate with ATS, HRIS, ERP, and client-proprietary systems of all types. We have standard integrations in place with many of the best-known systems including ADP, iCIMS, Taleo/Oracle, Kronos, Kenexa/Brass Ring, HR Logix, NowHire, PeopleAnswers, PeopleClick/PeopleFluent, Equifax Workforce Solutions (Formerly TALX), Towers Watson, several internal hiring systems, and many more. KeneXa pangea WMdeted ntWat.an l KRONOS CIMS 1 an IBM CumMnY ¢ T.Im (nir,,g use CWuA SR'YKO tt 2X fluent ~?17 C)PACLIEanuru I1kylesidt. Et v~Fax Vertafore vi r k d r: Taleo • I09*tR%WATT 4IN NOW NOTE: GIS is an Oracle Gold Partner and is validated for integration with Taleo Enterprise Cloud Service. Please reference the link to our page from the Oracle site: httpss:; /solutions.oracle.com/scwar/sc/Partner/SCPP-GENINFO.htmi Automating request/response information exchange completely eliminates any duplicate entry or additional work on the part of the client. We support secure exchange of request/response data exchange via Real Time or Batch. Real Time: SOAP web service with TLS encryption Authentication for security XML payload with support for transaction integrity Post-back service to send background check summary results to client listener service Call back service to retrieve PDF stream via XML Batch: Automated - SFTP/FTP-based PGP-encrypted file handling Manual upload - TLS encrypted secure site Authentication for security Transaction integrity support General • . S i.. '",e: 1 Summary results export/download PDF/TIFF Group 4 images for imaging systems Online: Secure authenticated remote access to a background report URL for a specific background report provided in both Real Time and Batch integrations Single Sign On web service available for automating online access to background report General Information • Y.. Implementing Your Account There is no room for literary embellishments when it comes to account implementation. We know that once you have decided on a solution, it is time for action. The key action items for implementation are listed below: Pre-Implementation - Phase One: Identify and introduce key contacts at GIS and your organization for project Identify and Finalize business requirements and develop statement of work Identify and Finalize accounting/billing procedures Develop training and implementation schedule Schedule Site Visit/Conversion Meeting Identify specific goals and outcomes of meeting Finalize and distribute site visit agenda Pre-Implementation - Phase Two: Site Visit Demonstrate internal processes Present Supplemental procedures Quality Assurance Process Review Compliance Process Review Demonstrate HRIS integration and user story (if applicable) Background screening ordering/reporting methods Explored Review background search criteria Finalize training and implementation approach and schedule Conduct User Training Implementation and Training As indicated in the pre-implementation checklist above, you will be fully trained on all aspects of the system and processes that will be rolled out to your users upon system implementation and training. Implementation can take anywhere from ten to thirty days, and the training time for requesters varies according to the size of your user group and methods used to execute training sessions. Of course, GIS will work closely with you during the pre-implementation phase to ensure the appropriate amount of resources and planning goes into creating the ideal timeline for your organization. When it is time to train your users we will send out an invitation to each group offering dates and times for training as well as a toll-free conference call number. Each participant chooses a date and time that works best with their calendar and confirms their attendance with GIS. At the beginning of each training session, GIS will take a roll call to determine who is present. At the end of each day, the appropriate team members will be notified of the attendees so that when a given groups rollout is complete, clients will be aware of those who were unable to participate in training. Make up sessions can then be scheduled to ensure compliance. General Services, s GIS provides each authorized representative a Getting Started Manual. This kit contains points of contact, how to interpret reports, delayed access areas, how to order backgrounds checks, FCRA and CFR compliance information, and will be customized to reflect the unique background screening program you have selected. Your Implementation Coordinator will review the Getting Started Kit with each of your users during the training sessions. Implementations managed by GIS follow the initial implementation plan approximately 75% of time. For the other 25% of the time, implementation plan timelines are extended often because of scope of work changes, modification to client business requirements, etc. General Information Services, Inc. (GIS)gf7io-76~177 i What You Can Expect Beyond Implementation (Our very important Di f ferentiators) Dedicated Account Management We do not mean "dedicated" in the buzz-word kind of way that most of our competitors are using it these days. When we say dedicated, we really mean it. All of our client relations representatives are directly employed by GIS, and we generally assign them according to relevance of their past experience to your industry. We have over fifty client relations experts with over 270 years of experience who work out of our two locations in the United States. Customer Service / Help Desk an ~ ♦ 4d M-F: 8:00 AM to 8:00 PM EST S: Support as Needed 3 S Hours of Operation 1 M-F: 7:00 AM to 12:00 AM EST 1 S: 8:00 AM to 1:00 PM EST Initial and Ongoing Training At GIS, we do not have levels of support that we offer as separate products for you to purchase. If you are using our services then you have got people who are ready to train your people - whoever, whenever - and with no fine print limitations or additional cost to consider. All GIS clients receive premium level support because that is the only level of support that we offer. Customized Management Reporting We consider relevant reporting to be just another part of customer support. Every product, service and our performance in support of those things can be measured to provide you with the information you need to justify maintaining a relationship with us. So if you think you have a crazy reporting request, it may not be as crazy as you think. As a provider of services to just about every employer type, in just about every industry where background screening is needed (i.e. all of them) we have pretty much seen it all-so feel free to go crazy and ask for customized management reporting. The Most Current Regulatory Update Information and Guidance Regulatory information and guidance is yet another part of the customer support we provide. We provide you with compliance alerts as they happen, summarized legislation notices on a quarterly basis (in case you missed one of our compliance alerts) and compliance webinars to keep you and your people on top of the most important topics of the day. GIS will also be launching a compliance blog in the near future which General Information Services, Inc. (GIS) 11"If" c will cover topics such as Legislation, Risk Mitigation, HR, Talent best practices, and more! We also do or use all of the following in an effort to keep ourselves and our clients as up to date as possible: We ensure that all regulatory changes are reflected in the standard operating procedure documents used to manage day-to-day activities related to providing background screening results to our clients We communicate regulatory updates and changes to you through your GIs account manager as they happen We provide an archive of regulatory updates (accessible twenty-four hours a day) on our corporate website: http: /www.geninfo.com /newsletter compliance/regulatory-archive.html We send out a quarterly e-newsletter with a dedicated compliance section which summarizes important legislative changes both federally and by state: htt /www.geninfo.com/newsletter/index.html We host regulatory discussion webinars typically presented by our Executive Vice President and General Counsel, Chris Lemens, our webinars explore the topics of the day and provide valuable feedback on what they really mean to employers. Our EEOC webinar was recently pre-approved for recertification credit by the HR Certification Institute as well: http:/ /www.aeninfo.com /news /WEBINA R-Backq rounds-and-EEO.asp In addition to updates of regulatory nature, GIs will also remain cognizant of changes made to other clients' programs in your industry to keep you abreast of developing trends or emerging technologies that could be used to optimize your programs. Visit http://www.geriinfo.cotn/research.asp to learn more about everything we do to keep you current. Disputes Resolution Service for Your Applicants If we report information that leads you to make the decision not to hire an applicant, we do all we can to help your applicant's understand the reporting and help them understand the recourse they have if they believe that information in a public record about them is incorrect. Your applicants can call or email us and we will get right back with them with a plan of action for re-verifying the information that was provided. If it is discovered that the information in the public record was incorrect, we will correct the information on the report and let you know that your applicant is ready to rejoin your talent pool. System Customization/Viewing Rights/Hierarchy Changes Customized workflows and the flexibility to make system configuration changes is something that we here at GIs have learned to embrace. While other providers may try to steer you to operate within the constraints of their standard system under the guise of it being "better this way", we happen to think that since we are providing a service that is part of your recruitment, screening and hiring program that it would be best if we delivered that service to you in a way that makes perfect sense to you. While we will General Information Services, Inc. (GIS) certainly speak up if we have discovered a possible process improvement, we will not enter into the relationship expecting you to change-that is part of what makes us a partner rather than just a vendor. Background Check Adjudication and Score Change Process Management Your hiring practices are not determined through the mere discovery of criminal history or other negative information in an individual's past; they are determined through how you interpret and adjudicate information that is uncovered. Our implementation team will guide you through the process of assigning pass, defer and review values to specific offenses where legal. Our QA team will review every that includes a hit report to ensure that reporting and scoring are being handled according to the mutually agreed upon standards. Even if your adjudication standards vary regionally or by job class and position, we can help you design a process that will keep everyone on the same page when it comes to your overarching goals. Protection of Your Personal Information We would tell you all about our information security policies but not all of us have the biometric access that is required to enter the security wing. As mentioned previously, GIS has never had a data breach in our forty-eight years of existence. We can also tell you that many of our competitors who have only been in business for a fraction of that time cannot make the some claim. Our information security is managed by our Network Operations Group (NOG) and yes they are as effective as they sound when it comes to managing our security. NOG uses the most advanced products on the market to protect our data and systems from outside intrusion, enforces our data privacy standards through network design and policy development and trains and tests all of our employees on protection of personal information. Conclusion Again, we cannot thank enough for taking the time to read our proposal for services. After reviewing our proposal, we hope to have demonstrated to you not only our capability to provide you with a solution that addresses your project objectives but more importantly our levels of dedication to helping your program succeed. GIS' 48 years of experience serving clients has given us the opportunity to cultivate relationships with our clients that have resulted in the development of exciting technology options. Our dedicated approach to helping our clients' improve their business processes by listening to their needs is what has fueled the development of the proprietary platforms discussed in this proposal. We are here and we ready to listen. General Information Services, Inc. (GIS) !,t0etir G I S Screening Services Agreement Customer name: Type of business: TN i% crry o r- AsH L,~ w .b N u NI C ( Pik I, 0OVEe-N M ENTT Subsidiary or division name if applicable): Years l business: HUMAN RES0 I -fType of entity (e.g., corporation): Dunn & Bradstreet (D&B) number: MNINVAL (IOUaNM jurisdiction of organization (e.g., Delaware): If publicly traded, exchange & ticker symbol: Customer's physical address: Customer's billing address: 2C. P_ NAI N STS 20 a, MAIN ST12-E~ N Customer's business contact's: Customer's billing contact's: Name: TINA G Name: Phone: 5LI0 55 I Phone: Fax: ( - Fax: Email: (na ash is OV , m Email: Send notices to Customer to: Send copy of notices to Customer to: / "7T TINA 6TV- n!I AlT J4,4 -6,4 LCNN~ Customer permits these references to give GIS_information for FCRA vetting purposes: Contact information for bank reference 41 Contact information for bank reference #2 Bank name: 6A NK OF ffWEMCA- Bank name: Account 7er')O&O5(r Account VUe OVl Contact: Contact: Title: Title: Phone: (~j~ l QjZ - 321 I Phone: Mail address: Mail address: Contact information for business reference #1 Contact information for business reference #2 Bus. name: Bus. name: Contact: Contact: Title: Title: Phone: Phone: Email: Email: Mail address: Mail address: This agreement is composed only of this signature page, the terms and conditions attached, and a price list. This agreement is the parties' entire, final agreement. Neither party relies on any state- ment representation, warranty, or agreement that is not in this agreement. Customer read, under- stood, and agreed to the entire agreement, including section 4 (Customer's certifications), section 8 Customer to secure information), and sections 11 & 12 (limiting warranties and remedies). Customer General I n~~tion Services, Inc. By: Name: Tv aK-r1 " 1 Name: Title: W, M4-- Title: c~ Date: Date: Pagel of 9 Confidential and © 2007-14 General Information Services, Inc. rev 2014707/ UM I S Terms and Conditions 1. Parties. General Information Services, Inc. Driver's Privacy Protection Act and state laws and ("GIS") and the customer named on the first page regulations issued under it (the "DPPA") regulate ("Customer") enter this screening services agree- the Services and the information CIS provides as ment. Customer may extend the benefit of this part of the Services (the "Reports") in order to pro- agreement to any company controlling, controlled tect the Consumer that the Report concerns. The by, or under common control with it (its "Affiliate") FCRA statute begins at 15 U.S.C. § 1681; most regu- if the Affiliate agrees to abide by this agreement. lations begin at 12 C.F.R. part 1022. The DPPA stat- ute begins at 18 U.S.C. § 2721. GIS is not a law firm, 2. Term. This agreement begins when the parties does not provide legal advice, and does not function sign it and ends when a party terminates it with at as Customer's legal counsel under this agreement. least 60 days' prior notice to the other. Termination GIS hereby advises Customer to assure its compli- of this agreement does not release Customer from ance with law by involving its own legal counsel. charges incurred before termination. GIS may sus- Customer has independently educated itself about pend Services if GIS has reason to believe that Cus- how the FCRA regulates its use of the Services and tomer is violating this agreement. has read the notices appearing at 12 C.F.R. part 1022 3. Services. Customer may order background app. K and N (see www.geninfo.com/docs/ screening reports, drug and medical screening re- Summary- of-Rights.pdf and www.geninfo.com/ ports, report grading, and adverse action services docs/Obligations-of-Users.pdf). By ordering a Re- that GIS offers its clients (the "Services"). For each port, Customer certifies and agrees: background screening order, GIS shall search the (a) the Report will be used only by Customer, only requested type of records concerning an individual as a "consumer report" for "employment purposes" (the "Consumer"). For each drug or medical screen- under the FCRA (which includes use for individual ing order, GIS shall arrange for drug or medical contractors and individual agents), only for a pur- screening at a contracted clinic. GIS shall report the pose that (if applicable) the DPPA permits, and only result of each background, drug, or medical screen- for individuals to be employees, contractors, or ing to Customer. If Customer orders report grading, agents for its own organization; GIS shall grade the results of screening according to (b) information in the Report will not be used in objective criteria and shall report the result to Cus- violation of any applicable Federal or State equal tomer. Customer shall provide the criteria to GIS, employment opportunity law or regulation; but GIS shall assist Customer in preparing criteria (c) before ordering a Report, Customer gave the that GIS can apply. Customer shall ensure that its Consumer a clear and conspicuous disclosure: (1) grading criteria are legal. If Customer orders ad- that consists only of the disclosure, (2) that Custom- verse action services, GIS shall (as Customer's agent) er will obtain a consumer report or investigative provide a pre-adverse action notice described in consumer report for employment purposes, (3) that section 4(g) if a screening fails in grading and an states GIS's name, mailing address, website address, adverse action notice described in section 4(i) below and toll-free telephone number; (4) that the Report 5 days later, unless the Consumer notifies GIS of a will include information on the Consumer's charac- dispute. If the Consumer notifies GIS of a dispute, ter, general reputation, personal characteristics, and GIS shall inform Customer of the dispute. Customer mode of living; (5) of the nature and scope of the shall provide all information that GIS does not have, investigation to be performed; and (6) that the Con- but needs for either notice. GIS shall provide a form sumer may inspect GIS's files about the Consumer by of each notice for Customer's modification and ap- providing proper identification and GIS will provide proval; Customer shall ensure that the form of no- the Consumer with trained personnel and explana- tice is legal. The parties may create one or more tion of any codes to help understand those files; documents ("Client Directives") that define pack- (d) before ordering a Report that is an "investiga- ages of Services, options for certain Services, grad- tive consumer report" under the FCRA, Customer ing criteria, and form letters for notification Ser- gave the consumer the written summary of rights vices. Nothing else in the Client Directives modifies promulgated under the FCRA (the "Summary of this agreement; anything else in it is for information Rights") and a statement that the Consumer has the only and is not legally binding. GIS shall start Ser- right to obtain a complete and accurate disclosure of vices after implementation and verification of Cus- the scope and nature of the investigation performed; tomer's business under applicable law. (e) before ordering a Report, Customer obtained the Consumer's written authorization to procure the 4. Compliance. The Fair Credit Reporting Act and Report (which may be on the disclosure document regulations issued under it (the "FCRA") and the described above); Page 2 of 9 Confidential and © 2007-14 General Information Services, Inc. Customer Initials G Is Terms and Conditions (f) Customer has (or will have timely) made any and (3) whether GIS fulfilled its duties for a Report; additional disclosures, offered any additional infor- (n) Customer will comply with the FCRA, DPPA, and mation, and obtained any additional authorizations any other applicable laws; and required by law including: (1) a box that the Con- (o) Customer will immediately inform GIS if its pur- sumer may check to obtain a copy of the Report and pose for using Reports changes or any of these certi- providing that copy when required, currently in fications is no longer accurate. California, Minnesota, and Oklahoma; (2) a copy of 5. Payment. Customer shall pay for the Services at Article 23-A of the New York Corrections Law when the prices set out on the price list attached to this required; and (3) disclosure of the nature and scope agreement (or at GIS's list prices for Services not on of the investigation leading to an investigative con- the price list). GIS may change the prices set out on sumer report under the FCRA when required; the price list by informing Customer in writing at (g) before taking any "adverse action" under the least 30 days' before the change; but that price FCRA based on a Report ("Adverse Action"), Cus- change does not occur if Customer terminates this tomer will provide the Consumer with the Summary agreement by delivering notice of termination to GIS of Rights and a copy of the Report (but Customer during that 30-day period. In addition to those pric- may purchase the Service of sending these notices); es, Customer shall pay GIS amounts that allow GIS to (h) Customer will not take any Adverse Action un- recover all fees that third-party information sources less (1) Customer has given the Consumer at least 5 charge GIS for access to information needed to per- business days in which to dispute or explain the in- form the Services (such as county court fees). Except formation in the Report, (2) the Consumer has not for taxes levied on GIS's net income, Customer shall disputed any information in the Report or GIS has pay or reimburse GIS for all taxes, assessments, and resolved any dispute, (3) Customer has considered withholdings based on charges, services, or pay- any explanation to the extent required by law, and ments under this agreement. GIS may bill charges (4) the information in the Report relates sufficiently for each month in a single invoice. Customer shall to the Consumer's duties to satisfy law; pay all charges within 30 days after invoice date. If (i) upon taking Adverse Action, Customer will noti- Customer does not pay any amount by the time this fy the Consumer in writing: (1) that Customer took agreement requires, Customer shall pay GIS interest the Adverse Action based on the Report; (2) of GIS's on the amount due, beginning with the invoice date, name, mailing and website addresses, and toll-free at a rate of 1.5% per month, or the highest rate ap- telephone number; (3) that GIS did not make the plicable law permits if less. Customer shall promptly decision to take the Adverse Action and is unable to provide any contract number, purchase order num- provide the Consumer with the reason for it; (4) that ber, or other information necessary for Customer's GIS will provide a free copy of the Report if the Con- billing systems. If Customer requires GIS to submit sumer requests within 60 days; and (5) that the bills or other information through any system that Consumer may dispute the accuracy or complete- charges GIS, Customer shall reimburse GIS for those ness of the Report (but Customer may purchase the charges. Service of sending these notices); (j) Customer will immediately request GIS to send 6. Additional Documents. For international, retail an adverse-action notice if: (1) GIS sends such notic- theft database, or compliance process review Ser- es for Customer under section 3, (2) GIS informs vices, as a condition to GIS's obligation to provide Customer that a Consumer has disputed a Report, the Services, Customer must sign an addendum re- and (3) Customer has taken or later takes Adverse lated to those Services. For certain other Services, as Action before the dispute's resolution; a condition to GIS's obligation to provide the Ser- (k) when law requires, Customer will inform the vices, (a) Customer must complete and sign addi- Consumer of the reason for the Adverse Action; tional agreements and other forms that law or GIS's (1) no agreement, order, or state or local law bind- suppliers require and (b) any agency or supplier ing Customer prohibits GIS's reporting of infor- that mandates that it approve those agreements or mation to Customer or prohibits GIS's use of infor- forms must provide the required approval. Two ex- mation that the grading criteria require; amples follow: For motor vehicle records, GIS's sup- (m) Customer will not use names or addresses in plier of those records may require Customer to en- any Report to take Adverse Action or for any pur- ter into separate contracts with the supplier and pose that the FCRA regulates, but may use them to with states that require such an agreement; the pri- decide (1) whether to request proof of identity from mary purpose of those agreements is to limit the use the Consumer, (2) under what names and in what of those records. For credit records, credit bureaus places to search for records about the Consumer, may require Customer to complete an application, a Page 3 of 9 Confidential and © 2007-14 General Information Services, Inc. Customer Initials • S Is Terms and Conditions letter of intended use, and a site survey that at- vice with reasonable effort or care results in a Re- tempts to verify the authenticity of Customer's busi- port that does not accurately reflect the information ness; those credit bureaus may also require that upon which that type of Report is based; (b) the fail- they approve Customer's application before Services ure is not caused by inaccurate information that can begin. Customer does not promise to sign the Customer or the Consumer provided; and (c) Cus- documents, but GIS cannot provide certain Services tomer requests a refund within the earlier of 30 until Customer does so. GIS's obligation to provide days Customer's discovery of the failure or 12 any Service requiring any such agreements or forms months after the failure occurred. is conditioned on Customer's compliance with them. 10. Indemnity. Each party (the "Indemnitor") shall 7. Technology. If GIS makes any software, web Indemnify (as defined below) the other, its Affiliates, site, or specifications ("Technology") available to and the employees, officers, directors, and similar Customer, GIS grants Customer a non-exclusive li- personnel ("Personnel") of the other or its Affiliate cense to use it, but only for the purpose of ordering (each of which is a "Defendant") from any third par- and receiving the Services and only during the term ty's claim against a Defendant arising from the In- of this agreement. Only Customer and its employees demnitor's Fault (as defined below), but only if the and independent contractors may use the Technolo- Defendant notifies the Indemnitor of the claim no gy. Customer shall keep the Technology confidential, later than 30 days after first receiving written notice prohibit its unauthorized use or disclosure, and de- of the claim. If both parties' Fault caused the claim, stroy all copies of it when this agreement ends. then the parties shall apportion the liability for the 8. Securi . Customer shall use the following secu- claim according to their comparative Fault giving rity procedures to protect the confidentiality of the rise to the claim. Any Fault arising from GIS's Com- data in GIS's databases and the privacy of Consum- pliance with Customer's express instructions is ap- ers in that data. Customer shall restrict the ability to portioned only to Customer. order or access Reports to those of its personnel (a) "Indemnify" means to pay or reimburse all of who have a need to know information in them. Cus- (1) the reasonable cost of defending the claim (in- tomer shall ensure that its computers from which a cluding reasonable attorney's and expert witness person could order or access Reports are in a secure fees and court costs) and (2) any monetary obliga- location and are locked or turned off after business tion that is imposed on Defendant in (A) a settle- hours or when unattended by Customer's personnel ment of the claim approved by the Indemnitor; (B) a who have a need to know information in them. Cus- settlement of the claim not approved by the Indem- tomer shall secure all printed copies of Reports. Cus- nitor, but only to the extent that it was reasonable; tomer shall not copy, distribute, disseminate, pub- or (C) a final judgment on the claim from which no lish, or otherwise use any Report (or any infor- appeal is reasonable. mation in a Report) except by distributing the Re- (b) A party has "Fault" when (1) the party breaches port to the Consumer, using the Report internally, or incurs liability under any contract between the and using and disclosing the Report as required by party and the third-party claimant; (2) the party, its law. Customer shall not provide Reports to its cli- Affiliate, or the Personnel of the party or its Affiliate ents, but may express its decisions based on Re- Publishes any information beyond the parties to this ports. Customer shall not store any information in- agreement and the Consumer; (3) the party per- cluded in any Report except to the extent required forms any process or provides anything that infring- for it to use the Report as this agreement permits. es any copyright, trademark, or U.S. patent or mis- Customer shall protect its account names and pass- appropriates any trade secret, unless the claim also words (the "Credentials") so that only its author- arose because either (i) the other party combined it ized personnel know them. Customer shall not post with something not so performed or provided or (ii) its Credentials anywhere or discuss its Credentials the other party used the thing provided in a manner by telephone. Any software that Customer uses to that this agreement does not permit; or (4) in any access GIS's systems must hide the Credentials so situation not covered by (1) through (3) above, the only specially authorized personnel can know them. party, its Affiliate, or the Personnel of the party or its Customer shall assign a unique username and pass- Affiliate commits a tort or negligence, violates any word to each user of that software. law applying to its operations, or breaches this agreement. 9. Warranty. GIS shall refund the fee that Custom- (c) For any claim under clause (b) (3) above, the er pays for an instance of a Service if all of the fol- Indemnitor may (at its option and expense) modify lowing occur: (a) GIS's failure to perform that Ser- the claim's subject matter, purchase a license to cure Page 4 of 9 Confidential and © 2007-14 General Information Services, Inc. Customer Initials GIs Terms and Conditions the misappropriation or infringement, or (if neither any later breach of the same condition or promise. of the foregoing options is practical) terminate the No party's delay or failure to exercise any right or Defendant's right to use the claim's subject matter. If remedy is a waiver, except as this agreement states. such a termination makes performance under this GIS's acceptance of Customer's purchase order does agreement impractical, then either party may also not change this agreement or waive any rights and is terminate this agreement by notice. for the convenience of Customer's systems. 11. Disclaimer. Other than in section 9, GIS makes 16. Force Majeure. Neither party has any liability no warranty or representation, whether express for any delay in performing or failure to perform to or implied (either in fact or by operation of law). the extent due to causes beyond its reasonable con- Without limiting this general disclaimer, GIS dis- trol and ability to mitigate, such as natural disasters, claims all warranties (a) of merchantability, fit- acts of God or government, disease, embargoes, ri- ness for a particular purpose, workmanlike per- ots, labor strikes, terrorism, and war. formance, accuracy, non-infringement, or title; 17. Parties' Relationship. The relationship of the (b) that arise from course of performance, course parties is that of independent contractors. Nothing of dealing, or usage of trade; or (c) that anything contained in this agreement creates a joint venture, that it does or provides is free of errors or oper- partnership, agency, employment, or fiduciary rela- ates without interruption. tionship between the parties, except the limited 12. Liabili . Even if any exclusive remedy fails of agency in section 3. The parties do not intend to cre- its essential purpose, GIS is not liable for (a) third- ate a right for any third party to enforce this agree- party claims against Customer except under sec- ment against either party, except under sections 1 tion 10; (b) indirect damages, consequential dam- and 10. To the extent that any third party can en- ages (including lost profits, opportunity, use, or force this agreement, its rights are limited by all the savings), incidental damages (even if advised of terms, conditions, and defenses that apply to the the possibility), or punitive damages; or (c) total party whose rights it seeks to enforce. damages for all claims exceeding the total fees 18. Governing Law. The internal laws of the state under this agreement for the calendar quarter of New York govern this agreement and all claims when the most recent claim arose. (in contract, in tort, or otherwise) that relate to this 13. Notices. A party giving notice to another party agreement or its negotiation, execution, perfor- shall do so: (a) in writing; (b) either (1) personally mance, or breach. This agreement is to be interpret- by hand; (2) by nationally recognized overnight de- ed as written and negotiated jointly by the parties livery service that requires a signature for delivery; and not to be construed against the drafter. or (3) by United States mail, return receipt request- 19. Disputes. Any party suing the other in relation ed, postage prepaid; and (c) to the notice address for to this agreement shall only sue in courts having the recipient. Customer's initial notice addresses are jurisdiction over the main notice address of the oth- set out on the front page of this agreement. GIS's er party. By so suing, a party consents to personal initial notice addresses are P.O. Box 353, Chapin, SC jurisdiction and venue in that court and waives any 29036-0363, Attn: CEO with a copy to 12770 Coit objection to that court as an inconvenient forum. If a Rd., Ste. 1200, Dallas, TX 75251, Attn: General Coun- party sues the other in relation to this agreement, sel. Each party may change its notice address by in- the losing party in a final judgment, or a party dis- forming the other party. missing without prejudice, shall pay the other par- 14. Severability. If any provision of this agreement ty's reasonable expenses incurred, including court or its application to any circumstance or person is costs and reasonable attorney fees paid or incurred. invalid, illegal, or unenforceable to any extent, the 20. Entire Agreement. This agreement replaces all remainder of this agreement and the provision's prior or contemporaneous oral and written commu- application to any other circumstance or person is nications, understandings, or agreements between not affected and is to be enforced to the fullest ex- the parties, including confidentiality agreements. tent permitted by applicable law. This agreement is not to be explained, supplement- 1S. Changes & Waiver. For a rescission, revocation, ed, or qualified by a prior course of dealings. The amendment, modification, or waiver of any of this parties may sign this agreement in one or more agreement to be valid, both parties must non- counterparts, with the same effect as if they had electronically sign it, but it needs no consideration. signed the same document. Each counterpart is an No waiver waives any other condition or promise or original; all together are one agreement. An image delivered electronically is a counterpart. Page S of 9 Confidential and © 2007-14 General Information Services, Inc. Customer Initials GIs Price List In addition to the prices below, the customer is responsible for sales taxes (unless Customer documents an exemption) and data access fees, which are not included in the prices below; see the agreement for further information. Any information GIS provides on data access fees may change. Services with no price stated are not available under this agreement. All of the following fees are for sources inside the United States (except for those that are specifically for Can- ada or a US Territory). For any KwikScreen-based Service, GIS will validate any records found. Unless the price list below expressly states the contrary, the price of the KwikScreen-based Service does not include the price of the validation. Validations are at the same price as a search of the jurisdiction of the record and, if needed, a name and ad- dress history Individual Services _ Price (US$) INSTRUCTIONS: Please read all of this every time. Delete this row • Provide a price for each service that the customer wants. • Delete every row that has a service that the customer does not want. (Right click the F row or use Alt-JLDR in Word 2007.) • Generally, you should not include both name and address history and social security number search. Use the latter if you include any so-called "unlimited county" searches. • If you include KwikScreen, you must specify whether validations are included in the KwikScreen price. • If you include KwikScreen and validations are not included in your price, you must in- clude prices for the following services, which are used in validation: county criminal, statewide criminal, federal criminal, and either social security number search or name and address history. • Never put a price of zero if something is included in KwikScreen. Just put a price on KwikScreen and add to the description of KwikScreen to show it is included. I r • For drug screening, you must identify the number of drugs screened in the panel and whether the location is eCup installed (for 5-panel only), in-network, or out-of- network. Panels with 5 to 9 drugs are standard, but 10+ panels are not - you need to identify the drugs because our cost varies. j • Please strongly consider including the compliance letters. Implementation often ends up adding this later. Ray has pre-authorized the prices set out below. • These products require addenda: CPR, NRMA, international. • These products require third-party documentation: credit records, driving records, and E-Verify employment eligibility verification. • Do not add Pangea or I-9 services to this list. • You must obtain Ray's approval of all pricing (including to waive setup fees). DELETE THIS ROW WHEN YOU ARE DONE. Data Validation Services Social security number search - one social security number j Name and address _history report - one social security number Social security number validation - one social security number KwikScreen Services Full KwikScreen database search - one name Sex offender registry search - one name National security sources search - one name Criminal History Services_ County criminal search - one coup for 7 ears before search date - one name County criminal search - one count for 10 ears before search date - one name County criminal search - all counties for all addresses provided by Customer or selected I from a social security number search for the recedin 7 ears - for records in 7 ears be- Page 6 of 9 Confidential and © 2007-14 General Information Services, Inc. Customer Initials ES' S Price List fore search date - one name -the rice does not include social securit number search j County criminal search - all counties for all addresses provided by Customer for the pre- ceding 7 years - for records in 7 years before search date - all names provided by Customer or selected from the social security number search - the price does not include social secu- ri number search ! Federal criminal search - one district, one name _ Statewide criminal search statewide re ositor or state olice -one state, one name' Canada provincial criminal search - one province, one name Canadian Police Information Center search - one name rr Puerto Rico criminal history search - one name I National wants and warrants search - one name National Retail Mutual Association database search - one name - addendum re uired Dru Screening Services _ 5-panel - eCup installed location 5-panel - in-Network but not installed location_ G 55-panel- out-of-network and not installed location 9 -panel - in-network location _ _ E 9- anel -out-of-network location i Civil Services Civil suits and jud ments - lower level - one local jurisdiction, one name Civil suits and judgments-- u er level - one local jurisdiction, one name Civil suits and judgments.-..federal - one district, one name Credit report - for employment purposes only - one social security number Driving motor vehicle record - one driver's license number Fraud and Abuse Control Information System search - one level only - level 1 Fraud and Abuse Control Information System search - one level only - level 2 _ Fraud and Abuse Control Information System search - one level only - level 3 GSA list General Services Administration excluded parties list) search - one name OFAC list (Office of Financial Asset Control specially designated nationals list) search - one name OIG list (Dept. of Health & Human Services Office of Inspector General exclusion list) search - one name Media search - per article located Verification Services j Educational history verification - one institution Employment eligibility verification through E-Verify - one social security number - MOU required Employment histor verification -one employer Employment histo verification - all re uested em to ers within revious 7 ears Professional credential not state board verifications - one credential, one name Reference - either personal or professional - one source State board verification (for insurance customers) _ Compliance Services CA, MN, NY, OK or comparable compliance notice - per notice sent $2.00 Pre-adverse-action notice - per notice sent ( $2.00 Adverse-action notice - er notice sent $2.00 Packaged Services Price US$ INSTRUCTIONS: Please read all of this every time. Delete this row • Any time two or more services are bundled together, that is a package. • List each service included in the package. • Make sure each service included in the package has a price in the Individual Services section above. Page 7 of 9 Confidential and © 2007-14 General Information Services, Inc. Customer Initials GIs Price List For each service, state how many of them are included in the package. • If we are to search for a period of time, state the period of time. • When you fill in the price column, you do not need to add "plus fees," unless you tamper with the language above this table. • If you include KwikScreen, you must specify when validations are included in the pack- age price. If any package includes KwikScreen, you must include the row at the end of this table that describes the need for KwikScreen validations. • If you include KwikScreen and validations are not included in your price, you must in- clude prices in the Individual Services section above for the following services, which I are used in validation: county criminal, statewide criminal, federal criminal, and either social security number search or name and address history. ! • Spell out all abbreviations. • If there could be zero of something in a package (e.g., educational verification), always say "up to" whatever number is included in the package. • Do not describe anything else about the services. This is not the place for marketing literature. In particular, do not state turn-around time. • If grading is included, specify it as follows: "Grading according to Customer's criteria and the agreement." • Do not include adverse action notices within the packages, unless the notices are part of the price. Either include another row or use the individual service price list. • See example below. DELETE THIS ROW AND THE EXAMPLE WHEN YOU ARE DONE. EXAMPLE Package 2 including the following individual services: • Social security number validation for one social security number • Name and address history based on one social security number • KwikScreen search of one name (validations not included) • County criminal searches of one name for the previous seven years with all counties in ' which the subject lived (according to the social security number search) during the previous seven years • Employment verification of one name with up to three employers • Educational verification of one name with up to one educational institution Grading according to Customer's criteria and the agreement Set-up Services i Price US$ Client set-up - one-time fee, credited back to the Customer if the Customer orders at least $100 100 Reports during the first year Driving records set-up- one-time fee if the Customer requires motor vehicle reports ( $50 through a gateway that charges GIS a setup or vetting fee Credit records set-up fee - one-time fee if the Customer requires credit reports and is nei- $75 ther publicly traded nor an insurance company with an A.M. Best rating of at least "A" j j Set-up for SAEP (secure automated end-to-end processing) system for Customer to upload and download order, acknowledgment, and result data - based on GIS's standard data maps - one-time fee if Customer requests the set-up Set-up for SSO (single sign on) between Customer's system and GIS's systems - based on GIS's standardspecifications - one-time fee if Customer requests the set-u ! 1 Set-up for Applicant Entry Portal - based on GIS's standard setup - one-time fee if Custom- er requests the set-up Maintenance for Applicant Entry Portal - annual fee if Customer requests the set-up - pay- able in advance Real-time interface for order, acknowledgment, and result data for Screening Services - I one-time fee if Customer requests the interface - based on GIS's standard interface specifi- cations Interface maintenance for interface to TALEO system - annual fee if Customer requests an Page 8 of 9 Confidential and © 2007-14 General Information Services, Inc. Customer Initials G iS Price List interface to a TALEO system -payable in advance Batch interface for order, acknowledgment, and result data for Screening Services - one- time fee if Customer requests the interface - based on GIS's standard interface specifica- tions Custom integration - one-time fee if Customer requests the integration - per person-hour $i50/hour expended in specifying, developing, testing, and implementing the integration - on request, LGIS will ro~ose a fixed rip ce after the parties specify the sco e of the inte ration Page 9 of 9 Confidential and © 2007-14 General Information Services, Inc. Customer Initials Credit Report Forms Instructions Attached are two forms that you must complete to obtain any information from a credit bureau. These forms are ones that the credit bureaus require us to collect from you. We do not have the ability to negotiate them. The first form attached is a credit bureau membership application. Please complete this form. Please note that this is not an application for us to extend credit to you. This is an application for you to obtain information from a credit bureau. The second form attached is a letter from you to us certifying your intended use of credit report information. Please complete the information that the letter requires, print the letter on your own letterhead, and have it signed by an authorized signatory. If either of these forms do not print properly for you, please contact us. Credit Bureau Membership Application A licant in ormation to be complete by all companies; Company name Doing business as Nature of business Date established Contact name Contact title Company main phone number Company main fax number Federal tax identification number Do you have an answering service? Company web site address Contact's email address Street address City, state & postal code Complete only i our company is a Corporation or LLC circle which one .you are Officer name Officer title Officer name Officer title Officer name Officer title I certify that I am authorized to sign this application and that the information provided on this application is true. I understand that by signature I answered the foregoing questions accurately to the best of my ability, and that I understand that falsification of this document is grounds for denial or termination of membership and/or legal prosecution. Signature Title Printed name Date Complete only i our company is a Sole Proprietorship or Partnership circle which one you are I certify that the information provided on this application is true and that I understand that falsification of this document is grounds for denial or termination of membership and/or legal prosecution, and that 1 understand that by signature below, the Credit Bureau may pul I a personal credit report on owner (s) of this company in connection with approval of this application. Owner name Title Residence street address Residence city, state & zip Social security number Signature Owner name Title Residence street address Residence city, state & zip code Social securit number Signature Date: General Information Services Attn: Implementation Department 917 Chapin Road Chapin, South Carolina 29036 Re: Credit Bureau User Certification and Letter of Intent To whom it may concern: We understand that, though you, we will obtain access to consumer reports from one or more consumer credit reporting agencies. We intend this letter to give certain assurances to those credit reporting agencies. We need consumer credit information in connection with the evaluation of individuals for employment, promotion, reassignment or retention as an employee ('Consumer Report for Employment Purposes"). The nature of our business is We anticipate that our monthly requests for Consumer Reports for Employment Purposes will be approximately We will request Consumer Reports for Employment Purposes on the following. basis: ❑ National ❑ Regional ❑ Local We agree to request Consumer Reports for Employment Purposes only pursuant to procedures that you prescribe from time to time and only when we are considering the subject of our inquiry for employment, promotion, reassignment or retention as an employee, and for no other purpose. We agree to use each Consumer Report for Employment Purposes only for a one-time use, to hold the report in strict confidence, and not to disclose it to any third parties not involved in the current employment decision. We agree to maintain copies of all authorizations for a minimum of five (5) years from the date of inquiry. We acknowledge that, with just cause, such as violation of the terms of a contract or a legal requirement, you may immediately discontinue providing us with Consumer Reports for Employment Purposes immediately. Very truly yours, By: Name: Title: International Service Addendum Article 1 BACKGROUND General Information Services, Inc. ("GIS") and the customer named in the signature block below ("Customer") are parties to an agreement under which GIS performs background investigation services for Customer. Capitalized terms that this addendum uses but does not define and that the agreement does define have the meaning set out in the agreement. Article 2 INTERNATIONAL INVESTIGATIONS The scope of the agreement includes background investigation services to discover information outside of the United States. Except as this addendum provides, all terms related to the Services apply to international background investigation services. Section 2.1 Required Documentation For GIS to be able to perform international Services, Customer must provide the following documents (in the form that GIS provides) for each international Service request for each individual being investigated: (a) International Consent, (b) Proof of Identification, and (c) any additional forms required to obtain information from specific countries. Section 2.2 Changes in Information Availability GIS has no control over or ability to predict the availability of information from jurisdictions outside the United States. Currently available information for a country might become unavailable with or without notice. In those cases, GIS will be unable to perform the international Service. Currently unavailable information might become available in the future, in which case Customer may order Services for those countries at an agreed price (or at GIS's list price if the parties do not agree to another price). Section 2.3 Delays from International Information GIS agrees to use reasonable efforts to promptly retrieve information to fulfill Customer's orders of international Services. But GIS cannot provide any assurance that it will retrieve any information outside of the United States within any set period of time. Therefore, no other statement, representation, promise, or warranty concerning the timeliness of Services applies to information from outside the United States. Section 2.4 Regulation of International Information Each party shall adhere to the safe harbor privacy principles and related frequently asked questions that the United States Department of Commerce (the "USDOC") issued on July 21, 2000. (See http://www.export.gov/safeharbor/SH_Privacy.asp.) GIS represents that it is currently registered on the USDOC's safe harbor list. Customer may, but need not, register on the USDOC's safe harbor list. In addition, each party shall abide by all foreign laws applying to information that GIS obtains from foreign jurisdictions and provides to Customer. If GIS requests, Customer and GIS shall complete and sign standard contractual clauses that are annexed to European Commission Decision 2004/915/EC. Section 2.5 Prices If a separate price list for international Services is attached to this addendum, that price list supplements (but does not replace) the price list under the agreement. All prices for international Services are in United States dollars. Because of fluctuations in exchange rates and changes in GIS's costs of international Services vary for reasons outside of GIS's control, GIS may change the prices for any international Services by informing Customer at least 30 days in advance. Rev 201204113 Confidential to and © 2009-12 General Information Services, Inc. Pagel of 2 Section 2.6 Additional Pass-Through Expenses Foreign authorities might require processing fees in foreign currency to obtain information. Customer shall reimburse GIS for these fees plus the cost of foreign bank drafts (required for remittance) and the cost of shipping and handling, at cost and in addition to the fees GIS charges for the international Services. Article 3 TERMINATION Either party may terminate this addendum, without terminating the agreement, with 60 days' notice to the other party. The other party may, by giving at least 30 days' notice within that 60-day period, terminate the entire agreement when the addendum terminates. General Information Services, Inc. Full legal name of organization that is the "Customer" full legal name of organization that is the "Vendor" 1 By: authorized signature `authorized signature Chris Lemens its Executive Vice President printed name and title of signatory printed name and title ofsignatory date ofsi nature date ofsi nature title of services agreement date of services agreement JL- Rev 20120418 Confidential to and © 2009-12 General Information Services, Inc. Page 2 of 2 Employment End User Agreement 1. An authorized agent or officer of the company ordering Motor Vehicle Reports ("End User") must sign agreement. 2. Make copies for your files, sign, and return a copy to GIS. Company Name Phone Number Address (Line I Fax Number Address Line 2) :Em,, ail Officer of Com any) Citv State Zi Code Ovvnerrnlana erName Primarv Contact N8184 P02638 CA Requester Code CA A reement Number Number of Em lovees Tv a of Business 1. Sole Use. The Motor Vehicle Records ("MVRs°). provided by General Information Services, Inc. ("GIS") and Softech International. Inc. ("Softech') to End User, are for the sole use of the End User and may not be resold. sub-licensed. delivered or displayed in any wav to or used by any third party. End User warrants and agrees that the MVRs. products and/or services are to be used internally by End User solely with respect to (i) continued employment of current employees or (ii) offers of employment to prospective employees unless otherwise restricted further by Specific State Forms as described in Item 4, Specific State Forms. Employers may retain the information only in the employee's employment history file. Failure of End User to comply in all respects with the requirements of this agreement is a material breach and. GIS and Softech may immediately terminate this Agreement and the delivery of any MVRs, services or other products to End User without notice or delay.A 2. Compliance with Laws. End User certifies that it shall order, receive, and otherwise use the MVRs in compliance with all applicable federal. state and local statutes, rules. codes and regulations. including but not limited to, the Fair Credit Reporting Act ("FORA") and its state equivalents and the Driver's Privacy Protection Act 18 U.S.C. $2721 et seq., ("DPPA") and its state equivalents, the Gramm-Leach-Bliley Act ("GLB") and its state equivalents. and including any changes, supplements or amendments to such statutes. rules, codes and regulations as well as any case lave interpreting such statutes. rules, codes and regulations (collectively referred to herein as -'The Laws"). End User shall be responsible for understanding and for staying current with all of The Laws. 3. Use of the Internet. End User will not further disseminate any MVRs over the Internet. Internet dissemination includes public c-mail. World Wide Web access. FTP and all other mechanisms where data is transmitted across the Internet. 06/19/2013 (02/22/05) Opbon Version EF2005.1 4. Archiving. End User shall not use MVR data supplied by GIS and Softech directly or indirectly compile, store, or maintain the MVRs (independent of or commingled with other databases) to develop its own source or database of MVRs. 5. Other Restrictions. GIS and Softech may from time to time impose additional restrictions, procedures or processes upon the use and/or delivery of the MVRs which it believes to be prudent to ensure compliance with The Laws, the Specific State Forms and/or the security. privacy or confidentiality of the MVRs. 6. Confidentiality. All Records made available or that become available to End User as a result of this Agreement shall be held in strict confidence by End User, its employees, agents. contractors and subcontractors. 7. Securitv. End User shall at all times maintain safeguards and procedures to ensure the security and protection of data and documents furnished by the State and shall take all necessary steps to prevent divulgence or use of such information or documents in any form or manner not expressly permitted by this Agreement. Minimum security measures shall include controlling access to data storage and production areas. secure destruction of data and documents and other reasonable security measures determined to be necessary at the sole discretion of the applicable State. 8. Assignment. The End User shall not, at any time during the term of this contract and any extension(s), assign its rights or delegate its duties under this contract. 9. Audits. Beginning on the date of this Agreement, End User shall maintain all records related to its order, purchase and use of each MVR for a period of five (5) years from the date each MVR is ordered. The End User acknowledges and agrees that GIS and Softech and/or the applicable State may audit the performance of the End User. The End User agrees to cooperate frilly with the GIS and Softech and/or the State's auditors. Signature Date Name (Printed) Title 06/19/2013 (0222/05) Option Version EE2005.1 Customer Name: Account No: ALASKA AGREEMENT Whereas, the State of Alaska, Department of Administration, Division of Motor Vehicles, may furnish an abstract of a drivers record as maintained by said office, only to a person who has been authorized in writing by such driver to obtain the driver's record; and NOW, THEREFORE, IN CONSIDERATION OF THE FOREGOING, THE UNDERSIGNED DOES HEREBY ACKNOWLEDGE AND CERTIFY AS FOLLOWS: 1. That the undersigned represents and warrants to GIS, that every person, on whom a request for an abstract is made by the undersigned, shall have first given his or her written consent to the release of such abstract. 2. That the original written authorization signed by the driver on whom an abstract is requested, or a copy thereof, shall be furnished by the undersigned to GIS, upon request by GIS. 3. The undersigned further agrees to indemnify and hold harmless GIS, for any liabilities and/or damages caused by virtue of the undersigned's breach of this agreement of the laws of the State of Alaska. Company or Organization Address City State Zip Signature Printed Name Date GIS Client Code ARKANSAS STATE FORM INSTRUCTIONS (EMPLOYMENT) The following information will assist you in completing the appropriate form to access MVRs in this state. • Note: This form is for employment purposes only. • Fill in all blanks in account information fields completely. • Sign and date the forms in the fields provided. • Only a person who is authorized to execute contracts for your company should complete and sign this form. ARKANSAS AGREEMENT Complete this form to order Arkansas MVRs WHEREAS, Section 1 of Act 465 of the 1977 Acts of Arkansas provides that the Office of Driver Services, Revenue Division, Department of Finance and Administration, State of Arkansas, may furnish an abstract of a drivers record as maintained by said office, only to a person who has been authorized in writing by such driver to obtain the driver's record; and NOW, THEREFORE, IN CONSIDERATION OF THE FOREGOING, THE UNDERSIGNED DOES HEREBY ACKNOWLEDGE AND CERTIFY AS FOLLOWS: (1) That the undersigned represents and warrants to Softech International, that every person, on whom a request for an abstract is made by the undersigned, shall have first given his or her consent to the release of such abstract. (2) That the original written authorization signed by the driver on whom an abstract is requested, or a copy thereof, shall be furnished by the undersigned to Softech, upon request by Softech (3) The undersigned further agrees to indemnify and hold harmless Softech, for any liabilities and/or damages caused by virtue of the undersigned's breach of this agreement or the provision of Act 465 of the 1977 Acts of Arkansas. Company or Organization Address City State Zip Softech Account Number Signature Date COLORADO STATE FORM INSTRUCTIONS (EMPLOYMENT) The following information will assist you in completing the appropriate form to access MVRs in this state. • Note: This form is for employment purposes only. • Fill in all blanks in account information fields completely. • Sign and date the forms in the fields provided. • Do not complete shaded area at bottom of page 1 titled: Information Below is intended... • On page 2; fill in company's name in first blank line provided. Sign and date page 3. • Only a person who is authorized to execute contracts for your company should complete and sign this form. • State form expires on an annual basis. EMPLOYMENT Account Number (State form expires on an annual basis) Colorado AFFIDAVIT OF INTENDED USE AND REQUESTOR RELEASE To obtain record(s), you must declare your intended use of record(s). If you are acting as an agent for an authorized user, you must identify the company or entity on whose behalf you are requesting the record(s). INFORMATION MAY BE USED ONLY FOR THE FOLLOWING APPROVED PURPOSES: ❑ By a government agency, including any court or law enforcement agency performing its functions for an approved purpose under DPPA. ❑ By an agency charged with driver/motor vehicle safety or theft including: MV product alterations, recalls, advisories, MV performance monitoring, MV parts/dealers, MV market research or surveys, removal of non- owner records from original records of MV manufacturers. ❑ By a business that will use the information to verify the accuracy of information submitted by individuals for the purposes of preventing fraud, pursuing legal remedies against or recovering a debt or security interest. ❑ In connection with a civil, criminal, administrative or arbitral proceeding in any court or before a self-regulatory body, including process service, investigation, execution of judgment, or pursuant to a court order. ❑ In research activities (the information may not be published, redisclosed, or used to contact the parties). ❑ By an insurer or insurance support agency in connection with claims, investigations, anti-fraud activities, rating or underwriting. ❑ To provide notice to owners of towed or impounded vehicles. 0 By an employer/agent or insurer of a Commercial Driver License Holder, ❑ In the operation of private toll facilities. 0 Attached is a written consent of the person whose record is being requested. Under penalty of perjury, I attest that I shall not obtain, resell, transfer, or use the information in any manner prohibited by law. I understand that motor vehicle or driver records that are obtained, resold, or transferred for purposes prohibited by law may subject me to civil penalties under federal and state law. Signature of Director. Principal DATE Email Address or Authorized Representative Printed Name Address Title of Signatory City. State. Zip Code Name of Company or Agency Phone Number Fax Number Information Below is intended for Individual Request DRIVER INFORMATION DRIVER NAME DRIVER LICENSE NUMBER DATE OF BIRTH VEHICLE INFORMATION OWNER NAME LICENSE PLATE NUMBER VEHICLE IDENTIFICATION NUMBER VIN Created 06-01-09 Version COE2009.1 Account Number (State form expires on an annual basis) ADDENDUM TO SUBSCRIPTION AGREEMENT FOR COLORADO MOTOR VEHICLE REPORTS This Addendum supplements the existing Subscription Agreement between ("Customer") and Softech International ("Softech"). Customer hereby requests Colorado Records and agrees to follow and be bound by the following terms and conditions: Definitions- For purposes of this addendum, the following definitions apply: "Vendor" is an entity that serves as the DMV's representative for the distribution of Records to Sub-vendors and End Users. "DMV" designates State of Colorado, Department of Revenue, and Motor Vehicle Business Group. "Driver License Records" or "DLRs" are records containing information identified in 42-1-206(3.7)(a), C.R.S. "End User' is a qualified person or entity that requests and obtains a copy of a MVR electronically from the Vendor or from a Sub-Vendor. "End User" also includes all persons or entities that subsequently obtain and use such Records from an "End User". "Motor Vehicle Record" or "MVR" is any class of records compiled and maintained by the DMV pertaining to a motor vehicle title application under section 42-6-116, a motor vehicle registration application under 42-3-1 t2, or other official record or document maintained by the DMV under section 42-2-121 pertaining to motor vehicles as defined in 42-1-102(58) CRS. "Records" are the driver history records; motor vehicle records; title, registration, or lien records or any portion of the records maintained by the DMV as defined under 42-2-121 and 42-1-206(3.7)(a), (d), C.R.S. "Records Containing Personal Information" or "RCPI" are those MVRs in which any data field of Personal Information has not been removed, thus revealing it to an End User upon Disclosure. "Sub-vendor" designates Softech. Additions - Treatment of RCPI: The following is added to the Subscription Agreement as regards Colorado Driver License Records: 1. Statement of Confidentiality: As an employee, officer, staff member, temporary employee or subcontractor of End User, you may have access to State of Colorado, Department of Revenue, Division of Motor Vehicles ("State") official motor vehicle and/or driver records. The confidentiality of the information contained within these Records shall be maintained at all times. Record information shall not be distributed, sold or shared with any third party nor used by you in any way except as expressly authorized by the State. Disclosure of such information may be cause for legal action against you, the Vendor and any involved third party. The State shall not be in any way responsible for defense of any such action. Pursuant to C.R.S. 42-1-206, any person who willfully and knowingly obtains, resells, transfers, or uses information in violation of law shall be liable to any injured party for treble damages, reasonable attorneys' fees, and costs. Other civil and criminal laws may also apply. 11. The End User agrees to: A. Abide by the legal restrictions and conditions upon use and Disclosure of the Personal Information contained within a Record and, B. Keep and maintain sufficient books and records to evidence use in accord with the Intended Use and, C. Abide by such other provisions of this Agreement as are indicated to require End User agreement. 111. End User shall destroy the RCPI and PI is not retained except as indicated into the intended use indicated by the Affidavit of Intended Use. The End User cannot give, sell, or loan a RCPI they have obtained or the PI in contains, to any other person or entity for any purpose whatsoever. IV. End User agrees to implement reasonable system and data security procedures to protect Records from unauthorized Disclosure. Such reasonable procedures may include, but are not limited to, username and password access policies, firewalls, background investigations of employees or any other individuals authorized to access Records, encryption during transmission, and execution of confidentiality agreements by such employees or other individuals with authorized access. V. The End User agrees to keep and maintain, in accordance with commercially reasonable data archive standards, for a period of time equal to five years after the last date the End User has an agreement with Sub-vendor for Disclosure of Records, books and records, including financial accounts, which contain: A. Documentation of Disclosure of any Records in or under its possession or control, B. Documentation of End User systems and operation for handling of and safeguarding from unauthorized Disclosure of Records and Created on 06-01-09 Version COE2009.1 Account Number (State form expires on an annual basis) C. Make available to Vendor, DMV, or the authorized representative of either of them, at any reasonable time, all such books and records including financial accounts, for auditing, compliance and monitoring purposes. Either Vendor or DMV shall have the right, but not the obligation, to conduct any inquiry or audit hereunder. VI. By signing this Addendum, End User agrees to indemnify, hold harmless, and release Vendor and the State of Colorado and their respective parent corporations, subsidiaries, officers, agents, agencies, contractors, subcontractors and employees (collectively, the "Releasees") from and against any and all loss, damages of any kind, injury, liability, court awards, suits and proceedings, including costs, expenses and attorneys' fees, arising from the performance of this Agreement or the performance, disclosure, or use of any data contained in any records maintained by DMV by the End User, its officers, agents, volunteers or employees, except insofar (with respect to indemnity, hold harmless and release of the State of Colorado) as they may result from the actions or inactions of the State of Colorado, its agencies, employees, contractors or subcontractors; and except insofar (with respect to indemnity-, hold harmless and release of Vendor) as they may result from the actions or inactions of Vendor, its parent corporation, its subsidiaries officers, agents, contractors, subcontractors or employees. VII. Breach of Security End Users shall report to Softech, who shall then promptly report to Vendor, the following occurrences within twenty-four (24) hours of discovery: A. Any misuse of and/or breach of security or confidentiality involving a Record furnished from Sub-vendor to End User; B. Any misuse of and/or breach of security or confidentiality involving a Record furnished to Sub-vendor and/or to End User issued by a state other than the State of Colorado; C. Any litigation, threatened litigation or Notice of Claim, involving the content or handling of a Record furnished from Sub-vendor to End User. Such an occurrence shall be reported by End User to Sub-vendor within three (3) business days of service of process; D. Any non-monetary breach of the Softech written Agreement with the End User. Such occurrence shall be reported by the End User to the Sub-vendor within three (3) business days of discovering such breach; VIII. End User shall be capable of generating, within twenty four (24) hours of a request by Vendor or DMV, a history of its Disclosures over time of any Records obtained under this Agreement. IX. End Users shall not use any Personal Information obtained under this agreement for direct mail or email solicitations, advertising, or surveys, nor shall it compile or publish, or permit others to compile or publish, including on the Internet, any portions of the Personal Information furnished to it in a Record. X. End User agrees that it is subject to remedial action by Vendor or DMV or both, in the event of violation of this Agreement. Such remedial action may range from suspension for a fixed period of time from receiving Records, to termination of the privilege of receiving Records and may include liability to Vendor and/or the DMV. XI. Third Party Beneficiary - No third-party rights are created or acquired by reason of this Agreement. XII. End User agrees that no tern or condition of any agreement with DMV or Vendor shall constitute a waiver, express or implied, of any provision of the Colorado Governmental Immunity Act (the "Immunity Act"), as amended from time to time, nor the risk management self insurance statutes (the "Risk Management Acts") as amended from time to time. Further, End User understands, acknowledges and agrees, that the liability of the State of Colorado for any claims or injuries arising out of any conduct of the State of Colorado, its departments, institutions, agencies, boards, officials and employees is controlled and limited by the provision of the Immunity Act and Risk Management Acts. X1I1. End User acknowledges that the continuing ownership of the original record underlying each copy of a Record remains with DMV. This Addendum does not modify, alter, expand or delete any other terms or conditions of the Subscription Agreement. IN WITNESS WHEREOF, the customer certifies that each has read, understands, and agrees to the terms and conditions described herein in this Addendum, and Specific State Forms. Date End User (Customer) Signature Print End User (Customer) Name Created on 06-01-09 Version COE2009.1 GEORGIA STATE FORM INSTRUCTIONS The following information will assist you in completing the form to access MVRs in this state. • Fill in all blanks in account information fields completely. • Indicate business type and reason for requesting driving records. • Sign and date the forms in the fields provided. • Only a person who is authorized to execute contracts for your company should complete and sign this form. GEORGIA DEPARTMENT OF MOTOR VEHICLE SAFETY Driver's Services Section/Motor Vehicle Records P.O. Box 80447 Conyers, Ga. 30013 678-413-8437 APPLICATION FOR MOTOR VEHICLE RECORDS Company Name: FEIN: Company Rep./Individual Name: Existing Customer ID: Mailing Address: City: State: Zip Code: Billing Address: City: State: Zip Code: Telephone Number: Fax Number: Type of Business: (Select Only one) Court Credit Employment Insurance Law Enforcement School Other Type of Certification Requested: (Select Only one) Internet User Bulk Requestor Bulk User Purpose For Requesting MVR: (Select Only one) Insurance Employment Limited Rating Information Credit Rental Car Agency Security Question: (Answer Only one of the following questions) What is your mother's maiden name? Answer: What is your pet's name`? Answer: What is your favorite color? Answer: What is your favorite food? Answer: What is your birth month? Answer: E-mail Address: Do you have a contract with a state agency that requires you to request MVR(s)? Yes No If yes. you will need to send in a copy of that contract with your signed application. By signing this agreement. I hereby certify the above information is true and correct and the information obtained will be used for the purpose stated above and in accordance with the Fair Credit Reporting Act. SIGNATURE TITLE DATE PRINTED NAME OF APPLICANT USER/REQUESTER ACKNOWLEDGMENTS I. I acknowledge and understand that the Company must abide by the statutory provisions set forth in O.C.G.A. X40-5-2 as well as the rules and regulations promulgated by the Georgia Technology Authority regarding the use of Motor Vehicle Records (hereinafter referred to as "MVR"). 2. 1 acknowledge and understand that MVR(s) shall be used exclusively with a) claims investigation, b) antifraud activities, c) rating. d) underwriting ofmotor vehicle insurance or e) for verification of information provided by an individual whose record is requested as part of an employment process. (I lercinafter referred to as "Permitted Use"). 3. I acknowledge and understand that MVR(s) may be resold only to entities and/or individuals authorized to receive the information. (I lercinafter referred to as a "User). I acknowledge and understand that Users must execute a certificate (hereinafter referred to as "User Certificate") and submit it to the Department of Motor Vehicle Safety (hereinafter referred to as the "DMVS"). 4. 1 acknowledge and understand that MVR(s) cannot be stored. copied, or downloaded except as required to transfer MVR(s) to a User. Furthermore, I understand that MVR(s) may not be published, transmitted to any other person and/or entity unless required by law or by express written consent of DMVS. 5. 1 acknowledge and understand that the Company's documentation supporting the request for MVR(s) shall be subject to inspection; review or audit by DMVS or the State Auditor for a period of three (3) years from the date the request was made. 6. 1 acknowledge and understand that notwithstanding the foregoing, the Company hereby waives, releases. relinquishes, discharges and agrees to indemnify, protect and save harmless the State (including the State Tort Claims Trust Fund) and DMVS of and from any and all claims, demands, liabilities, loss, costs and/or expenses for any loss or damage, including but not limited to libel, slander, defamation. and or invasion of privacy and attorney fees. caused by, growing out of, or otherwise happening in connection with Company's Permitted Use of MVR(s). due to any act or omission whether intentional or negligent. or otherwise on the part of Company. its agents, employees. subcontractors or others working at the direction of Company on its behalf. 7. 1 acknowledge and understand that DMVS will maintain a record of all MVR(s) which the Company requests for a period of four (4) years. I further acknowledge and understand that Company is required to maintain all of Company's requests to DMVS for MVR(s) for a period of three (3) years. 8. I understand that Company may be subject to criminal sanctions if Company. its agents, or employees disclose. distribute or sell the M VR(s) to an unauthorized third party or use the MVRS for an unauthorized purpose. I have been fully authorized and empowered to execute this acknowledgement on behalf of company. Signature Date MARYLAND STATE FORM INSTRUCTIONS (Note - form is 2 pages in length) The following information will assist you in completing the form to access MVRs in this state. Please note the state will return the form if not filled out per the below instructions. 1 Fill in your agency/company name on the first blank line provided in the first paragraph. 2 Fill in the day, month and year on the appropriate lines in the first paragraph. 3 Fill in your agency/company name on ALL blank lines in paragraphs #1,3,4,5,6 and 7. Note the name must.be the same in all name blanks 4 On second page please sign under the word Purchaser on the right side of form. Only a person who is authorized to execute contracts for your company should complete and sign this form. Please sign in the presence of a witness, and date the form on the line provided under your signature. Since the state of Maryland will not accept the form when the signature is illegible, we request that you print your name under the word Purchaser. 5 The witness should then sign under "Witness" on the left side of form and date the form on the line provided. Both dates must be the same. Customer Acct # STATE OF MARYLAND DEPARTMENT OF TRANSPORTATION MOTOR VEHICLE ADMINISTRATION PRIVACY PROTECTION POLICY In consideration of receiving personal information contained in Motor Vehicle Administration records, 1 HEREBY CERTIFY on behalf of as its authorized agent this day of , 200, that 1. understands that federal laws affect access to and use of computer information including, but not limited to, 15 U.S.C.A. § 278g-3 (Computer Security Act of 1987); 23 U.S.C.A. § 401 (National Driver Register Act); 5 U.S.C.A. § 552 (Freedom of Information Act); 5 U.S.C.A. § 552a (Privacy Act of 1974); 18 U.S.C.A.§ 1001 (Computer Fraud and Abuse Act of 1986); 17 U.S.C.A. § 109 (Computer Software Rental Amendments Act of 1990); 15 U.S.C.A. § 1681 (Fair Credit Reporting Act); and, 18 U.S.C.A. 2721 et seg. (Driver's Privacy Protection Act of 1994). 2. The Maryland Department of Transportation Office of Information Resources, its client agencies and their customers also adhere to state data processing security policies as set forth in Executive Order 01.01.1983.18 (Privacy and State Data System Security); Md. Code Ann., Crim. Law §8-606 (falsification of public records) and §7-302 (unauthorized access); Md. Code. Ann., State Gov't 10-611, 10-616 and 10-626 (Maryland Public Information Act); Md. Code Ann. Transp. II 12-111 to 12-113 (Motor Vehicle Administration Records); and, as published by the Secretary of the Department of Budget and Management from time to time under Md. Code Ann., State Fin. & Proc. § 3- 403. 3. and all employees agree to maintain in strictest confidence and not willfully disclose to any person, firm, or corporation information obtained as a result of their access to personal information from Motor Vehicle Records. 4. By signing this agreement, warrants that the signator and all personnel are familiar with all provisions of the federal Driver Privacy Protection Act of 1994, 18 U.S.C.A. 2721 et seq., and with 10-611, 10-616, 10-626 of the State Government Article and 12-111 through 12-113 of the Transportation Article, Annotated Code of Mar lam, which limit access to personal information from public records in Maryland. Further, , in behalf of itself, its successors and assigns further agrees that all users will abide by the terms of both the federal and state law including, but not limited to, those restricting Customer Acct # access to personal information from Motor Vehicle Administration records only to those persons and for those purposes which are permitted under both laws. 5. agrees to keep a record for five (5) years of all persons to whom information is redisclosed under this Agreement, and the purpose for which the information is to be used; and, to make that record available to the Motor Vehicle Administration upon request. 6. shall be liable for, and shall indemnify, defend, and hold the Motor Vehicle Administration harmless for, any misuse or misappropriation of any personal information in a record obtained from the Administration in connection with this agreement. 7. shall further indemnify the Motor Vehicle Administration for and against any and all losses, damages, judgments, liabilities or similar costs and expenses which arise in whole or part out of acts or omissions by with respect to laws restricting access to and disclosure of vehicle records including, without limitation, reasonable attorneys fees and all other costs of defending against such action or claim. IN WITNESS WHEREOF, the parties have caused these presents to be executed. Maryland Department of Transportation Motor Vehicle Administration Witness: By: Date: Date: Purchaser Witness: By: Date: Date: Approved as to form and legal sufficiency: Date: Assistant Attorney General REV: 0607043A GENERAL INFORMATION SERVICES State of Michigan - Motor Vehicle Records (MVRs) Insurance/Insurance Claims/Employment/ Subscriber Certification of Use I certify to the Michigan Department of State that abstracts of driving records obtained from GENERAL INFORMATION SERVICES (Company Name) shall be used exclusively for the purposes of rating and qualifying drivers for insurance, insurance claims or employment. I further certify that the company designated below further agrees that the information received will be used only in connection with the business purpose specified under this agreement. Additionally, designated company agrees that the information furnished under this Agreement will not be used to engage in any illegal activity, or in any method, act, or practice, which is unfair or deceptive in the solicitation or advertisement of goods, services, or real estate to Michigan or other consumers. Designated company further agrees not to use the information furnished under this Agreement to compile other records for resale or to store, in any shape or form, any record or data received from the Michigan Dept. of State any longer than required by law, and to destroy or otherwise dispose of the data at the earliest time permitted by law. GiS Account Number Subscriber: (Address) By: (Title) (Date) 1. THIS F70RM MUST BE COMPLETED IN ITS ENTIRETY. NEW HAMPSHIRE MOTOR VEHICLE RECORDS SUBSEQUENT USER CERTIFICATION (Please Type or Print Information) SOFTECH ACCOUNT # DATE: I hereby certify: A. That the COMPANY designated below is an employer or the agent of an employer that is requesting New Hampshire Driver/Vehicle Record Information on an employee or prospective employee because operating a motor vehicle is a condition of employment. [Saf-C 5605.02] B. That SOFTECH INTERNATIONAL INC is acting as Third Party Transaction facilitator for said COMPANY. (For Paragraph C, please check the applicable box.) ❑ Agent of an Employer C. That Driver/Vehicle Record Information obtained by SOFTECH INTERNATIONAL INC for said COMPANY shall be used exclusively for legitimate business, only as long as said COMPANY sells or packages the information with additional information for employment purposes to the ultimate and final end user. The end user will be prohibited from reselling, redisplaying, or otherwise redistributing the information to any other party. ❑ Employer C That Driver/Vehicle Record Information obtained by SOFTECH INTERNATIONAL INC for said COMPANY shall be used exclusively for legitimate business. That said COMPANY will be prohibited from reselling, redisplaying, or otherwise redistributing the information to any other party. D. That the information contained in the Driver/Vehicle Record Information obtained from New Hampshire Motor Vehicle Division shall be used in accordance with the requirements and in no way violate the New Hampshire state regulations, Saf-C 5600, and state law, RSA 260:14. http://www.gencourt.state.nh.us/rules/saf-c5600.htmI E. That all Fair Credit Reporting Act (F.C.R.A.) and Driver's Privacy Protection Act (D.P.P.A.) regulations have been met with regard to the requests submitted by said COMPANY to SOFTECH, including, but not limited to, obtaining a signed release for each Driver Record Information request submitted to SOFTECH. I affirm that I am a representative authorized to bind the COMPANY named below and I will comply with RSA 260:14 and New Hampshire Code of Administrative Rules Saf-C 5600 and I understand the limitations placed on the use of information received from the New Hampshire Department of Safety. This form is subject to the penalties by RSA 260:14, IX. "RSA 260:14, IX A person is guilty of a class B misdemeanor if such person knowingly discloses information from a department record to a person known by such person to be an unauthorized person, knowingly makes a false representation to obtain information from a department record, or knowingly uses such information for any use other than the use authorized by the department. In addition, any professional or business license issued by this state and held by such person may, upon conviction and at the discretion of the court, be revoked permanently or suspended. Each such unauthorized disclosure, unauthorized use or false representation shall be a separate offense." Name of Company Address Authorized Representative Signature Date City, State, Zip Code (Expires one year after date of signature) Printed Name Title Phone Number Email Address Fax Number OHIO STATE FORM INSTRUCTIONS (EMPLOYMENT) The following information will assist you in completing the appropriate form to access MVRs in this state. • Note: This form is for employment purposes only. • Fill in the following blocks in Part A: Name, address, city, state, zip code, company, and telephone number. • Sign where indicated and fill in the date in Part A. • You do not need to fill out Part B. • On page 2, items 2 and 13 require at least a Tax identification number (your Federal Tax ID number) • Sign and date Part C. • Only a person who is authorized to execute contracts for your company should complete and sign this form. ,o. OHIO DEPARTMENT OF PUBLIC SAFETY e , ,l BUREAU OF MOTOR VEHICLES N OBMV RECORD REQUEST (Ohio Revised Code [O.R.C.] 4501.15, 4501.27, AND 4507.53) This agency is requesting disclosure of information that is necessary to accomplish the statutory purpose as outlined under O.R.C. 4501.27. Disclosure of this information is REQUIRED. FAILURE to provide any information will result in this form not being processed. ► This request is being made by (check one): ❑ An individual inquiring regarding himself or herself: (Complete Part A) If inquiring in person for information on yourself, you must provide personal information regarding yourself, or prove your identity by presenting your driver license or identification card. ❑ An individual inquiring regarding another person: (Complete Parts A and B) If inquiring regarding another individual, you must attach a notarized BMV Form 5008 giving the written consent of the person. All mail requests without the BMV Form 5008 attached will be returned to the requester. ❑ Other: (Check applicable reason for request on Part C, and complete Parts A and B) ► I am requesting the following personal information contained in the Bureau of Motor Vehicles records: ❑ Driving Record 13021 ($5.00) ❑ Copy of Title Record ($5.00) ❑ Vehicle Registration Record 13o31 ($5.00) ❑ Last Known Address [405] ($5.00) ❑ Copy of Driver License Application [405A] ($5.00) PART A: Please provide current information regarding yourself: I NOTE: SIGNATURE REQUIRED YOUR NAME (REQUESTER) DATE OF BIRTH SIGNATURE i DATE X CURRENTSTREETADDRESS CITY STATE ZIP COMPANY (IF APPLICABLE) BMV ACCOUNT # (IF APPLICABLE) SOCIAL SECURITY # DRIVER LICENSE # LICENSE PLATE # VEHICLE IDENTIFICATION # TITLE # TELEPHONE #/FAX # PART B: Request regarding other person(s): PERSON'S NAME DATE OF BIRTH STREET ADDRESS CITY STATE ZIP SOCIAL SECURITY # DRIVER LICENSE # LICENSE PLATE # VEHICLE IDENTIFICATION # TITLE # If requesting information on more than 1 person or vehicle, attach additional sheet(s). ❑ Additional sheet(s) attached Make check or money order payable to Ohio Treasurer Kevin L. Boyce. If mailing, return to: Ohio Bureau of Motor Vehicles, Attn: Records Request, P.O. Box 16520, Columbus, Ohio 43216-6520. Results will be mailed to requester. NOTE: An additional $3.50 fee will be charged when submitting this form in person at any Deputy Registrar location or the Customer Service Center located at 1970 W. Broad St., Columbus, OH 43223. BMV 1173 12/09 Page 1 of 2 Part C: I ('requester) qualify as checked below, and I am requesting: 1. As an individual. (Complete Part A, front) 2. A record for use in the normal course of business by me as a legitimate business or an agent, employee, or contractor of a legitimate business, for one of the two following purposes: (a) to verify the accuracy of personal information submitted to the business, agent, employee, or contractor by an individual; (b) in case personal information submitted to the business, agent, employee, or contractor by an individual is incorrect or no longer is correct, to obtain the correct information, for the sole purpose of preventing fraud, by pursuing legal remedies against, or recovering on a debt or security interest against, the individual. My tax identification number is: My vendor number is: My professional license number is: Licensed by (agency): 3. With written consent. (Complete Parts A and B, front). 4. Records for bulk distribution for surveys, marketing, or solicitations, where the information will be used, rented, or sold solely for bulk distribution for surveys, marketing, or solicitations; 5. A record for the use of a government agency, including, but not limited to, a court or law enforcement agency, in carrying out its functions, or for the use of a private person or entity acting on behalf of an agency of this state, another state, the United States, or a political subdivision of this state or another state in carrying out its functions (a law enforcement agency does not need to fill out this form); 6. A record for use in connection with matters regarding motor vehicle or driver safety and theft; motor vehicle emissions; motor vehicle product alterations, recalls, or advisories; performance monitoring of motor vehicles, motor vehicle parts, and dealers; motor vehicle market research activities, including, but not limited to, survey research; and removal of non-owner records from the original owner records of motor vehicle manufacturers; 7. A record for use in connection with a civil, criminal, administrative, or arbitral proceeding in a court or agency of this state, another state, the United States, or a political subdivision of this state or another state or before a self-regulatory body, including, but not limited to, use in connection with the service of process, investigation in anticipation of litigation, or the execution or enforcement of a judgment or order (a subpoena or other court order may be used instead of this form). Please provide the court and case number, or if the case has not yet been filed, the court you anticipate to file in 8. A record pursuant to an order of a court of this state, another state, the United States, or a political subdivision of this state or another state (a subpoena or other court order may be used instead of this form). Please attach a certified copy of the court order: 9. Records for use in research activities or in producing statistical reports, where the personal information will not be published, redisclosed, or used to contact an individual, 10. Records for use by an insurer, insurance support organization, or self-insured entity, or by an agent, employee, or contractor of that type of entity, in connection with a claims investigation activity, anti-fraud activity, rating, or underwriting. Please provide your Tax Identification, Vendor, or Professional license number along with the name of the licensing agency: 11. A record for use in providing notice to the owner of a towed, impounded, immobilized, or forfeited vehicle. Please provide your Tax Identification, Vendor, or Professional license number along with the name of the licensing agency: 12. A record for use by a licensed private investigative agency or licensed security service for any purpose permitted under numbers 1 through 15 of this form, my agency license number is: 13. A record for use by an employer or by the agent or insurer of an employer to obtain or verify information relating to the holder of a commercial driver license or permit that is required under the "Commercial Motor Vehicle Safety Act of 1986", 100 Stat. 3207-170, 49 U.S.C. 2701, et seq., as now or hereafter amended. Please provide your Tax Identification, Vendor, or Professional license number along with the name of the licensing agency: 14. A record for use in connection with the operation of a private toll transportation facility; 15. A record for any other use specifically authorized by law that is related to the operation of a motor vehicle or to public safety. Please provide a copy of the relevant statute. 16. A record in order to carry out the purposes of either the "Automobile Information Disclosure Act", 72 Stat. 325, 15 U.S.C. 1231-1233, the "Motor Vehicle Information and Cost Saving Act", 86 Stat. 947, 15 U.S.C. 1901, et seq., the "National Traffic and Motor Vehicle Safety Act of 1986" 80 Stat. 718, 15 U.S.C. 1381, et seq., the "Anti-Car Theft Act of 1992", 106 Stat 3384, 15 U.S.C. 2021, et seq., or the "Clean Air Act", 69 Stat. 322, 42 U.S.C. 7401, et seq., all as now or hereafter amended, for use in connection with one or more of the following matters: (a) motor vehicle or driver safety and theft; (b) motor vehicle emissions; (c) motor vehicle product alterations, recalls, or advisories, (d) performance monitoring of motor vehicles and dealers by motor vehicle manufacturers; (e) removal of non-owner records from the original owner records of motor vehicle manufacturers. I understand that if I receive personal information under numbers 2, 3, or 5-16 of this form, I may resell or disclose the personal information only for uses permitted under numbers 2, 3, or 5-16. 1 understand that if I receive personal information under number 2-16 of this form, and I resell or redisclose any personal information, I must keep for a period of five years a record that identifies each person or entity that receives any of the personal information and the permitted purpose for which the information is to be used, and I must make all such records available to the Registrar of Motor Vehicles upon request. I hereby certify that all of the information contained on this form is true and accurate to the best of my knowledge and belief. I understand that providing false information may constitute a criminal offense of falsification with a maximum penalty of 6 months in jail and a $1000 fine. IGNATURE DATE X BMV 1173 12/09 Page 2 of 2 DL•AFF01 EMPLOYMENT Company Rev. 01 /03 Instructions for completing the Affidavit of Intended Use 1. The affidavit must be completed and signed by a member of your agency or firm who has the authority to certify the agency or firm's compliance. 2. Please complete each line on the form in its entirety to avoid delays in processing your affidavit. If requested information does not apply to your business insert n/a (not- applicable) on that line. 3. The person responsible for completing the affidavit must initial each of the nine (9) declaration statements, then sign and date the form in the presence of a Notary. 4. This affidavit must be filed with your information provider and approved by PennDOT. 5. You are required to complete, notarize and file a new Affidavit of Intended Use whenever information about your company changes. (name, address, ownership, telephone, website, etc.) DL-9105 (11-0-7) EMPLOYMENT AFFIDAVITOF INTENDED USE INFORMATION SALES UNIT PA Department of Transportation Bureau of Driver Licensing P.O. OBox Box 68272 68272 • Harraarrisbuurgrg, , PA A 17106-8272 PLEASE TYPE OR PRINT IN BLUE OR BLACK INK ALL INFORMATION (See Reverse Side for Instructions) Business Type (check one): ❑ Individual ❑ Partnership ❑ Corporation ❑ Non-Profit Legal Business Name: D/B/A Name (if applicable): Person Responsible: Name: Title: Street Address: P.O. Box: City: State: Zip: Business Telephone: ( ) Fax No.: ( ) E-mail: Web Site Address: Federal Employer ID No.: If Corporation, Date & State of Incorporation: Year Business Established: Dun & Bradstreet U.S. DOT (if applicable) Location of Records: For departmental on-site inspection, audit and review purposes. J Check here, If address is same as above. Street Address: City: State: Zip: Type of Business: Ownership: List below individual, each partner, or each corporate officer participating in the direction, control or management of the business. Attach list if needed. Name (Last, First, MI) Title Date of Birth STATE Driver Day-Time (Muwlyyyy) Lic. Issued Phone Number 1. 2. 3. Please initial each statement below and sign at the bottom of the form. 1. I swear and affirm that any requested information will be used for employment purposes only. 2. 1 swear and affirm that I have on file a signed release for the subject of each driver record requested. 3. 1 swear and affirm that I understand the driver record is confidential and restricted information and I will establish procedures to protect the confidentiality of these records. 4. 1 swear and affirm that I will not request driver information from the Department for personal reasons. (Examples of inappropriate access or misuse of Department information include, but are not limited to: making personal inquiries on my own record or those of my relatives; accessing information about another person, including locating their residence address, for any reason that is not related to my job responsibilities.) 5. 1 swear and affirm that the information obtained from the Department shall not be sold, assigned or otherwise transferred to any other party. 6. 1 swear and affirm that I understand that the Department retains exclusive ownership of all driver record information provided and no record shall be combined and/or linked in with any other data on any database for any reason. 7. 1 swear and affirm that the information obtained from the Department will not be used for direct mail advertising or any other type or types of mail or mailings. 8. 1 swear and affirm that I will not disseminate or publish on the Internet the personal information obtained from the Department or allow any other person to disseminate or publish the personal information on the Internet without the express written permission of the Department. 9. 1 swear and affirm that the statements made herein are true and correct, and that any statement made on or pursuant to this form is subject to the penalties of 18 PA C.S. Section 4903(a)(2) (relating to false swearing), which shall include punishment of a fine not exceeding $5,000, or a term of imprisonment of not more than two years, or both. Subscribed and Sworn to Before Me: Mo. Day Year S Signature of Person Administering Oath Signature Date E Sign in Presence of Notary A L Title VIRGINIA STATE FORM INSTRUCTIONS (EMPLOYMENT) The following information will assist you in completing the appropriate form to access MVRs in this state. • Note: This form is for employment purposes only. • Fill in all blanks in account information fields completely. • Sign and date the forms in the fields provided. • Only a person who is authorized to execute contracts for your company should complete and sign this form. INFORMATION USE ACKNOWLEDGEMENT EMPLOYMENT WHEREAS, the Commonwealth of Virginia, Department of Motor Vehicles, may under existing statutes furnish an abstract of a driver's record as maintained by said office for the purpose of employment screening, Va. Code §46.2-208 (B) (11) which limits the release of such abstract to an employer, potential employer, or authorized agent who has been authorized in writing by such driver to obtain the driver's record; NOW, THEREFORE, IN CONSIDERATION OF THE FOREGOING, THE UNDERSIGNED DOES HEREBY ACKNOWLEDGE AND CERTIFY AS FOLLOWS: 1. That the undersigned represents and warrants to Softech International ("Softech") that as prescribed by the laws of the Commonwealth of Virginia, every person on whom a request for an abstract for employment purposes is made by the undersigned, shall have first given his or her written consent to the release of such an abstract when required for statutory compliance. 2. That anytime an employment record request is made, a signed release by the person for whom the report is ordered must be received and maintained by the customer ordering the report. The original written authorization signed by the driver on whom the abstract is requested, or a copy thereof, shall be maintained by the undersigned for a minimum of five years from the date of the record's request. 3. That the original written authorization signed by the driver on whom an abstract is requested, or a copy thereof, shall be furnished by the undersigned to Softech or the Commonwealth of Virginia upon request. 4. That the undersigned further agrees to indemnify and hold harmless Softech and the Commonwealth of Virginia for any liabilities and/or damages caused by virtue of the undersigned's breach of this agreement or the laws of the Commonwealth of Virginia. 5. That the reports your company obtains from Softech may not be offered for sale over the internet, sent via email or provided to a third party. 6. When a report is ordered, you will not pass this information to a third party either in verbal or written form. This is due to F.C.R.A. regulations that prohibit a person from obtaining a consumer report from a consumer reporting agency (CRA) unless the person has certified to the CRA the permissible purpose for which the report is being obtained and certifies that the report will not be used for any other purpose. 7. That you will not provide the report to the consumer directly, unless you have taken an adverse action against the consumer, such as denial of employment. In the instance of an adverse action, you must provide a copy of the MVR along with a copy of the consumer's rights under FCRA and provide them with Softech's toll free phone number (as the consumer reporting agency). The consumer may request a free copy of the report, in the case of an adverse action, from Softech. 8. That Softech will conduct random audits to ensure compliance measures are maintained. I have read and understand the above requirements. Company or Organization Signature Address Date City, State Account ID(s) Created on01/07/04 Version VAE2004.1 WASHINGTON STATE FORM INSTRUCTIONS (TRANSIT) The following information will assist you in completing the appropriate form to access MVRs in this state. • Note: This form is for transit authority purposes only • Fill in all blanks in account information fields completely. • Sign and date the forms in the fields provided. • Only a person who is authorized to execute contracts for your company should complete and sign this form. Account Number TRANSIT AUTHORITY is s N alid err for s two year certification valid s) SUBSCRIBER CERTIFICATION OF USE TO WASHINGTON STATE DEPARTMENT OF LICENSING (DEPARTMENT) I hereby certify: (A) That the company or their agent designated below as SUBSCRIBER is a transit authority for its vanpool program. (B) That Softech International ("Softech") is acting as agent for SUBSCRIBER. (C) That abstracts of driver records shall be used exclusively for determining whether the volunteer licensee meets those insurance and risk management requirements necessary to drive a vanpool vehicle, and that no information contained therein shall be divulged, sold, assigned, or otherwise transferred to any third person or party. (D) That the information contained in the abstracts of driver records obtained from the DEPARTMENT shall be used in accordance with the requirements and in no way violate the provisions of RCW 46.52.130, attached in part for easy reference. The SUBSCRIBER listed below agrees to, and shall, indemnify and hold harmless the State of Washington, Department of Licensing (DEPARTMENT), the Director of the DEPARTMENT and all of the DEPARTMENT employees from any and all suits at law or equity, and from any and all claims, demands or loss of any nature, including but not limited to all costs and attorney's fees, arising from any incorrect or improper disclosure of individual names or addresses under this "Certification of Use,- any defects in any of SUBSCRIBER's procedures followed or omitted or arising from the failure of SUBSCRIBER or its officers, employees, customers, contractors or agents to fulfill any of its obligations under this Contract; or arising in any manner from any negligent act or omission b SUBSCRIBER or its officers, employees, customers, contractors or agents. 1 affirm that I am a representative authorized to bind the SUBSCRIBER below named. SUBSCRIBER Address Name (print) Title Signature Date RCW 46.52.130 Abstract of driving record Access Fees Penalty. (1) A certified abstract of the driving record shall be furnished only to: (a) The individual named in the abstract:... (c) An employee or agent of a transit authority checking prospective volunteer vanpool drivers for insurance and risk management needs;... (5) Upon proper request, a certified abstract of the full driving record maintained by the department shall be furnished to a city or county prosecuting attorney, to the individual named in the abstract. to an employer or prospective employer or an agent acting on behalf of an employer or prospective employer of the named individual, or to an employee or agent of a transit authority checking prospective volunteer vanpool drivers for insurance and risk management needs. (6) The abstract, whenever possible, shall include: (a) An enumeration of motor vehicle accidents in which the person was driving; (b) The total number of vehicles involved; (c) Whether the vehicles were legally parked or moving: (d) Whether the vehicles were occupied at the time of the accident; (e) Whether the accident resulted in any fatality: (f) Any reported convictions, forfeitures of bail, or findings that an infraction was committed based upon a violation of any motor vehicle law: (g) The status of the person's driving privilege in this state: and (h) Any, reports of failure to appear in response to a traffic citation or failure to respond to a notice of infraction served upon the named individual by an arresting officer.... (9) The director shall collect for each abstract the sum of five dollars, which shall be deposited in the highway safety fund (12) Any, employee or agent of a transit authority receiving a certified abstract for its vanpool program shall use it exclusively for determining whether the volunteer licensee meets those insurance and risk management requirements necessary to drive a vanpool vehicle. The transit authority may not divulge any information contained in the abstract to a third part. (15) Any negligent violation of this section is a gross misdemeanor. (16) Any intentional violation of this section is a class C felony. DOL Control # 20041 RS 10417105 Created on 10/0912003 Version WAT2003.1 Subject: Letter of Permissible Purpose From: (Name) (Company Name) (Address) (City, State, Zip Code) Attn: State of Washington Department of Licensing RE: Statement of Permissible Purpose to obtain driving records This will certify that we are an employer authorized to hire drivers from the State of Washington, pursuant to RCW 46.52.130. We will obtain our Washington driving record requests through General Information Services, Inc. GiS will act as our authorized agent to process our Washington driving records. We will only access Washington Driving Records through GiS to determine whether the named individual should be employed to operate a commercial vehicle or school bus on the public highways. As our employee that would operate a vehicle with the principal use of which is the transportation of commodities, merchandise, produce, freight, animals or passengers for hire. Specific to our company, our line of business is We understand that failure to comply with Washington state law is subject to criminal penalties and that we may not divulge any information from the driving record to a third party. Sincerely, (Signature of Director, Principal or Owner) (Printed name and title of signatory) Date Customer Account # Page 1 / 1 b .r r mo.'s [ CITY OF y } A S H i A ND DATE PO NUMBER 20 E MAIN ST. 6/2/2015 12892 ASHLAND, OR 97520 (541) 488-5300 VENDOR: 019468 SHIP TO: City of Ashland GENERAL INFORMATION SERVICES (541) 488-6002 PO BOX 538450 20 E MAIN STREET ATLANTA, GA 30353 ASHLAND, OR 97520 FOB Point: Req. No.: Terms: Net Dept.: Req. Del. Date: Contact: Tina Gray Special Inst: Confirming? No Quantity Unit Description Unit Price Ext. Price On-Line background screeninq services 3,000.00 for all new hires and volunteers, Estimate for balance of FY 2014-2015 - $3,000.00 Contract Background Screening Services Beqinninq date: March 1, 2015 Completion date: Mav 12, 2017 (Contract was signed by City representative on May 12, 2015, initial contract for 2-year term with option to renew annually for up to 3 additional years for a maximum term of 5 vears.) SUBTOTAL 3,000.00 BILL TO: Account Payable TAX 0.00 20 EAST MAIN ST FREIGHT 0.00 541-552-2010 TOTAL 3,000.00 ASHLAND, OR 97520 Account Number Project Number Amount Account Number Project Number Amount E 710.01.49.00.60410 3,000.00 i P VENDOR COPY Author d Signature FORM #3 CITY OF ASHLAND REQUISITION Date of request: Required date for delivery: Vendor Name &IY~~AG //vFpr~°~W7.Qy 6;~FWV145AS Address, City, State, Zip X117 /19D/h ~~Oll?, G 7 ~~i~ Contact Name & Telephone Number pF~?1J~~_~,~ Ufa x~ ~32'2?70~0 Fax Number SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Emergency ❑ Reason for exemption: ❑ Invitation to Bid (Copies on file) ❑ Form #13, Written findings and Authorization ❑ AMC 2.50 Date approved by Council: ❑ Written quote or proposal attached ❑ Written quote or proposal attached ❑ Small Procurement Cooperative Procurement Less than $5,000 ❑ Request for Proposal (Copies on file) ❑ State of Oregon ❑ Direct Award Date approved by Council: Contract # ❑ Verbal/Written quote(s) or proposal(s) ❑ State of Washington Intermediate Procurement El Sole Source Contract # GOODS & SERVICES ! ] Applicable Form (#5,6, 7 or 8) ❑ Other government agency contract $5,000 to $100,000 ❑ Written quote or proposal attached Agency ❑ (3) Written quotes and solicitation attached ❑ Form #4, Personal Services $5K to $75K Contract # PERSONAL SERVICES ❑ Special Procurement Intergovernmental Agreement x,000 to $75,000 ❑ Agency ❑ Form #9, Request for Approval ❑ Less than $35,000, by direct appointment ❑ Written quote or proposal attached Date original contract approved by Council: (3) Written proposals/written solicitation Date approved by Council: (Date) ❑ Form #4, Personal Services $5K to $75K Valid until: Date Description of SERVICES Total Cost olv-414t? 9^a45ir"U1Vb 4~/IM* XD,P- AZL N H/2~s -f il'out ows . ON NF- s0~ Glty ~NoG>!Gd ~OT° ocez~v 020/e~m • $ 2 p1 DOD (~vT<~1.1A7~d~ Item # Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL. COST ❑ Per attached quotelproposal $ Project Number - AccountNumbe - - - Account Number Account Number---. 'Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. IT Director in collaboration with department to approve all hardware and software purchases: IT Director Date Support -Yes / No By signing this requisition form, 1 certify that the City's public contracting requirements have been satisfied. Employee: H Department Head: (Equat to or greater than $5,000) Department Manager/Supervisor: City Administrator: -y' {Equatto or greater than $25,000) Funds appropriated for current fiscal year: YES / NO c'L ~ a,'- A C fr, l ~ i 1.1 Finance Director (Equal to or greater than $5,000) a e Comments: Form #3 - Requisition Kari Olson From: Tina Gray [grayt@ashland.or.us] Sent: Monday, May 18, 2015 9:29 AM To: 'Kari Olson' Subject: RE: GIS requisition Hi Kari Your right, I was thinking next FY. Could e $3,000 for May/Ju (We have a lot of seasonal hires right now). I hope that $20K is enough for next year. - From: Kari Olson [mailto:kari.olson@ashland.or.us] Sent: Friday, May 15, 2015 2:28 PM To: Tina Gray Cc: 'Kari Olson' Subject: GIS requisition Hello Tina, I am guessing the $20,000 you requested is for next fiscal year, correct? What we need now is the amount you estimate these services will cost for the remainder of May and June. Can you estimate what the services will cost for 1-1/2 months? Thank you. Kariann Kariann Olson Purchasing Representative City of Ashland 90 N. Mountain Avenue Ashland, OR 97520 Tel: 541.488.5354 Fax: 541.488.5320 TTY: 800.735.2900 kari.olson ashiand.or.us Visit the City's web site at: www.ashland.or.us This email transmission is official business of the City of Ashland, and it is subject to Oregon Public Records law for disclosure and retention. If you have received this message in error, please contact me at (541) 488-5354. Thank you. 1