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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY Edmund G. Brown Jr., Governor CALIFORNIA DEPARTMENT OF CHILD SUPPORT SERVICES P.O. Box 419064, Rancho Cordova, CA 95741-9064

DEPARTMENT OF CHILD SUPPORT SERVICES INVITATION FOR BID (IFB) #261 Kiosk Payment Services Notice to Prospective Bidders

March 21, 2016

The California Department of Child Support Services (DCSS) invites you to review and respond to this Invitation for Bid (IFB), IFB #261 entitled “Kiosk Payment Services.” In submitting your bid, you must comply with these instructions.

Note that all agreements entered into with the State of California will include by reference General Terms and Conditions and Contractor Certification Clauses that may be viewed and downloaded at Internet site: http://www.dgs.ca.gov/ols/Resources/StandardContractLanguage. If you do not have Internet access, a hard copy can be provided by contacting the person listed on this bid.

Military & Veterans Code section 999 establishes a contract participation goal of at least three percent (3%) for Disabled Veteran Enterprise (DVBE). This goal applies to a state agency’s overall contracting program. State agencies have the discretion to apply the DVBE participation goal to individual contracts. THE DCSS ELECTS TO WAIVE THE DVBE PROGRAM REQUIREMENTS IN THIS SOLICITATION, BUT OPTS TO INCLUDE THE DVBE INCENTIVE. The California DVBE Bid Incentive Instructions (09/03/09) include information about the DVBE incentive. Proposers must comply with requirements in Attachment 8. Out- of-state firms must also comply with California DVBE program requirements.

In the opinion of the Department of Child Support Services, this IFB is complete and without need of explanation. However, if you have questions, or should you need any clarifying information, the contact person for this IFB is: Shauna Ladd, Contracts and Purchasing Section Department of Child Support Services P.O. Box 419064 (916) 464-5363--FAX (916) 464-5064 [email protected]

Please note that no verbal information given will be binding upon the State unless such information is issued in writing as an official addendum.

REMINDER TO ALL VENDORS: Cal eProcure is DGS’ new online platform that replaced BidSync and was launched in December 2015. It is a feature of the Financial Information System for California (FI$Cal). If you have not already done so, please register on Cal eProcure to be able to participate in any solicitations that are posted. Contract Award will only be made to vendors that are successfully registered. Learn more at: www.dgs.ca.gov/caleprocure.

Reasonable Accommodation: To comply with the non-discrimination requirements of the Americans with Disability Act (ADA), it is the policy of the State to make every effort to ensure that its programs, activities and services are available to all persons, including persons with disabilities. For persons with a disability needing a reasonable modification to participate in the procurement process, or for persons having questions regarding reasonable modifications for the procurement process, you may notify the DCSS contact above. To ensure that we can meet your need, it is best that we receive your request for reasonable modification at least five (5) working days before the scheduled event or the due date of procurement documents. Department of Child Support Services IFB Number 261 Page 2 of 54

Table of Contents Section Page

A. Bidder Minimum Qualifications...... 3

B. Bid Requirements and Information...... 4 1. Key Action Dates:...... 4 2. Contract Term...... 4 3. Subcontractors...... 4 4. Submission of Bid...... 5 5. Evaluation and Selection...... 7 6. Award and Protest...... 7 7. Disposition of Bids...... 8 8. Agreement Execution and Performance...... 8 9. Darfur Contracting Act (Act)...... 8 10. Iran Contracting Act...... 9 11. Loss Leader Clause...... 9 12. Secretary of State Certificate...... 9 C. Preference and Participation Programs...... 9 1. Small Business Enterprise (SBE)...... 9 2. Disabled Veteran Business Enterprise (DVBE) Participation Requirements...... 10 D. Required Attachments...... 11 Attachment 1 – Required Attachment Checklist...... 12 Attachment 2 – Bid/Bidder Certification Sheet...... 13 Attachment 3 – Cost Sheet (Exhibit B.1)...... 15 Attachment 4 – Bidder References...... 16 Attachment 5 - Bidder Agreement With Scope of Work...... 17 Attachment 6 – Payee Data Record...... 20 Attachment 7 – Contractor Certification Clauses...... 21 Attachment 8 – Darfur Contracting Act (Act)...... 25 Attachment 9 – Iran Contract Act...... 26 Attachment 10 – California Disabled Veteran Business Enterprise (DVBE) Bid Incentive Instructions...... 27 Attachment 10A –Bidder Declaration...... 32 Attachment 10B – STD 843 Disabled Veteran Business Enterprise Declarations...... 35 Attachment 11– Workplace Policy Enforcement...... 36 Attachment 12 - Secretary Of State Certificate...... 37 E. SAMPLE STANDARD AGREEMENT (STD 213) CONTRACT...... 39 Exhibit A – Scope of Work...... 40 Exhibit B- Budget Detail and Payment Provisions...... 43 Exhibit B.1. – Cost Sheet...... 45 Exhibit D – Special Terms and Conditions...... 46 Exhibit E - Information Security Provisions...... 49 Department of Child Support Services IFB Number 261 Page 3 of 54

Purpose and Description of Services

In an effort to improve customer service and increase the efficiency and accessibility of receiving in-person child support payments, the Department of Child Support Services (DCSS) seeks a payment service provider that will accept cash, checks, credit card and debit card payments for child support through free-standing payment kiosks.

The number of kiosks will be determined by the amount of in-person payments anticipated by the Local Child Support Agencies (LCSA) and election by the LCSAs in consultation with DCSS to participate. Bidders must comply with the LCSAs and DCSS with the decision regarding placement of location and relocation of each kiosk. In addition to placing kiosks in their offices, LCSAs may choose to install kiosks in other locations, such as in court houses and/or share kiosks with other county government departments. In a survey, the LCSAs indicated interest in acquiring approximately 75 kiosks. Location or relocation of the kiosks must in the best interest of the LCSA and subject to the approval of the LCSA and DCSS.

There are a total of 51 LCSAs, each having one or multiple offices. Some have free standing office(s) and some share space with other county government operations. Specific locations have not been determined at this time; prospective bids should establish costs based with this taken into consideration as different locations may impact the bidder’s operational costs. A spreadsheet that shows the caseload size, number and amount of cash transactions and checks by LCSA is attached separately to this IFB. It is provided solely for the purpose of demonstrating historical volume and is not binding on the State as to future volume.

A kiosk was installed in the Marin LCSA office in July 2014 as a pilot. A kiosk was installed in the public library for the Napa LCSA in September 2014. Both counties continue to utilize kiosks provided by TouchPay until a statewide vendor is selected.

Presently, all credit and debit card payments are made through DCSS’ on-line web application, including any in-person payments made at LCSA offices. Payments may be made from any location by computer or mobile phone. DCSS’ payment system does not identify if whether the payment was initiated by an in-person visit, therefore, there is no way of estimating the volume of payments that may be made at a kiosk. From October 2014 through September 2015, there were 397,831 credit/debit card payments for a total of $145,389,876. For the same period, there were 234 chargebacks for a total of $275,901 and 51 reversals totaling $80,087.

In January 2015, DCSS began offering alternative cash payment services in retail stores. Offering alternative payment services may decrease the number of payments made in LCSA offices.

A. Bidder Minimum Qualifications

The Bidder must demonstrate having experience in providing payment services through a large kiosk network and shall have a proven track record of successfully partnering with clients receiving similar payment services. Department of Child Support Services IFB Number 261 Page 4 of 54

The Bidder must provide three (3) customer references that are similar in scope to the services required in this Bid. See Attachment 4 – Bidder References. Submission of this attachment is mandatory. Failure to complete and return this attachment with your bid will cause your bid to be rejected and deemed nonresponsive.

The Bidder must provide proof of a Money Transmitter License (MTL) or proof of exemption. Please indicate the license and/or certification information on Attachment 2, Bidder Certification Sheet, Section 9. Failure to submit either the Money Transmitter License or proof of exemption with your bid will cause your bid to be rejected and deemed nonresponsive.

BIDS THAT EXCEED THE COST OF MORE THAN $ 2.00 PER TRANSACTION WILL BE DEEMED NONRESPONSIVE AND DISQUALIFIED FROM CONSIDERATION FOR AWARD.

B. Bid Requirements and Information

1. Key Action Dates:

Event Date

IFB available to prospective Bidders March 21, 2016

Witten Question Submittal Deadline March 28, 2016 (2:00 PM PT)

Final Date for Bid Submission April 06, 2016 (2:00 PM PT)

Bid Opening April 06, 2016

Notice of Intent to Award April 12, 2016

Last Day to Submit Protest the Award April 19, 2016

Tentative Agreement Start Date May 16, 2016, or upon all approvals

All times are Pacific Time. Proposals mailed using the U.S. Postal Service may be delayed. General mail is delivered to a central mailroom at 11150 International Drive, Rancho Cordova, CA 95670. All dates after proposal submission are approximate and may be adjusted as conditions arise, without addendum to this IFB.

2. Contract Term

The term of the contract shall be for a period of two (2) years, with an estimated start date of May 16, 2016 through May 15, 2018, or upon all approvals.

3. Subcontractors

a) Any subcontractor that the contractor chooses to use in fulfilling the requirement of this solicitation must also meet all the requirement of this IFB, including the Department of Child Support Services IFB Number 261 Page 5 of 54

minimum qualifications. If Bidder proposes the use of a subcontractor, the Bidder must also submit a list of references, Attachment 4, Bidder References, on behalf of the subcontractor.

b) Bidder may not substitute any proposed subcontractor without advance written consent of the DCSS.

4. Submission of Bid

a) All bids must be submitted under sealed cover and sent to the DCSS by dates and times shown in Section B, Bid Requirements and Information, Item 1. Key Action Dates (above). The sealed cover must be plainly marked with the IFB number and title, must show your firm name and address, and must be marked with "DO NOT OPEN", as shown in the following example: U.S. Mail* IFB – #261– Kiosk Payment Services DEPARTMENT OF CHILD SUPPORT SERVICES Contracts and Purchasing Section P.O. Box 419064, MS 621 Rancho Cordova, CA 95741 Attn: Shauna Ladd, MS 621 BID – DO NOT OPEN DUE: April 06, 2016, 2:00 PM PT Overnight or Hand Delivery** IFB – #261 – Kiosk Payment Services DEPARTMENT OF CHILD SUPPORT SERVICES Contracts and Purchasing Section 11150 International Drive, MS 621 Rancho Cordova, CA 95741 Receiving Unit Attn: Shauna Ladd, MS 621 BID – DO NOT OPEN DUE: April 06, 2016, 2:00 PM PT

Also include the (IFB - #261 – Kiosk Payment Services) in the subject line

*For U.S. Mail, please use P.O. Box. Use street address for all other mail. **Deliver response to the Receiving Unit, located on the east side of the building.

Mail bids not submitted under sealed cover may be rejected. A minimum of three (3) copies (one (1) marked ORIGINAL and two (2) marked COPY), and one (1) CD copy clearly labeled to the Contract Administrator of the bid must be submitted. Department of Child Support Services IFB Number 261 Page 6 of 54 a) All bids shall include the documents identified in Attachment 1, Required Attachment Checklist. Bids not including the proper "required attachments" may be deemed non-responsive. A non-responsive bid is one (1) that does not meet the basic bid requirements. b) All documents requiring a signature must bear an original, wet signature and must be signed in blue ink with a person authorized to bind the bidding firm. c) Bids must be submitted for the performance of all the services described herein. Any deviation from the work specifications will not be considered and will cause a bid to be rejected. d) A bid may be rejected if it is conditional or incomplete, or if it contains any alterations of form or other irregularities of any kind. The State may reject any or all bids and may waive an immaterial deviation in a bid. The State's waiver of an immaterial deviation shall in no way modify the IFB document or excuse the Bidder from full compliance with all requirements if awarded the agreement. e) Costs incurred for developing bids and in anticipation of award of the agreement are entirely the responsibility of the Bidder and shall not be charged to the State of California. f) An individual who is authorized to bind the Bidder contractually shall sign Attachment 2, Bid/Bidder Certification Sheet. The signature should indicate the title or position that the individual holds in the firm. An unsigned bid may be rejected. g) If the Bidder’s firm is a certified small, micro-business, or Disabled Veteran Business Enterprise (DVBE), please complete Attachment 10A, Bidder Declaration, in response to this bid. h) A Bidder may modify a bid after its submission by withdrawing its original bid and resubmitting a new bid prior to the bid submission deadline. Bidder modifications offered in any other manner, oral or written, will not be considered. i) A Bidder may withdraw its bid by submitting a written withdrawal request to the State, signed by the Bidder or an authorized agent. A Bidder may thereafter submit a new bid prior to the bid submission deadline. Bids may not be withdrawn without cause subsequent to bid submission deadline. j) The awarding agency may modify the IFB prior to the date fixed for submission of bids by the issuance of an addendum to all parties who received a bid package. k) The awarding agency reserves the right to reject all bids. The agency is not required to award an agreement. l) Before submitting a response to this solicitation, Bidders should review, correct all errors and confirm compliance with the IFB requirements. Department of Child Support Services IFB Number 261 Page 7 of 54

m) The State does not accept alternate contract language from a prospective contractor. A bid with such language will be considered a counter proposal and will be rejected. The State’s General Terms and Conditions (GTC) are not negotiable.

n) No oral understanding or agreement shall be binding on either party.

5. Evaluation and Selection

a) At the time of bid opening, each bid will be checked for the presence or absence of required information in conformance with the submission requirements of this IFB.

b) The State will evaluate each bid to determine its responsiveness to the published requirements. To be considered responsive, Bidders must certify that they agree to each Contractor Task by initialing “Yes” next to each contractor task and signing Attachment 5, Bidder Agreement with Scope of Work.

c) Bids that contain false or misleading statements, or which provide references, which do not support an attribute or condition claimed by the Bidder, may be rejected.

d) Award, if made, will be to the responsive, responsible Bidder with the lowest bid amount.

e) In the event of a tie, the DCSS shall determine the tiebreaker by a coin toss or an ace-high draw of playing cards. Such an event must be observed by witnesses.

6. Award and Protest

a) Whenever an agreement is awarded under a procedure, which provides for competitive bidding, but the agreement is not to be awarded to the low Bidder, the low Bidder shall be notified by telegram, electronic facsimile transmission, overnight courier, or personal delivery five (5) working days prior to the award of the agreement.

b) Upon written request by any Bidder, notice of the proposed award shall be posted in a public place in the office of the awarding agency at least five (5) working days prior to awarding the agreement.

c) If any Bidder, prior to the award of agreement, files a written protest with the Department of General Services, Office of Legal Services, 707 Third Street, 7th Floor, West Sacramento, CA 95605 and the DCSS on the grounds that the (protesting) Bidder is the lowest responsive responsible Bidder, the agreement shall not be awarded until either the protest has been withdrawn or the Department of General Services has decided the matter.

d) Within five (5) calendar days after filing the initial protest, the protesting Bidder shall file with the Department of General Services and the awarding agency a detailed written statement specifying the grounds for the protest. The Department of Child Support Services IFB Number 261 Page 8 of 54

written protest must be sent to the Department of General Services, Office of Legal Services, 707 Third Street, 7th Floor, West Sacramento, California 95605. A copy of the detailed written statement should be mailed to the awarding agency. It is suggested that you submit any protest by certified or registered mail.

e) Upon resolution of the protest and award of the agreement, Contractor must complete and submit to the awarding agency the Payee Data Record (STD 204), to determine if the Contractor is subject to state income tax withholding pursuant to California Revenue and Taxation Code Sections 18662 and 26131. This form can be found on the Internet at: http://www.osp.dgs.ca.gov/StandardForms/default.html

No payment shall be made unless a completed STD 204 has been returned to the awarding agency.

f) Upon resolution of the protest and award of the agreement, Contractor must sign and submit to the awarding agency, page one (1) of the Contractor Certification Clauses (CCC), which can be found on the Internet at: http://www.dgs.ca.gov/ols/Resources/StandardContractLanguage.aspx

This document is only required if the Bidder has not submitted this form to the awarding agency within the last three (3) years.

7. Disposition of Bids

a) Upon bid opening, all documents submitted in response to this IFB will become the property of the State of California, and will be regarded as public records under the California Public Records Act (Government Code Section 6250 et seq.) and subject to review by the public.

b) Bid packages may be returned only at the Bidder's expense, unless such expense is waived by the awarding agency.

8. Agreement Execution and Performance

a) Performance shall start no later than the express date set by the awarding agency and the Contractor, after all approvals have been obtained and the agreement is fully executed. Should the Contractor fail to commence work at the agreed upon time, the awarding agency, upon five (5) days written notice to the Contractor, reserves the right to terminate the agreement. In addition, the Contractor shall be liable to the State for the difference between Contractor's bid price and the actual cost of performing work by the second lowest Bidder or by another contractor.

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

9. Darfur Contracting Act (Act) Department of Child Support Services IFB Number 261 Page 9 of 54

All Bidders must address the requirements of the Darfur Contracting Act of 2008 for the reason described in Public Contract Code section 10475. Refer to Attachment 8, Darfur Contracting Act (Act). Any scrutinized companies are ineligible to, and cannot, bid on or submit a proposal for contract with a State agency for goods or services. A scrutinized company is defined in Public Contract Code section 10476. However, bids may be submitted by scrutinized companies if permission is obtained first from the Department of General Services according to the criteria set forth in Public Contract Code Section 10477(b).

10. Iran Contracting Act

All Bidders must address the requirements of the Iran Contracting Act of 2011 for the reason described in Public Contract Code sections 2202-2208. Refer to Attachment 9, Iran Contracting Act for further instructions.

11. Loss Leader Clause

It is unlawful for any person engaged in business within this state to sell or use any article or product as a “loss leader” as defined in Section 17030 of the Business and Professions Code.

12. Secretary of State Certificate

When agreements are to be performed in the state by corporations; the contracting agencies will be verifying that the Vendor is currently qualified to do business in California in order to ensure that all obligations due to the state are fulfilled. Information regarding this requirement is available on the Secretary of State’s website at: http://www.ss.ca.gov

13. License

All Bidders must provide proof of Money Transmitter License (MTL) or proof of exemption.

C. Preference and Participation Programs

1. Small Business Enterprise (SBE)

a) Small Business Regulations: The Small Business regulations, located in the California Code of Regulations (Title 2, Division 2, Chapter 3, Subchapter 8, Section 1896 et seq.), concerning the application and calculation of the small business preference, small business certification, responsibilities of small business, department certification. The new regulations can be viewed at (www.pd.dgs.ca.gov/smbus). For those without Internet access, a copy of the regulations can be obtained by calling the Office of Small Business and DVBE Services at (916) 375-4940. Department of Child Support Services IFB Number 261 Page 10 of 54

b) Non-Small Business Subcontractor Preferences: A 5% bid preference is now available to a non-small business claiming 25% California certified small business subcontractor participation.

c) Small Business Nonprofit Veteran Service Agencies (SB/NVSA): SB/NVSA prime Bidders meeting requirements specified in the Military and Veterans Code Section 999.50 et seq., and obtaining a California certification as a small business are eligible for the 5% small business preference.

d) Attachment with Bid required if claiming the Small Business Preference: All Bidders must complete and include Attachment 10A, Bidder Declaration, if claiming the non-small business subcontractor preference. The form must list all the California certified small businesses with which you commit to subcontract in an amount of a least twenty-five percent (25%) of the net bid price. All certified small businesses must perform a “commercially useful function” in the performance of the contract as defined in Government Code Section 14837(d) (4).

The State of California provides a five percent (5%) preference to certified Small Business (SB) Bidders. The standard contract language for the preference programs can be found at http://www.pd.dgs.ca.gov/smbus/default.htm. For the purposes of this section, the definitions specified in Title 2, California Code of Regulations (CCR), §1896.4 shall apply unless otherwise noted.

2. Disabled Veteran Business Enterprise (DVBE) Participation Requirements

a) Subject to exceptions in the Government Code and pursuant to regulations, State law requires awarding agencies to have an annual participation goal of three percent (3%) for disabled veteran-owned business enterprises. The DCSS elects to waive the DVBE Program Requirements in this solicitation, but opts to include the DVBE incentive.

b) For more information about the DVBE incentive refer to Attachment 10, California DVBE Bid Incentive Instructions.

c) If for this agreement Contractor made a commitment to achieve Disabled Veteran Business Enterprise (DVBE) participation, then Contractor must within 60 days of receiving final payment under this agreement (or within such other time period as may be specified elsewhere in this agreement) certify in a report to the awarding department: (1) the total amount the prime contractor received under the contract; (2) the name and address of the DVBE(s) that participated in the performance of the contract; (3) the amount each DVBE received from the prime contractor; (4) that all payments under the contract have been made to the DVBE(s); and (5) the actual percentage of DVBE participation that was achieved. A person or entity that knowingly provides false information shall be subject to a civil penalty for each violation. (Military & Veterans Code (M&VC) §999.5(d)).

d) Contractor understands and agrees that should award of this contract be based in part on their commitment to use the Disabled Veteran Business Enterprise (DVBE) subcontractor(s) identified in their bid or offer, per Military and Veterans Department of Child Support Services IFB Number 261 Page 11 of 54

Code 999.5 (e), a DVBE subcontractor may only be replaced by another DVBE subcontractor and must be approved by the Department of General Services (DGS). Changes to the scope of work that impact the DVBE subcontractor(s) identified in the bid or offer and approved DVBE substitutions will be documented by contract amendment.

e) Failure of Contractor to seek substitution and adhere to the DVBE participation level identified in the bid or offer may be cause for contract termination, recovery of damages under the rights and remedies due to the State, and penalties as outlined in M&VC § 999.9; Public Contract Code (PCC) § 10115.10, or PCC § 4110 (applies to public works only). Attachment 10, California DVBE Bid Incentive Instructions (09/03/09) includes information about the DVBE incentive.

f) Attachment 10B, STD 843 DVBE Declarations: If applicable, the disabled veteran (DV) owner(s) and DV manager(s) of the DVBE must complete this declaration when a DVBE contractor or subcontractor will provide materials, supplies, services or equipment (Military and Veterans Code Section 999.2).

g) Bidders must complete and sign this form Attachment 10B and submit with bid.

D. Required Attachments

Refer to the following pages for additional Required Attachments that are a part of this agreement. Department of Child Support Services IFB Number 261 Page 12 of 54

Attachment 1 – Required Attachment Checklist

A complete bid or bid package will consist of the items identified below.

Complete this checklist to confirm the items in your bid. Place a check mark or “X” next to each item that you are submitting to the State. For your bid to be responsive, all required attachments must be returned. This checklist should be returned with your bid package also.

Attachment Attachment Name/Description

Attachment 1 Required Attachment Checklist Attachment 2 Bid/Bidder Certification Sheet

Attachment 3 Cost Sheet (Exhibit B.1)

Attachment 4 Bidder References

Attachment 5 Bidder Agreement with Scope of Work

Attachment 6 Payee Data Record (STD 204) **

Attachment 7 Contractor Certification Clauses (CCC) 307**

Attachment 8 Darfur Contracting Act (Act)

Attachment 9 Iran Contracting Act

Attachment 10 Disabled Veteran Business Enterprise (DVBE) Incentive Instructions *(Mandatory Participation Not Required. Submit if applicable.

Attachment 10A Bidder Declaration

Attachment 10B STD 843 DVBE Declarations (if applicable)

Attachment 11 Workplace Policy Enforcement

Attachment 12 Secretary of State Certificate

Attachment 13 Copy of Money Transfer License or Proof of exemption

**These documents are not required with the bid package but are required upon award of the contract.

Department of Child Support Services IFB Number 261 Page 13 of 54

Attachment 2 – Bid/Bidder Certification Sheet

This Bid/Bidder Certification Sheet must be signed and returned along with all the "required attachments" as an entire package in duplicate with original signatures. The bid must be transmitted in a sealed envelope in accordance with IFB instructions.

A. Our all-inclusive bid is submitted as detailed in Attachment 3, Cost Sheet.

B. All required attachments are included with this certification sheet.

C. The signature affixed hereon and dated certifies compliance with all the requirements of this bid document. The signature below authorizes the verification of this certification.

An Unsigned Bid/Bidder Certification Sheet May Be Cause for Rejection

1. Company Name 2. Telephone Number 2a. Fax Number ( ) ( ) 3. Address

Indicate your organization type: 4. Sole Proprietorship 5. Partnership 6. Corporation Indicate the applicable employee and/or corporation number: 7. Federal Employee ID No. (FEIN) 8. California Corporation No. 9. Indicate applicable license and/or certification information, including, but not limited to any required money transmitter license(s) or proof of exemption: (See page 4, Section A of this IFB). MTL #______If yes, please submit copy of License. If no, please submit proof of exemption.

10. Bidder’s Name (Print) 11. Title

12. Signature 13. Date

14. Are you certified with the Department of General Services, Office of Small Business and DVBE Services (OSDS) as: a. California Small Business b. Disabled Veteran Business Enterprise Yes No Yes No If yes, enter your service code below: If yes, enter certification number:

NOTE: A copy of your Certification is required to be included if either of the above items is checked “Yes”. Date application was submitted to OSDS, if an application is pending: ______Department of Child Support Services IFB Number 261 Page 14 of 54

Completion Instructions for Bid/Bidder Certification Sheet

Complete the numbered items on the Bid/Bidder Certification Sheet by following the instructions below. Item Numbers Instructions

1, 2, 2a, 3 Must be completed. These items are self-explanatory.

4 Check if your firm is a sole proprietorship. A sole proprietorship is a form of business in which one (1) person owns all the assets of the business in contrast to a partnership and corporation. The sole proprietor is solely liable for all the debts of the business.

5 Check if your firm is a partnership. A partnership is a voluntary agreement between two (2) or more competent persons to place their money, effects, labor, and skill, or some or all of them in lawful commerce or business, with the understanding that there shall be a proportional sharing of the profits and losses between them. An association of two (2) or more persons to carry on, as co-owners, a business for profit.

Check if your firm is a corporation. A corporation is an artificial person or legal entity 6 created by or under the authority of the laws of a state or nation, composed, in some rare instances, of a single person and his successors, being the incumbents of a particular office, but ordinarily consisting of an association of numerous individuals.

7 Enter your federal employee tax identification number.

Enter your corporation number assigned by the California Secretary of State’s Office. 8 This information is used for checking if a corporation is in good standing and qualified to conduct business in California.

9 Complete, if applicable, by indicating the type of license and/or certification that your firm possesses and that is required for the type of services being procured.

10, 11, Must be completed. These items are self-explanatory. 12, 13

If certified as a California Small Business, place a check in the "Yes" box, and enter 14 your certification number on the line. If certified as a Disabled Veterans Business Enterprise, place a check in the "Yes" box and enter your service code on the line. If you are not certified to one (1) or both, place a check in the "No" box. If your certification is pending, enter the date your application was submitted to OSDS. Department of Child Support Services IFB Number 261 Page 15 of 54

Attachment 3 – Cost Sheet (Exhibit B.1) Instructions to Bidders

The successful bidder will be paid a flat fee per transaction plus a monthly maintenance and operation fee for each kiosk. The flat fee per transaction applies to all child support payment types (cash, check, credit, and debit card) and shall not exceed $2.00 per transaction. The flat fee per transaction and the monthly maintenance and operation (M&O) fee for each kiosk shall remain firm and fixed for the term of the Contract. The transaction fee will be paid by the user making the transaction. The maintenance and operation fee will be paid by DCSS on a monthly basis.

The successful bidder will be reimbursed separately for actual merchant fees, including interchange charges, service charges and fees associated with child support credit and debit card payments itemized on the monthly invoice.

THE BIDDER MUST BID: THE FLAT FEE PER TRANSACTION $______X 200,000 TRANSACTIONS = $______

THE MONTHLY M&O FEE $______X 75 KIOSKS X 12 MONTHS = $______

CONTRACT TOTAL $______The multipliers are strictly hypothetical for comparison purposes only.

Signature of Authorized Representative:

By signing this document Bidder is making a firm, irrevocable offer for thirty (30) days from the date of submission.

FAILURE TO SIGN IS GROUNDS FOR REJECTION.

Signature of Authorized Representative: Print Name:

Title: Date: Department of Child Support Services IFB Number 261 Page 16 of 54

Attachment 4 – Bidder References

Submission of this attachment is mandatory. Failure to complete and return this attachment with your bid will cause your bid to be rejected and deemed nonresponsive. List below three (3) references for services performed within the last three (3) years, which are similar to the scope of work to be performed in this contract.

REFERENCE 1 Name of Firm Street Address City State Zip Code Contact Person Telephone Number Dates of Service Value or Cost of Service Brief Description of Service Provided

REFERENCE 2 Name of Firm Street Address City State Zip Code Contact Person Telephone Number Dates of Service Value or Cost of Service Brief Description of Service Provided

REFERENCE 3 Name of Firm Street Address City State Zip Code Contact Person Telephone Number Dates of Service Value or Cost of Service Brief Description of Service Provided Department of Child Support Services IFB Number 261 Page 17 of 54

Attachment 5 - Bidder Agreement with Scope of Work

The Bidder must address each Contractor’s task described in Exhibit A, Scope of Work (SOW), Section 3 and listed below. By initialing “Yes” the Bidder is certifying that they can perform the task. Please initial “Yes”(Y) or “No” (N) next to each task listed below, and submit this required Attachment in the bid package: ___Y ___N Comply with DCSS and the Local Child Support Agencies (LCSA) with the decision regarding placement location or relocation of each Kiosk machines. ___Y ___N Work with DCSS and the LCSAs to develop an installation plan for LCSAs choosing to participate in the payment services contract. ___Y ___N Assume all costs associated with this Scope of Work including hardware, software, consumables, maintenance, credit/debit card related processing costs (excluding merchant fees) and costs required to process and pick up cash and checks. ___Y ___N Provide kiosks that are usable 24/7/365, depending on the location as determined by the LCSA. ___Y ___N Ensure that each kiosk includes reliable equipment with no or very minimal down time, not to exceed 2% annually. ___Y ___N Money Transmitter License (MTL) or proof of Exemption must remain in good standing for the life of the contract. See Section A. Bidder Minimum Qualifications. ___Y ___N Retain title to all hardware and bear the risk of loss or damage to that hardware. ___Y ___N Accept cash, checks, credit cards and debit cards from payers for the purpose of transferring payments from the payer to the DCSS State Disbursement Unit (SDU). ___Y ___N Guarantee funds to DCSS once cash, checks and approved credit and debit card transactions are accepted. No credit or debit card chargebacks will be incurred by the DCSS. ___Y ___N Remit child support payments and payment information electronically through the Automated Clearing House (ACH) Network to the SDU. The Child Support Application Banking Convention forms the basis for remitting payments together with remittance detail using the NACHA CCD+ format. ___Y ___N Initiate an ACH credit to the California SDU designated account within 48 hours of the transaction—cash and approved checks, credit and debit payments. ___Y ___N Monitor and manage kiosks in real-time and perform all necessary maintenance timely when repairs or equipment replacement is needed with no intervention or responsibility by the LCSAs or DCSS. ___Y ___N Pick up cash timely so that transactions are never prevented due to the kiosk reaching the maximum cash amount that can be accepted. ___Y ___N Provide the ability to view payments in real-time via the Internet with search capabilities by participant identifier number, name, payment location and time. Department of Child Support Services IFB Number 261 Page 18 of 54

___Y ___N Provide daily reports electronically to LCSAs and DCSS that include participant identifier- number (13-15 numeric characters), name, phone number, payment location and time, transaction amount, transaction type and fees related to child support payment transactions broken down by LCSA. ___Y ___N Ensure monies in transit are handled by a FDIC insured bank.

___Y ___N Provide monitors that allow advertising and communication of messages to payers from DCSS. ___Y ___N Ensure kiosks include at a minimum, English and Spanish language capabilities.

___Y ___N Ensure that identifying information (name, participant identifier number, address and phone number) can be manually entered or scanned and that payers will receive an accurate and legible receipt at the time of payment.

___Y ___N Provide back-up information for credit and debit card merchant fees related to child support payments to be reimbursed to the contractor, as part of the monthly invoice.

___Y ___N Be responsible for responding to and resolving all claims, inquiries or complaints arising out the acceptance and remittance of payments in a timely fashion.

___Y ___N Prominently display the contractor’s customer service number and provide English and Spanish, at a minimum, customer support to the LCSA and payers for all hours of operation.

___Y ___N Ensure that a back-up plan is fully operational at all times in the event of a power- outage or other catastrophe so that no data will be lost or compromised and that processing will continue with minimal disruption. The back-up plan should delineate in detail the steps that the contractor should take to minimize the disruption of the workflow in the event of a disaster. The Contractor must test this plan annually to ensure the on-going functionality of the system.

___Y ___N Ensure and guarantee complete confidentiality of all client information and all data security requirements as described in Exhibit E, Information Security Provisions.

___Y ___N Relocate a kiosk to a specified location when requested by DCSS and/or the LCSAs in a timely fashion. The LCSAs, in coordination with DCSS, will determine kiosk locations that best meet the needs of DCSS and LCSA customers.

Department of Child Support Services IFB Number 261 Page 19 of 54

Signature of Authorized Representative:

To be considered responsive, Bidders must certify that they agree to each Contractor’s Task by initialing “Yes” next to each contractor task listed on the preceding pages.

Failure to sign is grounds for rejection.

Signature of Authorized Representative: Date:

Print Name: Title: Department of Child Support Services IFB Number 261 Page 20 of 54

Attachment 6 – Payee Data Record This will be required at contract award The Payee Data record is available online at Payee Data Record . http://www.documents.dgs.ca.gov/dgs/fmc/pdf/std204.pdf

This is a .pdf fill and print form. You must have Adobe Acrobat 4.0 or higher to use this feature. It is acceptable to print the form and complete it manually. Please return the completed form to: DEPARTMENT OF CHILD SUPPORT SERVICES Contracts and Purchasing Section Attn: Shauna Ladd P.O. Box 419064, MS 621 Rancho Cordova, CA 95741 Department of Child Support Services IFB Number 261 Page 21 of 54

Attachment 7 – Contractor Certification Clauses This will be required at contract award

CCC-307 CERTIFICATION

I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am duly authorized to legally bind the prospective Contractor to the clause(s) listed below. This certification is made under the laws of the State of California. Contractor/Bidder Firm Name (Printed) Federal ID Number

By (Authorized Signature)

Printed Name and Title of Person Signing

Date Executed Executed in the County of

CONTRACTOR CERTIFICATION CLAUSES 1. STATEMENT OF COMPLIANCE: Contractor has, unless exempted, complied with the nondiscrimination program requirements. (Gov. Code §12990 (a-f) and CCR, Title 2, Section 8103) (Not applicable to public entities.)

2. DRUG-FREE WORKPLACE REQUIREMENTS: Contractor will comply with the requirements of the Drug-Free Workplace Act of 1990 and will provide a drug-free workplace by taking the following actions:

a. Publish a statement notifying employees that unlawful manufacture, distribution, dispensation, possession or use of a controlled substance is prohibited and specifying actions to be taken against employees for violations.

b. Establish a Drug-Free Awareness Program to inform employees about: 1) the dangers of drug abuse in the workplace; 2) the person's or organization's policy of maintaining a drug-free workplace; 3) any available counseling, rehabilitation and employee assistance programs; and, 4) penalties that may be imposed upon employees for drug abuse violations. c. Every employee who works on the proposed Agreement will: 1) receive a copy of the company's drug-free workplace policy statement; and, 2) agree to abide by the terms of the company's statement as a condition of employment on the Agreement. Failure to comply with these requirements may result in suspension of payments under the Agreement or termination of the Agreement or both and Contractor may be ineligible for award of any future State agreements if the department determines that any of the following has occurred: the Contractor has made false certification, or violated the Department of Child Support Services IFB Number 261 Page 22 of 54

certification by failing to carry out the requirements as noted above. (Gov. Code §8350 et seq.)

3. NATIONAL LABOR RELATIONS BOARD CERTIFICATION: Contractor certifies that no more than one (1) final unappealable finding of contempt of court by a Federal court has been issued against Contractor within the immediately preceding two-year period because of Contractor's failure to comply with an order of a Federal court, which orders Contractor to comply with an order of the National Labor Relations Board. (Pub. Contract Code §10296) (Not applicable to public entities.)

4. CONTRACTS FOR LEGAL SERVICES $50,000 OR MORE- PRO BONO REQUIREMENT: Contractor hereby certifies that contractor will comply with the requirements of Section 6072 of the Business and Professions Code, effective January 1, 2003.

Contractor agrees to make a good faith effort to provide a minimum number of hours of pro bono legal services during each year of the contract equal to the lessor of 30 multiplied by the number of full time attorneys in the firm’s offices in the State, with the number of hours prorated on an actual day basis for any contract period of less than a full year or 10% of its contract with the State.

Failure to make a good faith effort may be cause for non-renewal of a state contract for legal services, and may be taken into account when determining the award of future contracts with the State for legal services.

5. EXPATRIATE CORPORATIONS: Contractor hereby declares that it is not an expatriate corporation or subsidiary of an expatriate corporation within the meaning of Public Contract Code Section 10286 and 10286.1, and is eligible to contract with the State of California.

6. SWEATFREE CODE OF CONDUCT:

a. All Contractors contracting for the procurement or laundering of apparel, garments or corresponding accessories, or the procurement of equipment, materials, or supplies, other than procurement related to a public works contract, declare under penalty of perjury that no apparel, garments or corresponding accessories, equipment, materials, or supplies furnished to the state pursuant to the contract have been laundered or produced in whole or in part by sweatshop labor, forced labor, convict labor, indentured labor under penal sanction, abusive forms of child labor or exploitation of children in sweatshop labor, or with the benefit of sweatshop labor, forced labor, convict labor, indentured labor under penal sanction, abusive forms of child labor or exploitation of children in sweatshop labor. The contractor further declares under penalty of perjury that they adhere to the Sweatfree Code of Conduct as set forth on the California Department of Industrial Relations website located at www.dir.ca.gov, and Public Contract Code Section 6108.

b. The contractor agrees to cooperate fully in providing reasonable access to the contractor’s records, documents, agents or employees, or premises if reasonably required by authorized officials of the contracting agency, the Department of Industrial Relations, or the Department of Justice to determine the contractor’s compliance with the requirements under paragraph (a).

7. DOMESTIC PARTNERS: For contracts over $100,000 executed or amended after January 1, 2007, the contractor certifies that contractor is in compliance with Public Contract Code section 10295.3. Department of Child Support Services IFB Number 261 Page 23 of 54

DOING BUSINESS WITH THE STATE OF CALIFORNIA

The following laws apply to persons or entities doing business with the State of California.

1. CONFLICT OF INTEREST: Contractor needs to be aware of the following provisions regarding current or former state employees. If Contractor has any questions on the status of any person rendering services or involved with the Agreement, the awarding agency must be contacted immediately for clarification.

Current State Employees (Pub. Contract Code §10410):

a. No officer or employee shall engage in any employment, activity or enterprise from which the officer or employee receives compensation or has a financial interest and which is sponsored or funded by any state agency, unless the employment, activity or enterprise is required as a condition of regular state employment.

b. No officer or employee shall contract on his or her own behalf as an independent contractor with any state agency to provide goods or services.

Former State Employees (Pub. Contract Code §10411):

a. For the two-year period from the date he or she left state employment, no former state officer or employee may enter into a contract in which he or she engaged in any of the negotiations, transactions, planning, arrangements or any part of the decision-making process relevant to the contract while employed in any capacity by any state agency.

b. For the twelve-month period from the date he or she left state employment, no former state officer or employee may enter into a contract with any state agency if he or she was employed by that state agency in a policy-making position in the same general subject area as the proposed contract within the 12-month period prior to his or her leaving state service.

If Contractor violates any provisions of above paragraphs, such action by Contractor shall render this Agreement void. (Pub. Contract Code §10420)

Members of boards and commissions are exempt from this section if they do not receive payment other than payment of each meeting of the board or commission, payment for preparatory time and payment for per diem. (Pub. Contract Code §10430 (e))

2. LABOR CODE/WORKERS' COMPENSATION: Contractor needs to be aware of the provisions which require every employer to be insured against liability for Worker's Compensation or to undertake self-insurance in accordance with the provisions, and Contractor affirms to comply with such provisions before commencing the performance of the work of this Agreement. (Labor Code Section 3700)

3. AMERICANS WITH DISABILITIES ACT: Contractor assures the State that it complies with the Americans with Disabilities Act (ADA) of 1990, which prohibits discrimination on the basis of disability, as well as all applicable regulations and guidelines issued pursuant to the ADA. (42 U.S.C. 12101 et seq.)

4. CONTRACTOR NAME CHANGE: An amendment is required to change the Contractor's name as listed on this Agreement. Upon receipt of legal documentation of the name change Department of Child Support Services IFB Number 261 Page 24 of 54

the State will process the amendment. Payment of invoices presented with a new name cannot be paid prior to approval of said amendment.

5. CORPORATE QUALIFICATIONS TO DO BUSINESS IN CALIFORNIA:

a. When agreements are to be performed in the state by corporations, the contracting agencies will be verifying that the contractor is currently qualified to do business in California in order to ensure that all obligations due to the state are fulfilled.

b. "Doing business" is defined in R&TC Section 23101 as actively engaging in any transaction for the purpose of financial or pecuniary gain or profit. Although there are some statutory exceptions to taxation, rarely will a corporate contractor performing within the state not be subject to the franchise tax.

c. Both domestic and foreign corporations (those incorporated outside of California) must be in good standing in order to be qualified to do business in California. Agencies will determine whether a corporation is in good standing by calling the Office of the Secretary of State.

6. RESOLUTION: A county, city, district, or other local public body must provide the State with a copy of a resolution, order, motion, or ordinance of the local governing body which by law has authority to enter into an agreement, authorizing execution of the agreement.

7. AIR OR WATER POLLUTION VIOLATION: Under the State laws, the Contractor shall not be: (1) in violation of any order or resolution not subject to review promulgated by the State Air Resources Board or an air pollution control district; (2) subject to cease and desist order not subject to review issued pursuant to Section 13301 of the Water Code for violation of waste discharge requirements or discharge prohibitions; or (3) finally determined to be in violation of provisions of federal law relating to air or water pollution.

8. PAYEE DATA RECORD FORM STD. 204: This form must be completed by all contractors that are not another state agency or other governmental entity.

9. SECRETARY OF STATE CERTIFICATE: When agreements are to be performed in the state by corporations; the contracting agencies will be verifying that the Vendor is currently qualified to do business in California in order to ensure that all obligations due to the state are fulfilled. Department of Child Support Services IFB Number 261 Page 25 of 54

Attachment 8 – Darfur Contracting Act (Act)

DARFUR CONTRACTING ACT CERTIFICATION

Public Contract Code Sections 10475 - 10481 applies to any company that currently or within the previous three (3) years has had business activities or other operations outside of the United States. For such a company to bid on or submit a proposal for a State of California contract, the company must certify that it is either a) not a scrutinized company; or b) a scrutinized company that has been granted permission by the Department of General Services to submit a proposal. If your company has not, within the previous three (3) years, had any business activities or other operations outside of the United States, you do not need to complete this form. OPTION #1 - CERTIFICATION If your company, within the previous three (3) years, has had business activities or other operations outside of the United States, in order to be eligible to submit a bid or proposal, please insert your company name and Federal ID Number and complete the certification below. I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that a) the prospective Bidder/Bidder named below is not a scrutinized company per Public Contract Code 10476; and b) I am duly authorized to legally bind the prospective Bidder/Bidder named below. This certification is made under the laws of the State of California. Company/Vendor Name (Printed) Federal ID Number

By (Authorized Signature) Printed Name and Title of Person Signing Date Executed Executed in the County and State of

OPTION #2 – WRITTEN PERMISSION FROM DGS Pursuant to Public Contract Code section 10477(b), the Director of the Department of General Services may permit a scrutinized company, on a case-by-case basis, to bid on or submit a proposal for a contract with a state agency for goods or services, if it is in the best interests of the state. If you are a scrutinized company that has obtained written permission from the DGS to submit a bid or proposal, complete the information below. We are a scrutinized company as defined in Public Contract Code section 10476, but we have received written permission from the Department of General Services to submit a bid or proposal pursuant to Public Contract Code section 10477(b). A copy of the written permission from DGS is included with our bid or proposal. Company/Vendor Name (Printed) Federal ID Number Initials of Submitter

Printed Name and Title of Person Initialing

Attachment 9 – Iran Contract Act IRAN CONTRACTING ACT (Public Contract Code sections 2202-2208) Department of Child Support Services IFB Number 261 Page 26 of 54

Prior to bidding on, submitting a proposal or executing a contract or renewal for a State of California contract for goods or services of $1,000,000 or more, a vendor must either: a) certify it is not on the current list of persons engaged in investment activities in Iran created by the California Department of General Services (“DGS”) pursuant to Public Contract Code section 2203(b) and is not a financial institution extending twenty million dollars ($20,000,000) or more in credit to another person, for 45 days or more, if that other person will use the credit to provide goods or services in the energy sector in Iran and is identified on the current list of persons engaged in investment activities in Iran created by DGS; or b) demonstrate it has been exempted from the certification requirement for that solicitation or contract pursuant to Public Contract Code section 2203(c) or (d).

To comply with this requirement, please insert your vendor or financial institution name and Federal ID Number (if available) and complete one of the options below. Please note: California law establishes penalties for providing false certifications, including civil penalties equal to the greater of $250,000 or twice the amount of the contract for which the false certification was made; contract termination; and three-year ineligibility to bid on contracts. (Public Contract Code section 2205.)

OPTION #1 - CERTIFICATION I, the official named below, certify I am duly authorized to execute this certification on behalf of the vendor/financial institution identified below, and the vendor/financial institution identified below is not on the current list of persons engaged in investment activities in Iran created by DGS and is not a financial institution extending twenty million dollars ($20,000,000) or more in credit to another person/vendor, for 45 days or more, if that other person/vendor will use the credit to provide goods or services in the energy sector in Iran and is identified on the current list of persons engaged in investment activities in Iran created by DGS.

Vendor Name/Financial Institution (Printed) Federal ID Number (or n/a)

By (Authorized Signature) Printed Name and Title of Person Signing Date Executed Executed in

OPTION #2 – EXEMPTION Pursuant to Public Contract Code sections 2203(c) and (d), a public entity may permit a vendor/financial institution engaged in investment activities in Iran, on a case-by-case basis, to be eligible for, or to bid on, submit a proposal for, or enters into or renews, a contract for goods and services.

If you have obtained an exemption from the certification requirement under the Iran Contracting Act, please fill out the information below, and attach documentation demonstrating the exemption approval.

Vendor Name/Financial Institution (Printed) Federal ID Number (or n/a) By (Authorized Signature)

Printed Name and Title of Person Signing Date Executed Department of Child Support Services IFB Number 261 Page 27 of 54

Attachment 10 – California Disabled Veteran Business Enterprise (DVBE) Bid Incentive Instructions (Revision Date 09/03/2009)

Please read the requirements and instructions carefully before you begin.

AUTHORITY: The Disabled Veteran Business Enterprise (DVBE) Participation Goal Program for State contracts is established in Public Contract Code (PCC), §10115 et seq., Military and Veterans Code (MVC), §999 et seq., and California Code of Regulations (CCR), Title 2, §1896.60 et seq. Recent legislation has modified the program significantly in that a Bidder may no longer demonstrate compliance with program requirements by performing a “good faith effort” (GFE).

This solicitation does not include a minimum DVBE participation percentage or goal.

DVBE BID INCENTIVE: Unless stated elsewhere in the solicitation that the DVBE incentive has been waived, in accordance with Section 999.5(a) of the Military and Veterans Code an incentive will be given to Bidders who provide DVBE participation. For evaluation purposes only, the State shall apply an incentive to bids that propose California certified DVBE participation as identified on the Bidder Declaration GSPD-05-105 and confirmed by the State. The incentive amount for awards based on low price will vary in conjunction with the percentage of DVBE participation. Unless a table that replaces the one (1) below has been expressly established elsewhere within the solicitation, the following percentages will apply for awards based on low price.

DVBE Participation DVBE Incentive 100% 5% 50% up to 99.99% 4% 11% up to 49.99% 3% 3% up to 10.99% 2% 1% up to 2.99% 1%

As applicable: (1) Awards based on low price - the net bid price of responsive bids will be reduced (for evaluation purposes only) by the amount of DVBE incentive as applied to the lowest responsive net bid price. If the #1 ranked responsive, responsible bid is a California certified small business, the only Bidders eligible for the incentive will be California certified small businesses. The incentive adjustment for awards based on low price cannot exceed 5% or $100,000, whichever is less, of the #1 ranked net bid price. When used in combination with a preference adjustment, the cumulative adjustment amount cannot exceed $100,000. (2) Awards based on highest score - the solicitation shall include an individual requirement that identifies incentive points for DVBE participation.

INTRODUCTION: Bidders must document DVBE participation commitment by completing and Department of Child Support Services IFB Number 261 Page 28 of 54 submitting a Bidder Declaration, GSPD-05-105, (located elsewhere within the solicitation documents). Bids or proposals (hereafter called “bids”) that fail to submit the required form to confirm the level of DVBE participation will not be eligible to receive the DVBE incentive.

Information submitted by the intended awardee to claim the DVBE incentive(s) will be verified by the State. If evidence of an alleged violation is found during the verification process, the State shall initiate an investigation, in accordance with the requirements of the PCC §10115, et seq., and MVC §999 et seq., and follow the investigatory procedures required by the 2 CCR §1896.80. Contractors found to be in violation of certain provisions may be subject to loss of certification, penalties and/or contract termination.

Only State of California, Office of Small Business and DVBE Services (OSDS), certified DVBEs (hereafter called “DVBE”) who perform a commercially useful function relevant to this solicitation, may be used to satisfy the DVBE program requirements. The criteria and definition for performing a commercially useful function are contained herein on the page entitled Resources & Information. Bidders are to verify each DVBE subcontractor’s certification with OSDS to ensure DVBE eligibility.

At the State’s option prior to award of the contract, a written confirmation from each DVBE subcontractor identified on the Bidder Declaration must be provided. As directed by the State, the written confirmation must be signed by the Bidder and/or the DVBE subcontractor(s). The written confirmation may request information that includes but is not limited to the DVBE scope of work, work to be performed by the DVBE, term of intended subcontract with the DVBE, anticipated dates the DVBE will perform required work, rate and conditions of payment, and total amount to be paid to the DVBE. If further verification is necessary, the State will obtain additional information to verify compliance with the above requirements.

THE DVBE BUSINESS UTILIZATION PLAN (BUP): DVBE BUPs are a company’s commitment to expend a minimum of 3% of its total statewide contract dollars with DVBEs -- this percentage is based on all of its contracts held in California, not just those with the State. A DVBE BUP does not qualify a firm for a DVBE incentive. Bidders with a BUP, must submit a Bidders Declaration (GSPD-05-105) to confirm the DVBE participation for an element of work on this solicitation in order to claim a DVBE incentive(s).

THE FOLLOWING MAY BE USED TO LOCATE DVBE SUPPLIERS:

Awarding Department: Contact the department’s contracting official named in this solicitation for any DVBE suppliers who may have identified themselves as potential subcontractors, and to obtain suggestions for search criteria to possibly identify DVBE suppliers for the solicitation.

Other State and Federal Agencies, and Local Organizations:

STATE: Access the list of all certified DVBEs by using the Department of General Services, Procurement Division (DGS-PD), online certified firm database at www.eprocure.dgs.ca.gov. To begin your search, click on “SB/DVBE Search.” Search by “Keywords” or “United Nations Standard Products and Services Codes (UNSPSC) that apply to the elements of work you want to subcontract to a DVBE. Check for subcontractor Department of Child Support Services IFB Number 261 Page 29 of 54 ads that may be placed on the California State Contracts Register (CSCR) for this solicitation prior to the closing date. You may access the CSCR at: www.eprocure.dgs.ca.gov. For questions regarding the online certified firm database and the CSCR, please call the OSDS at (916) 375-4940 or send an email to: [email protected].

FEDERAL: Search the U.S. Small Business Administration’s (SBA) Central Contractor Registration (CCR) on-line database at www.ccr.gov to identify potential DVBEs and click on the "Dynamic Small Business Search" button. Search options and information are provided on the CCR Dynamic Small Business Search site. First time users should click on the “help” button for detailed instructions. Remember to verify each firm’s status as a California certified DVBE.

LOCAL: Contact local DVBE organization to identify DVBEs. For a list of local organizations, go to www.pd.dgs.ca.gov/smbus and select: DVBE Local Contacts (New 02/09) (pdf). Department of Child Support Services IFB Number 261 Page 30 of 54

RESOURCES AND INFORMATION For questions regarding bid documentation requirements, contact the contracting official at the awarding department for this solicitation. For a directory of SB/DVBE Advocates for each department go to: http://www.pd.dgs.ca.gov/smbus/advocate.htm. The Department of General Services, Procurement Division (DGS-PD) publishes a list of trade and focus publications to assist Bidders in locating DVBEs for a fee. To obtain this list, please go to www.pd.dgs.ca.gov/smbus and select:  DVBE Trade Paper Listing (New 02/09) (pdf)  DVBE Focus Paper Listing (New 02/09) (pdf)

U.S. Small Business Administration (SBA): FOR: Use the Central Contractor Registration (CCR) on- Service-Disabled Veteran-owned line database. businesses in California Internet contact only –Database: www.ccr.gov. (Remember to verify each DVBE’s California certification.)

Local Organizations: Go to 1-FOR: www.pd.dgs.ca.gov/smbus List of potential DVBE and select: DVBE Local Contacts (New 02/09) (pdf) subcontractors

DGS-PD EProcurement FOR: Website: www.eprocure.dgs.ca.gov • SB/DVBE Search Phone: (916) 375-2000 • CSCR Ads Email: [email protected] • Click on Training tab to Access eProcurement Training Modules including: Small Business (SB)/DVBE Search

DGS-PD Office of Small Business and DVBE Services (OSDS) FOR: 707 Third Street, Room 1-400, West Sacramento, CA 95605 • Directory of California- Certified DVBEs Website: www.pd.dgs.ca.gov/smbus • Certification Applications OSDS Receptionist, 8 am-5 pm: (916) 375-4940 • Certification Information PD Receptionist, 8 am-5 pm: (800) 559-5529 • Certification Status, Concerns Fax: (916) 375-4950 • General DVBE Program Info. Email: [email protected] • DVBE Business Utilization Plan • Small Business/DVBE Advocates Department of Child Support Services IFB Number 261 Page 31 of 54

State of California—Department of General Services, Procurement Division Solicitation Number______GSPD– 05–105 (REV Commercially Useful Function Definition 08/09)

California Code of Regulations, Title 2 §1986.61(I): The term “DVBE” contractor, subcontractor or supplier” means any person or entity that satisfies the ownership (or management) and control requirements of §1896.61(f); is certified in accordance with §1896.70; and provides services or goods that contribute to the fulfillment of the contract requirements by performing a commercially useful function. As defined in MVC §999, a person or an entity is deemed to perform a “commercially useful function” if a person or entity does all of the following:  Is responsible for the execution of a distinct element of the work of the contract.  Carries out the obligation by actually performing, managing, or supervising the work involved.  Performs work that is normal for its business services and functions.  Is not further subcontracting a portion of the work that is greater than that expected to be subcontracted by normal industry practices. A contractor, subcontractor, or supplier will not be considered to perform a commercially useful function if the contractor’s, subcontractor’s, or supplier’s role is limited to that of an extra participation in a transaction, contract, or project through which funds are passed in order to obtain the appearance of disabled veteran business enterprise participation. Attachment 10A –Bidder Declaration ______1. Prime Bidder information (Review attached Bidder Declaration Instructions prior to completion of this form): a. Identify current California certification(s) (MB, SB, NVSA, DVBE): ______or None ____ (If “None”, go to Item #2) b. Will subcontractors be used for this contract? Yes ___ No ___ (If yes, indicate the distinct element of work your firm will perform in this contract e.g., list the proposed products produced by your firm, state if your firm owns the transportation vehicles that will deliver the products to the State, identify which solicited services your firm will perform, etc.). Use additional sheets, as necessary. ______c. If you are a California certified DVBE: (1) Are you a broker or agent? Yes ___ No ___ (2) If the contract includes equipment rental, does your company own at least 51% of the equipment provided in this contract (quantity and value)? Yes ___ No ___ N/A ___ 2. If no subcontractors will be used, skip to certification below. Otherwise, list all subcontractors for this contract. (Attach additional Department of Child Support Services IFB Number 261 Page 32 of 54 pages if necessary)

Subcontractor Name, CA Certification Work performed or Subcontractor Address & Corresponding Good 51% Contact Person, Phone # (MB, SB, NVSA, goods provided for this Email Address % of bid price Standing? Rental? & Fax # DVBE or None) contract

CERTIFICATION: By signing the bid response, I certify under penalty of perjury that the information provided is true and correct. Department of Child Support Services IFB Number 261 Page 33 of 54 State of California—Department of General Services, Procurement Division GSPD–05–105 (REV 08/09) Instructions ______BIDDER DECLARATION Instructions

All prime Bidders (the firm submitting the bid) must complete the Bidder Declaration. 1.a. Identify all current certifications issued (1) Declare whether the prime Bidder is a broker or by the State of California. If the prime agent by marking either “Yes” or “No”. The Bidder has no California certification(s), Military and Veterans Code Section 999.2 (b) check the line labeled “None” and defines “broker” or “agent” as a certified DVBE proceed to Item #2. If the prime Bidder contractor or subcontractor that does not have possesses one (1) or more of the title, possession, control, and risk of loss of following certifications, enter the materials, supplies, services, or equipment applicable certification(s) on the line: provided to an awarding department, unless  Microbusiness (MB) one (1) or more of the disabled veteran owners  Small Business (SB) has at least 51-percent ownership of the  Nonprofit Veteran Service Agency quantity and value of the materials, supplies, (NVSA) services, and of each piece of equipment  Disabled Veteran Business Enterprise provided under the contract. (DVBE) (2) If bidding rental equipment, mark either “Yes” or “No” to identify if the prime Bidder owns at least 51% of the equipment provided (quantity and 1.b. Mark either “Yes” or “No” to identify value). If not bidding rental equipment, mark whether subcontractors will be used for the “N/A” for “not applicable.” contract. If the response is “No”, proceed 2. If no subcontractors are proposed, do not to Item #1.c. If “Yes”, enter on the line the complete the table. Read the certification distinct element of work contained in the at the bottom of the form and complete contract to be performed or the goods to be “Page ___ of ___” on the form. provided by the prime Bidder. Do not If subcontractors will be used, complete the include goods or services to be provided by table listing all subcontractors. If subcontractors. necessary, attach additional pages and Bidders certified as MB, SB, NVSA, and/or complete the “Page ___ of ___” DVBE must provide a commercially useful accordingly. function as defined in Military and Veterans Code Section 999 for DVBEs and Government Code Section 14837(d)(4)(A) Subcontractor Name, Contact Person, for small/ microbusinesses. Phone Number & Fax Number—List each Bids must propose that certified Bidders provide element for all subcontractors. a commercially useful function for the Subcontractor Address & Email Address— resulting contract or the bid will be deemed Enter the address and if available, an Email non-responsive and rejected by the State. address. For questions regarding the solicitation, contact the procurement official identified in CA Certification (MB, SB, NVSA, DVBE or the solicitation. None)—If the subcontractor possesses a Note: A subcontractor is any person, firm, current State of California certification(s), corporation, or organization contracting verify on this website to perform part of the prime’s contract. (www.eprocure.pd.dgs.ca.gov). 1.c. This item is only to be completed by Work performed or goods provided for this businesses certified by California as a contract—identify the distinct element of DVBE. work contained in the contract to be performed or the goods to be provided by Department of Child Support Services IFB Number 261 Page 34 of 54 State of California—Department of General Services, Procurement Division GSPD–05–105 (REV 08/09) Instructions ______BIDDER DECLARATION Instructions

All prime Bidders (the firm submitting the bid) must complete the Bidder Declaration. each subcontractor. Certified equipment (regardless of whether or subcontractors must provide a commercially not subcontractor is a DVBE) useful function for the contract. (See Enter “Yes” if the subcontractor is a paragraph 1.b above for code citations California certified DVBE providing rental regarding the definition of commercially equipment and the subcontractor owns at useful function.) If a certified subcontractor least 51% of the rental equipment is further subcontracting a greater portion of (quantity and value) it will be providing for the work or goods provided for the resulting the contract. contract than would be expected by normal industry practices, attach a separate sheet Enter “No” if the subcontractor is a California of paper explaining the situation. certified DVBE providing rental Corresponding % of bid price—Enter the equipment but the subcontractor does corresponding percentage of the total bid NOT own at least 51% of the rental price for the goods and/or services to be equipment (quantity and value) it will be provided by each subcontractor. Do not providing. enter a dollar amount. Good Standing?—Provide a response for each subcontractor listed. Enter either “Yes” or “No” to indicate that the prime Bidder has verified that the subcontractor(s) is in good standing for all of the following:  Possesses valid license(s) for any license(s) or permits required by the solicitation or by law  If a corporation, the company is qualified to do business in California and designated by the State of California Secretary of State to be in good standing  Possesses valid State of California certification(s) if claiming MB, SB, NVSA, and/or DVBE status 51% Rental?—This pertains to the applicability of rental equipment. Based on the following parameters, enter either “N/A” (not applicable),“Yes” or “No” for each subcontractor listed. Enter “N/A” if the:  Subcontractor is NOT a DVBE (regardless of whether or not rental equipment is provided by the subcontractor) or  Subcontractor is NOT providing rental Department of Child Support Services IFB Number 261 Page 35 of 54 Attachment 10B – STD 843 Disabled Veteran Business Enterprise Declarations

The disabled veteran (DV) owner(s) and DV manager(s) of the Disabled Veteran Business Enterprise (DVBE) must complete this declaration when a DVBE contractor or subcontractor will provide materials, supplies, services or equipment (Military and Veterans Code Section 999.2).

Please visit link listed below to complete this form at: http://www.documents.dgs.ca.gov/pd/poliproc/STD-843FillPrintFields.pdf Department of Child Support Services IFB Number 261 Page 36 of 54

Attachment 11– Workplace Policy Enforcement

Applicable to this IFB, policies located at http://www.childsup.ca.gov/Home/Acquisitions/DCSSProcurementDocuments/tabid/317/ Default.aspx

Not Applicable to this SB Option

I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am duly authorized to legally bind the prospective Contractor to adhere to the Workplace Policies as listed below: 1. Incompatible Activities Statement 2. Internet/Electronic Mail (E-Mail) 3. Sexual Harassment 4. Smoking Policy 5. Information Security 6. Workplace Violence Prevention Program This certification is made under the laws of the State of California.

Contractor/Bidder Firm Name (Printed) Federal ID Number

By (Authorized Signature)

Printed Name and Title of Person Signing

Date Executed Department of Child Support Services IFB Number 261 Page 37 of 54

Attachment 12 - Secretary Of State Certificate

Provide copy of Secretary of State Certificate, Attachment 12. When agreements are to be performed in the state by corporations; the contracting agencies will be verifying that the Vendor is currently qualified to do business in California in order to ensure that all obligations due to the state are fulfilled. Information regarding this requirement is available on the Secretary of State’s website at: http://www.ss.ca.gov Department of Child Support Services IFB Number 261 Page 38 of 54

Attachment 13 – Proof of Money Transmittal License (MTL) or Exemption Letter

A MTL or Exemption letter is required to bid on this contract.

(Failure to complete and return this attachment with your bid will cause your bid to be rejected and deemed nonresponsive). Department of Child Support Services IFB Number 261 Page 39 of 54 State of California E. SAMPLE STANDARD AGREEMENT (STDExhibit 213) CONTRACT A – Scope of Work

STD 213 (Rev 06/03) AGREEMENT NUMBER

REGISTRATION NUMBER

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

STATE AGENCY'S NAME Department of Child Support Services (DCSS)

CONTRACTOR'S NAME Contractor’s Name

2. The term of this Or upon all approvals Agreement is:

3. The maximum amount $ TBD of this Agreement is: Contract Amount in Words

4. The parties agree to comply with the terms and conditions of the following exhibits which are by this reference made a part of the Agreement.

Exhibit A – Scope of Work 3 page(s) Exhibit B – Budget Detail and Payment Provisions 2 page(s) Exhibit B.1 – Cost Sheet 1 page Exhibit C* – General Terms and Conditions GTC-610 Exhibit D – Special Terms and Conditions 3 page(s) Exhibit E – Information Security Provisions 3 page(s) Items shown with an Asterisk (*), are hereby incorporated by reference and made part of this agreement as if attached hereto. These documents can be viewed at : http://www.dgs.ca.gov/ols/Resources/StandardContractLanguage

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

CONTRACTOR California Department of General Services Use Only CONTRACTOR’S NAME (if other than an individual, state whether a corporation, partnership, etc.) Contractor’s Name To Be Determined

BY (Authorized Signature) DATE SIGNED(Do not  type) PRINTED NAME AND TITLE OF PERSON SIGNING Person signing agreement

ADDRESS Company Address

STATE OF CALIFORNIA AGENCY NAME Department of Child Support Services

BY (Authorized Signature) DATE SIGNED(Do not type)  PRINTED NAME AND TITLE OF PERSON SIGNING TBD ADDRESS P.O. Box 419064 Rancho Cordova, CA 95741-90 Department of Child Support Services IFB Number 261 Page 40 of 54

1. The purpose of this Scope of Work (SOW) is to define the terms and conditions applicable to providing service to DCSS.

2. The Contract Managers during the term of this agreement will be:

Department of Child Support Services Contractor Name: Name: TBA Title: Title: Phone: Phone: Fax: Fax: E-mail: E-mail:

If either DCSS or Contractor requires a change of contact, a written notification will be provided to the other party.

3. The Contractor agrees to:

A. Comply with DCSS and the Local Child Support Agencies (LCSA) with the decision of the placement location or relocation of each kiosk.

B. Work with DCSS and the LCSAs to develop an installation plan for LCSAs choosing to participate in the payment services contract.

C. Assume all costs associated with this Scope of Work including hardware, software, consumables, maintenance, credit/debit card related processing costs (excluding merchant fees) and costs required to process and pick up cash, checks.

D. Provide kiosks that are usable 24/7/365, depending on the location as determined by the LCSA.

E. Ensure that each kiosk includes reliable equipment with no or very minimal down time, not to exceed 2% annually.

F. Money Transmitter License (MTL) or proof of exemption must remain in good standing for the life of the contract.

G. Retain title to all hardware and bear the risk of loss or damage to that hardware.

H. Accept cash, checks, credit cards and debit cards from payers for the purpose of transferring payments from the payer to the DCSS State Disbursement Unit (SDU).

I. Guarantee funds to DCSS once cash, checks, and approved credit and debit card transactions are accepted. No credit or debit card chargebacks will be incurred by the DCSS. Department of Child Support Services IFB Number 261 Page 41 of 54 J. Remit child support payments and payment information electronically through the Automated Clearing House (ACH) Network to the SDU. The Child Support Application Banking Convention forms the basis for remitting payments together with remittance detail using the NACHA CCD+ format.

K. Initiate an ACH credit to the California SDU designated account within 48 hours of the transaction—cash and approved checks, credit and debit payments.

L. Monitor and manage kiosks in real-time and perform all necessary maintenance timely when repairs or equipment replacement is needed with no intervention or responsibility by the LCSAs or DCSS.

M. Pick up cash timely so that transactions are never prevented due to the kiosk reaching the maximum cash amount that can be accepted.

N. Provide the ability to view payments in real-time via the Internet with search capabilities by participant identifier number, name, payment location and time.

O. Provide daily reports electronically to LCSAs and DCSS that include participant identifier number- (13-15 numeric characters), name, phone number, payment location and time, transaction amount, transaction type and fees related to the child support payment transaction broken down by LCSA.

P. Ensure monies in transit are handled by a FDIC insured bank.

Q. Provide monitors that allow advertising and communication of messages to payers from DCSS.

R. Ensure kiosks include at a minimum, English and Spanish language capabilities.

S. Ensure that identifying information (name, participant identifier number, address and phone number) can be manually entered or scanned and that payers will receive an accurate and legible receipt at the time of payment.

T. Provide back-up information for credit and debit card merchant fees to be reimbursed to the contractor, as part of the monthly invoice.

U. Be responsible for responding to and resolving all claims, inquiries or complaints arising out the acceptance and remittance of payments in a timely fashion.

V. Prominently display the contractor’s customer service number and provide, at a minimum, English and Spanish customer support to the LCSA and payers for all hours of operation.

W. Ensure that a back-up plan is fully operational at all times in the event of a power-outage or other catastrophe so that no data will be lost or compromised and that processing will continue with minimal disruption. The back-up plan should delineate in detail the steps that the contractor should take to minimize the disruption of the workflow in the event of Department of Child Support Services IFB Number 261 Page 42 of 54 a disaster. The Contractor must test this plan annually to ensure the on-going functionality of the system.

X. Ensure and guarantee complete confidentiality of all client information and all data security requirements as described in Exhibit E, Information Security Provisions.

Y. Relocate a kiosk to a specified location when requested by DCSS and/or the LCSAs in a timely fashion. The LCSAs, in coordination with DCSS, will determine kiosk locations that best meet the needs of DCSS and LCSA customers.

4. DCSS agrees to:

A. Provide a DCSS project manager who will oversee all Contractor activities in coordination with the LCSAs.

B. Provide appropriate participant identifier numbers to customers.

C. Resolve any claims, inquiries or complaints arising out of the application of payments to accounts.

D. Monitor contractor responsibilities in coordination with the LCSAs.

5. LCSA Responsibilities

A. Provide the contractor with information regarding the location(s) within the county.

B. Be responsible for necessary power and internet connections. Department of Child Support Services IFB Number 261 Page 43 of 54

Exhibit B- Budget Detail and Payment Provisions

1. Invoicing and Payment

A. For services satisfactorily rendered, and upon receipt and approval of the invoices, the State agrees to compensate the Contractor for actual expenditures incurred in accordance with the rate(s) specified in the attached Exhibit B.1, Cost Sheet. The rate(s) agreed upon in this contract will not increase for the term of this Agreement.

B. Itemized invoice(s) shall include the Agreement Number, supporting documentation, and be submitted in triplicate per file request in arrears to the following address:

DEPARTMENT OF CHILD SUPPORT SERVICES Contracts Fiscal Unit P.O. BOX 419064, MS 621 Rancho Cordova, CA 95741-9064

2. State Budget Contingency Clause

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

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

3. For Contract With Federal Funds

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

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

C. It is mutually agreed that if the Congress does not appropriate sufficient funds for the program, this Agreement shall be amended to reflect any reduction in funds. Department of Child Support Services IFB Number 261 Page 44 of 54

D. The DCSS has the option to void the Agreement under the 30-day cancellation clause or to amend the Agreement to reflect any reduction of funds.

4. Prompt Payment Clause

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

5. Taxes The State of California is exempt from Federal Excise Taxes, and no payment will be made for any taxes levied on employees’ wages. The State will pay for any applicable State of California or local sales or use taxes on the services rendered or equipment or parts supplied pursuant to this agreement. California may pay any applicable sales or use tax imposed by another state.

6. Final Billing

Final billing for services must be received by the State within 90 days following the end of the contract. Department of Child Support Services IFB Number 261 Page 45 of 54

Exhibit B.1. – Cost Sheet

The successful Contractor’s completed Attachment 3 – Cost Sheet (Exhibit B.1) will be inserted here upon award and contract execution. Department of Child Support Services IFB Number 261 Page 46 of 54 Exhibit D – Special Terms and Conditions

1. TERMINATION WITHOUT CAUSE

This Agreement may be terminated without cause by DCSS upon 30 days written notice to the other party.

2. AMENDMENT

This Agreement may be amended by the State with 30 days advance written notice to Contractor.

3. DISPUTE PROVISIONS:

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

1) The decision under dispute;

2) The reason(s) Contractor believes the decision of the DCSS Representative to have been in error (if applicable, reference pertinent contract provisions);

3) Identification of all documents and substance of all oral communication which support Contractor’s position; and,

4) Dollar amount in dispute, if applicable.

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

1) Description of the dispute;

2) Reference to pertinent contract provisions, if applicable;

3) Statement of the factual areas of agreement or disagreement; and,

4) Statement of the representative’s decision with supporting rationale.

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

California Department of Child Support Services Administrative Services Division Attention: Chief, Budget & Procurement Branch P.O. Box 419064, MS 621 Rancho Cordova, CA 95741-9064 Department of Child Support Services IFB Number 261 Page 47 of 54

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

4. CONFIDENTIALITY OF DATA

All financial, personal, technical and other data/information designated as confidential by the State and made available to the Contractor shall be protected by the Contractor from unauthorized use and disclosure. The Contractor shall ensure that all staff comply with California Family Code §17212 and Title 22 of the California Code of Regulations, §111430 and §111440.

5. CONTRACT LANGUAGE FOR GENERAL SERVICES

The Contractor agrees to comply with and assume responsibility for compliance by his or her employees of the terms and conditions of the Contract Language for General Services contained in Internal Revenue Services (IRS) Publication 1075, Tax Information Security Guidelines for Federal, State and Local Agencies and Entities. The Contract Language for General Services is found within the IRS Publication 1075 at the following website: http://www.irs.gov/pub/irs-pdf/p1075.pdf.

6. AUDIT PROVISIONS:

A. Both parties will accept responsibility for receiving, replying to and/or complying with any audit exceptions by appropriate State and Federal audit agencies that are directly related to the services to be performed under this Agreement. In addition, each party agrees to pay to the other the amount of the State’s liability to the Federal Government which results from that party’s failure to perform the services or comply with the conditions required by this Agreement.

B. The Contractor agrees to comply with federal procedures in accordance with Title 2, Code of Federal Regulations (CFR) Part 200 – Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards.

7. DEBARMENT AND SUSPENSION

For federally funded agreements in the amount of $25,000 or more, the Contractor certifies by signing a Debarment and Suspension Agreement that neither it, nor its principals, is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. Where the prospective recipient of federal funds is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. (Executive Order 12549, 7 CFR Part 3017, 45 CFR Part 76, and 44 CFR Part 17). http://www.documents.dgs.ca.gov/ofa/FederalSurplus/Debarment.pdf

8. CERTIFICATION REGARDING LOBBYING

Applicable to Grants, Subgrants, Cooperative Agreements, and Contracts Exceeding $100,000 in Federal Funds. Department of Child Support Services IFB Number 261 Page 48 of 54

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

(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of Contractor, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, Contractor shall complete and submit Standard Form-LLL,``Disclosure Form to Report Lobbying,'' in accordance with its instructions. (3) The Contractor shall require that certification language be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.

B. This certification is a prerequisite for making or entering into this transaction and is imposed by Section 1352, Title 31, U.S. Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Any person who fails to file the required certification shall be subject to a civil penalty of no less than $10,000 and not more than $100,000 for each such failure. Department of Child Support Services IFB Number 261 Page 49 of 54

Exhibit E - Information Security Provisions Department of Child Support Services

Contractor shall agree to comply with and implement the following administrative, physical, and information security safeguards to ensure the integrity, security, and confidentiality of all Department of Child Support Services (DCSS) information (including, but not limited to electronic files, data, paper documents and forms) for the terms and length of this agreement and while in possession of, maintaining, or accessing DCSS information.

I. ADMINISTRATIVE SAFEGUARDS 1. CONTACTS: Information security contacts responsible for security and confidentiality responsibilities related to this Agreement.

DCSS Contractor DCSS Information Security Office P.O. Box 419064 Rancho Cordova, CA 95741-9064 916-464-5045 [email protected]

2. DATA OWNERSHIP: The confidential or sensitive information being provided under this Agreement remains the exclusive property of the providing party. Confidential and sensitive information is not open to the public and requires special precautions to protect from loss and unauthorized use, disclosure, modification, or destruction. 3. INCIDENT REPORTING: All unauthorized or suspected unauthorized access, uses and/or disclosures (incidents) of information obtained under this agreement shall be thoroughly reviewed by each agency. Each party shall comply with the incident reporting requirements in accordance with Civil Code Section 1798.29 and California State Administrative Manual section 5350. Contractor will notify DCSS ISO via telephone of any confirmed information security breach involving information accessed or obtained under this agreement as soon as practical, but no more than seven (7) business days of discovery; and provide all appropriate information via email to facilitate the required reporting requirements. 4. USE OF INFORMATION: Contractor acknowledges and agrees that the information furnished or secured pursuant to this Agreement shall be used solely for the purposes described in this Agreement and shall agree to implement policies and procedures to ensure the confidentiality of such information. Contractor further agrees that information obtained under this Agreement will not be reproduced, published, sold or released in original or any other form for any other purpose other than identified in this Agreement. 5. STATEMENT OF CONFIDENTIALITY: Each party and each of its employees who may have access to the confidential or sensitive data of the other party will be required to sign a confidentiality statement attesting to the fact that he/she is aware Department of Child Support Services IFB Number 261 Page 50 of 54

of the confidential data and the penalties for unauthorized use and disclosure under applicable state and federal law thereof. 6. EMPLOYEE ACCESS TO INFORMATION: Both parties agree that information will be kept in the strictest confidence and shall only be made available to authorized personnel on a business “need-to-know” basis and only for the purposes authorized under this Agreement. The term “need-to-know” refers to those authorized persons who need information to perform their official duties in connection with the purpose as described in the Agreement. The parties recognize their mutual responsibilities to protect the confidentiality of the information in their custody as provided by law and ensure such information is disclosed only to those individuals and of such purpose, as authorized by the respective laws. 7. SECURITY AWARENESS TRAINING: Both parties, DCSS and Contractor, and all their users authorized to access confidential and sensitive information furnished or obtained under this agreement must receive security awareness training prior to accessing such information and annually thereafter. Security awareness training must contain instructional components required by each party, such as, but not limited to, information about the confidential nature of information, laws and regulations protecting the confidentiality of information, user responsibility for protecting the information, and the consequences and legal liability of unauthorized inspection or disclosure of the information.

II. PHYSICAL SAFEGUARDS 1. ACCESS AUTHORIZATION RECORDS: Each agency shall maintain records of all authorized users and authorization level of access granted to the information obtained under in this agreement with the purpose as described in this agreement. 2. ACCESS CONTROL: Each party shall maintain and secure, any of its computer systems (network, hardware, software and applications) used in the performance of this Agreement. 3. SECURE AREAS: Computer monitors, printers, hard copy printouts or any other forms of information accessed or obtained under the performance of this agreement must be placed so that they may not be viewed by the public or other unauthorized persons as described in the agreement. 4. SECURE STORAGE: Information in all forms, such as but not limited to tapes, cartridges, or other removable media, must be stored in areas physically secure from access by unauthorized persons as described in this agreement. 5. MEDIA PROTECTION: Each party shall employ the use of encryption for all confidential information stored on media such as, but not limited to, portable computing devices, CDs, DVDs, USB flash drives, tapes, and cartridges in its custody. 6. DESTRUCTION OF RECORDS: All data received by Contractor from the Client under this Agreement shall be either destroyed, including information stored on magnetic tapes, discs, and other medium, using confidential destruct methods, such as secure shredding, burning, degaussing, erasing, or other certified or witnessed destruction upon written request of Client or within thirty (30) calendar days of termination. Notwithstanding anything to the contrary, Contractor shall have the Department of Child Support Services IFB Number 261 Page 51 of 54

right to retain data for evidence a transaction occurred, audit purposes, dispute resolution, and to fulfill legal requirements. Also Contractor may retain data on encrypted backup media until such time as such backup media is re-used or destroyed. Contractor shall maintain security guidelines of this agreement for the period that such data is under the control of Contractor.

III. INFORMATION SECURITY 1. ELECTRONIC TRANSMISSION: All confidential information transmitted over a public network shall be encrypted using strong encryption standards. 2. ANNUAL ASSESSMENTS: Annual assessments of the security controls in the information systems containing information used in the performance of this agreement must be conducted and assessment report provided to the Contractor’s ISO for review upon request. 3. UNIQUE IDENTIFICATION: Each agency’s network security architecture must be able to identify uniquely all access to information obtained and used in the performance of this agreement. 4. TEST AND DEVELOPMENT: Use only deidentified information in test and development environments. Use of non-deidentified data for testing and development must be approved in advance by the providing Contractor’s ISO. 5. CHANGE CONTROL: All changes to computer systems, hardware, software, applications, storage media, and network components used for storing and/or accessing information in the performance of this agreement must be approved by each party in writing prior to implementation. 6. SCREEN-LOCKING: Computers capable of accessing information for the performance of this agreement must not be left unattended and logged on, unless secured by a screen-locking process or mechanism to prevent unauthorized access, or secured in a locked room not accessible to unauthorized personnel. 7. AUDITING: Maintain an audit trail and record data access of authorized users and authorization level of access granted to information, based on job function. Said logs must be made available to the Contractor’s ISO upon request. 8. INSPECTION: Vendor shall allow audits or inspections by individuals authorized by DCSS at Vendor’s premises during regular business hours, on three (3) business day’s prior notice for purposes of determining compliance with the terms of this Agreement. 9. EXCEPTIONS: Both parties will accept responsibility for receiving, replying to, and/or complying with any audit exceptions by appropriate State and Federal audit agencies that are directly related to the services to be performed under this Agreement.

IV. FEDERAL TAX INFORMATION SAFEGUARDS

1. PERFORMANCE In performance of this contract, the Vendor agrees to comply with and assume responsibility for compliance by his or her employees with the following requirements: Department of Child Support Services IFB Number 261 Page 52 of 54

A. All work will be done under the supervision of the Vendor or the Vendor's employees.

B. Any return or return information made available in any format shall be used only for the purpose of carrying out the provisions of this contract. Information contained in such material will be treated as confidential and will not be divulged or made known in any manner to any person except as may be necessary in the performance of this contract. Disclosure to anyone other than an officer or employee of the Vendor will be prohibited.

C. All returns and return information will be accounted for upon receipt and properly stored before, during, and after processing. In addition, all related output will be given the same level of protection as required for the source material.

D. The Vendor certifies that the data processed during the performance of this contract will be completely purged from all data storage components of his or her computer facility, and no output will be retained by the Vendor at the time the work is completed. If immediate purging of all data storage components is not possible, the Vendor certifies that any IRS data remaining in any storage component will be safeguarded to prevent unauthorized disclosures.

E. Any spoilage or any intermediate hard copy printout that may result during the processing of IRS data will be given to the agency or his or her designee. When this is not possible, the Vendor will be responsible for the destruction of the spoilage or any intermediate hard copy printouts, and will provide the agency or his or her designee with a statement containing the date of destruction, description of material destroyed, and the method used.

F. All computer systems receiving, processing, storing, or transmitting Federal tax information must meet the requirements defined in IRS Publication 1075. To meet functional and assurance requirements, the security features of the environment must provide for the managerial, operational, and technical controls. All security features must be available and activated to protect against unauthorized use of and access to Federal tax information.

G. No work involving Federal tax information furnished under this contract will be subcontracted without prior written approval of the IRS.

H. The Vendor will maintain a list of employees authorized access. Such list will be provided to the agency and, upon request, to the IRS reviewing office.

I. The agency will have the right to void the contract if the Vendor fails to provide the safeguards described above.

2. CRIMINAL/CIVIL SANCTIONS

A. Each officer or employee of any person to whom returns or return information is or may be disclosed will be notified in writing by such person that returns or return information disclosed to such officer or employee can be used only for a purpose and to the extent authorized herein, and that further disclosure of any such returns or return information for a purpose or to an extent unauthorized herein constitutes a felony punishable upon conviction by a fine of as much as $5,000 or imprisonment for as long as 5 years, or Department of Child Support Services IFB Number 261 Page 53 of 54 both, together with the costs of prosecution. Such person shall also notify each such officer and employee that any such unauthorized further disclosure of returns or return information may also result in an award of civil damages against the officer or employee in an amount not less than $1,000 with respect to each instance of unauthorized disclosure. These penalties are prescribed by IRC sections 7213 and 7431 and set forth at 26 CFR 301.6103(n)-1.

B. Each officer or employee of any person to who returns or return information is or may be disclosed shall be notified in writing by such person that any return or return information made available in any format shall be used only for the purpose of carrying out the provisions of this contract. Information contained in such material shall be treated as confidential and shall not be divulged or made known in any manner to any person except as may be necessary in the performance of the contract. Inspection by or disclosure to anyone without an official need to know constitutes a criminal misdemeanor punishable upon conviction by a fine of as much as $1,000 or imprisonment for as long as 1 year, or both, together with the costs of prosecution. Such person shall also notify each such officer and employee that any such unauthorized inspection or disclosure of returns or return information may also result in an award of civil damages against the officer or employee [United States for Federal employees] in an amount equal to the sum of the greater of $1,000 for each act of unauthorized inspection or disclosure with respect to which such defendant is found liable or the sum of the actual damages sustained by the plaintiff as a result of such unauthorized inspection or disclosure plus in the case of a willful inspection or disclosure which is the result of gross negligence, punitive damages, plus the costs of the action. These penalties are prescribed by IRC section 7213A and 7431.

C. Additionally, it is incumbent upon the Vendor to inform its officers and employees of the penalties for improper disclosure imposed by the Privacy Act of 1974, 5 U.S.C. 552a. Specifically, 5 U.S.C. 552a(i)(1), which is made applicable to Vendors by 5 U.S.C. 552a(m)(1), provides that any officer or employee of a Vendor, who by virtue of his/her employment or official position, has possession of or access to agency records which contain individually identifiable information, the disclosure of which is prohibited by the Privacy Act or regulations established thereunder, and who knowing that disclosure of the specific material is prohibited, willfully discloses the material in any manner to any person or agency not entitled to receive it, shall be guilty of a misdemeanor and fined not more than $5,000.

D. Granting a Vendor access to FTI must be preceded by certifying that each individual understands the agency’s security policy and procedures for safeguarding IRS information. Vendors must maintain their authorization to access FTI through annual recertification. The initial certification and recertification must be documented and placed in the agency's files for review. As part of the certification and at least annually afterwards, Vendors should be advised of the provisions of IRC Sections 7431, 7213, and 7213A (see Exhibit 6,

IRC Sec. 7431 Civil Damages for Unauthorized Disclosure of Returns and Return Information and Exhibit 5, IRC Sec. 7213 Unauthorized Disclosure of Information). The training provided before the initial certification and annually thereafter must also cover the incident response policy and procedure for reporting unauthorized disclosures and data breaches. (See Section 10) For both the initial certification and the annual Department of Child Support Services IFB Number 261 Page 54 of 54 certification, the Vendor should sign, either with ink or electronic signature, a confidentiality statement certifying their understanding of the security requirements.

3. INSPECTION

The IRS and the Agency shall have the right to send its officers and employees into the offices and plants of the Vendor for inspection of the facilities and operations provided for the performance of any work under this contract. On the basis of such inspection, specific measures may be required in cases where the Vendor is found to be noncompliant with contract safeguards.

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