ADDENDUM
Contract # 0000000000000000000021676
This Addendum is entered into by and between Indiana Bureau of Motor Vehicles (BMV) (“the State”) and
the entity designated as “Contractor” below.
The purpose of this Addendum is to modify, delete, or amend certain terms and conditions set forth in the
attached Form Contract prepared by Contractor (the “Form Contract”). This Addendum and the Form
Contract are incorporated into each other and, when read together, shall constitute one integrated document
(“this Contract”). Any inconsistency, conflict, or ambiguity between this Addendum and the Form Contract
shall be resolved by giving precedence and effect to this Addendum.
Contractor Name:

The American Association of Motor Vehicle Administrators, Inc. (“ AAMVA”)

Contractor Address:

4401 Wilson Blvd
Arlington, VA 22203

Title of Form Contract: DIGITAL IMAGE ACCESS AND EXCHANGE PARTICIPATION AGREEMENT

1.

Form Contract/Duties of Contractor
A. The Contractor shall provide the Services or Products described in the Form Contract.
B. The Contractor shall maintain on-site, review and abide by the BMV Data/Information Security
Policy for Contractors, Attachment A, which is attached hereto and fully incorporated into this
Contract. The BMV may modify Attachment A. If the BMV modifies Attachment A, the BMV shall
immediately forward an updated Attachment A to the Contractor and this updated Attachment A
shall, upon receipt, immediately be fully incorporated into this Contract without need for
amendment.

2.

Term

This Contract shall commence on August 15, 2017 and be effective for a period of two (2) years, ending on
August 15, 2019.

3.

Consideration

Total consideration for the term of this Contract is Twenty-Seven Thousand Five Hundred Dollars
($27,500.00).
By mutual agreement of the BMV and the Contractor (collectively, the “Parties”), the following terms and
conditions are deleted from the Form Contract:
A.
B.
C.
D.
E.
F.
G.
H.

Indiana BMV

Any provision requiring the State of Indiana to provide insurance
Any provision requiring the State of Indiana to provide indemnity
Any provision providing that the Contract be construed in accordance with laws other than those of
the State of Indiana
Any provision providing that suit be brought in any state other than Indiana
Any provision providing for resolution of contract disputes
Any provision requiring the State of Indiana to pay any taxes
Any provision requiring the State of Indiana to pay penalties, liquidated damages, interest or
attorney’s fees
Any provision modifying the applicable Indiana statute of limitations

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 I.
J.
K.
L.
M.
N.

4.

Any provision relating to the time within which a claim must be made.
Any provision requiring payment of consideration in advance unless authorized by an exception
listed in IC §4-13-2-20
Any provision limiting disclosure of the contract in violation of the Access to Public Records Act,
IC §5-14-3. This is a Public Contract and will be posted on the State’s website pursuant to Executive
Order 05-07
Any provision requiring payment in less than 35 days
Any provision providing for automatic renewal
Any provision giving the Form Contract precedence over this Addendum

Access to Records

The Contractor and its subcontractors, if any, shall maintain all books, documents, papers, accounting
records, and other evidence pertaining to all costs incurred under this Contract. They shall make such
materials available at their respective offices at all reasonable times during this Contract, and for three (3)
years from the date of final payment under this Contract, for inspection by the State or its authorized
designees. Copies shall be furnished at no cost to the State if requested.

5.

Assignment; Successors

The Contractor binds its successors and assignees to all the terms and conditions of this Contract. The
Contractor shall not assign or subcontract the whole or any part of this Contract without the State's prior
written consent. The Contractor may assign its right to receive payments to such third parties as the
Contractor may desire without the prior written consent of the State, provided that the Contractor gives
written notice (including evidence of such assignment) to the State thirty (30) days in advance of any
payment so assigned. The assignment shall cover all unpaid amounts under this Contract and shall not be
made to more than one party.

6.

Assignment of Antitrust Claims

Deleted by mutual agreement of the Parties.

7.

Audits

The Contractor acknowledges that it may be required to submit to an audit of funds paid through this
Contract. Any such audit shall be conducted in accordance with IC §5-11-1, et. seq. and audit guidelines
specified by the State. The State may request the Contractor provide, at their sole cost and expense, copies
of independent third party audits and certain information pertaining to this Contract. The Parties shall
mutually agree on the submission date of a copy of the audit(s) results/findings to the State.

8.

Authority to Bind Contractor

The signatory for the Contractor represents that he/she has been duly authorized to execute this Contract on
behalf of the Contractor and has obtained all necessary or applicable approvals to make this Contract fully
binding upon the Contractor when his/her signature is affixed, and accepted by the State.

9.

Changes in Work

The Contractor shall not commence any additional work or change the scope of the work until authorized in
writing by the State. The Contractor shall make no claim for additional compensation in the absence of a
prior written approval and amendment executed by all signatories hereto. This Contract may only be
amended, supplemented or modified by a written document executed in the same manner as this Contract.

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 10.

Compliance with Laws
A. The Contractor shall comply with all applicable federal, state, and local laws, rules, regulations, and
ordinances, and all provisions required thereby to be included herein are hereby incorporated by
reference. The enactment or modification of any applicable state or federal statute or the
promulgation of rules or regulations thereunder after execution of this Contract shall be reviewed by
the State and the Contractor to determine whether the provisions of this Contract require formal
modification.
B. The Contractor and its agents shall abide by all ethical requirements that apply to persons who have
a business relationship with the State as set forth in IC §4-2-6, et seq., IC §4-2-7, et seq., and the
regulations promulgated thereunder. If the Contractor has knowledge, or would have acquired
knowledge with reasonable inquiry, that a state officer, employee, or special state appointee,
as those terms are defined in IC 4-2-6-1, has a financial interest in the Contract, the
Contractor shall ensure compliance with the disclosure requirements in IC 4-2-6-10.5 prior to
the execution of this contract. If the Contractor is not familiar with these ethical requirements, the
Contractor should refer any questions to the Indiana State Ethics Commission, or visit the Inspector
General’s website at http://www.in.gov/ig/. If the Contractor or its agents violate any applicable
ethical standards, the State may, in its sole discretion, terminate this Contract immediately upon
notice to the Contractor. In addition, the Contractor may be subject to penalties under IC §§4-2-6, 42-7, 35-44.1-1-4, and under any other applicable laws.
C. The Contractor certifies by entering into this Contract that neither it nor its principal(s) is presently in
arrears in payment of taxes, permit fees or other statutory, regulatory or judicially required payments
to the State of Indiana. The Contractor agrees that any payments currently due to the State of
Indiana may be withheld from payments due to the Contractor. Additionally, further work or
payments may be withheld, delayed, or denied and/or this Contract suspended until the Contractor is
current in its payments and has submitted proof of such payment to the State.
D. The Contractor warrants that it has no current, pending or outstanding criminal, civil, or enforcement
actions initiated by the State, and agrees that it will immediately notify the State of any such actions.
During the term of such actions, the Contractor agrees that the State may delay, withhold, or deny
work under any supplement, amendment, change order or other contractual device issued pursuant
to this Contract.
E. If a valid dispute exists as to the Contractor's liability or guilt in any action initiated by the State or its
agencies, and the State decides to delay, withhold, or deny work to the Contractor, the Contractor
may request that it be allowed to continue, or receive work, without delay. The Contractor must
submit, in writing, a request for review to the Indiana Department of Administration (IDOA) following
the procedures for disputes outlined herein. A determination by IDOA shall be binding on the parties.
Any payments that the State may delay, withhold, deny, or apply under this section shall not be
subject to penalty or interest, except as permitted by IC §5-17-5.
F. The Contractor warrants that the Contractor and its subcontractors, if any, shall obtain and maintain
all required permits, licenses, registrations, and approvals, and shall comply with all health, safety,
and environmental statutes, rules, or regulations in the performance of work activities for the State.
Failure to do so may be deemed a material breach of this Contract and grounds for immediate
termination and denial of further work with the State.
G. The Contractor affirms that, if it is an entity described in IC Title 23, it is properly registered and owes
no outstanding reports to the Indiana Secretary of State.
H. As required by IC §5-22-3-7:
1. The Contractor and any principals of the Contractor certify that:

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 (A) the Contractor, except for de minimis and nonsystematic violations, has not violated the
terms of:
(i) IC §24-4.7 [Telephone Solicitation Of Consumers];
(ii) IC §24-5-12 [Telephone Solicitations]; or
(iii) IC §24-5-14 [Regulation of Automatic Dialing Machines]; in the previous three hundred
sixty-five (365) days, even if IC §24-4.7 is preempted by federal law; and
(B) The Contractor will not violate the terms of IC §24-4.7 for the duration of the Contract, even if
IC §24-4.7 is preempted by federal law.
2.

The Contractor and any principals of the Contractor certify that an affiliate or principal of the
Contractor and any agent acting on behalf of the Contractor or on behalf of an affiliate or
principal of the Contractor, except for de minimis and nonsystematic violations,
(A) has not violated the terms of IC §24-4.7 in the previous three hundred sixty-five (365) days,
even if IC §24-4.7 is preempted by federal law; and
(B) will not violate the terms of IC §24-4.7 for the duration of the Contract, even if IC §24-4.7 is
preempted by federal law.

11.

Condition of Payment

Deleted by mutual agreement of the Parties.

12.

Confidentiality of State Information.
A. The Contractor understands and agrees that data, materials, and information disclosed to the
Contractor may contain confidential and protected information. Except as provided in the Form
Contract, the Contractor covenants that data, material and information gathered, based upon or
disclosed to the Contractor for the purpose of this Contract, will not be disclosed to or discussed with
third parties without the prior written consent of the State.
B. The Parties acknowledge that pursuant to the Contract that the data, materials, and/or information
that the State may provide to the Contractor may contain personal information (as defined in IC §§ 41-11-3 and 9-14-6-6) that the State maintains in its computer system or other records. In addition to
the covenant made in this section and pursuant to 10 IAC 5-3-1(4), the Parties agree to comply with
provisions of IC 4-1-10, 4-1-11, 9-14-12 and 9-14-13.
C. If the Contractor discloses any personal information received from the State without the express
written authorization from the State or in violation of any State statute, the cost(s) of the notice(s) of
any and all disclosure(s) of the breach(es) shall be the responsibility of the Contractor. Additionally,
promptly upon becoming aware of such disclosure(s) the Contractor shall notify the State’s General
Counsel by e-mail of the breach(es).
D. The Contractor shall not use or disclose the information furnished by the State for any other purpose
other than for the purposes set forth in this Contract. By entering into this Contract, the Contractor
warrants that they shall comply fully with the Federal Driver’s Privacy Protection Act, 18 U.S.C. 2721,
et seq., as amended, and all other applicable laws and regulations governing access and use of
motor vehicle records and the personal information contained therein.
E. The Contractor shall identify contact persons and provide contact information for these individuals to
the State. The Contractor shall conduct prompt investigations of alleged misuses or security
breaches, and will cooperate fully with State personnel to address issues and concerns.
F. Acceptance of this Contract by the State shall not be construed as a determination by the State that
the Contractor’s procedures are indeed adequate.

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 G. Should the Contractor or any of its principals, employees, subcontractors, agents or clients obtain
access to any information not permitted under this Contract, or discover that information was, or has
a reason to believe information may have been, acquired by an unauthorized person, the Contractor
shall immediately, but not later than one (1) calendar day thereafter, notify the State and the Indiana
Attorney General’s Identity Theft Unit via telephone and in writing. Furthermore, the Contractor shall
notify the appropriate Federal authorities of any suspected misuse or security breaches, and shall
cooperate fully with the designees of the State or Federal authorities to investigate suspected
misuse(s) or security breach(es), and/or to address related issues and concerns.
H. The obligations and duties concerning the confidentiality of the State information and information
obtained by performing this Contract shall survive the termination of the Contract and any applicable
renewals indefinitely.

13.

Continuity of Services
A. The Parties recognize that the service(s) to be performed under this Contract are vital to the State
and must be continued without interruption.
B. The Contractor shall, upon the State's written notice furnish phase-in, phase-out services for up to
sixty (60) days after this Contract expires (this may include maintaining all current services).
C. Deleted by mutual agreement of the Parties.
D. Deleted by mutual agreement of the Parties

14.

Debarment and Suspension

A. The Contractor certifies by entering into this Contract that neither it nor its principals nor any of its
subcontractors are presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily
excluded from entering into this Contract by any federal agency or by any department, agency or political
subdivision of the State of Indiana. The term "principal" for purposes of this Contract means an officer,
director, owner, partner, key employee or other person with primary management or supervisory
responsibilities, or a person who has a critical influence on or substantive control over the operations of the
Contractor.
B. Deleted by mutual agreement of the Parties.

15.

Default by State

If the State, ninety (90) days after receipt of written notice, fails to correct or cure any material breach of this
Contract, the Contractor may cancel and terminate this Contract and institute measures to collect monies
due up to and including the date of termination.

16.

Disputes
A. Should any disputes arise with respect to this Contract, the Contractor and the State agree to act
immediately to resolve such disputes. Time is of the essence in the resolution of disputes.

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 B. The Contractor agrees that, the existence of a dispute notwithstanding, it will continue without delay
to carry out all of its responsibilities under this Contract that are not affected by the dispute. Should
the Contractor fail to continue to perform its responsibilities regarding all non-disputed work, without
delay, any additional costs incurred by the State or the Contractor as a result of such failure to
proceed shall be borne by the Contractor, and the Contractor shall make no claim against the State
for such costs.
C. If the parties are unable to resolve a contract dispute between them after good faith attempts to do
so, a dissatisfied party shall submit the dispute to the Commissioner of the Indiana Department of
Administration for resolution. The dissatisfied party shall give written notice to the Commissioner
and the other party. The notice shall include (1) a description of the disputed issues, (2) the efforts
made to resolve the dispute, and (3) a proposed resolution. The Commissioner shall promptly issue
a Notice setting out documents and materials to be submitted to the Commissioner in order to
resolve the dispute; the Notice may also afford the parties the opportunity to make presentations
and enter into further negotiations. Within thirty (30) business days of the conclusion of the final
presentations, the Commissioner shall issue a written decision and furnish it to both parties. The
Commissioner’s decision shall be the final and conclusive administrative decision unless either
party serves on the Commissioner and the other party, within ten (10) business days after receipt of
the Commissioner’s decision, a written request for reconsideration and modification of the written
decision. If the Commissioner does not modify the written decision within thirty (30) business days,
either party may take such other action helpful to resolving the dispute, including submitting the
dispute to an Indiana court of competent jurisdiction. If the parties accept the Commissioner’s
decision, it may be memorialized as a written Amendment to this Contract if appropriate.
D. Deleted by mutual agreement of the Parties.
E. With the written approval of the Commissioner of the Indiana Department of Administration, the
parties may agree to forego the process described in subdivision C. relating to submission of the
dispute to the Commissioner.
F. This paragraph shall not be construed to abrogate provisions of Ind. Code 4-6-2-11 in situations
where dispute resolution efforts lead to a compromise of claims in favor of the State as described in
that statute. In particular, releases or settlement agreements involving releases of legal claims or
potential legal claims of the state should be processed consistent with Ind. Code 4-6-2-11, which
requires approval of the Governor and Attorney General.

17.

Drug-Free Workplace Certification

As required by Executive Order No. 90-5 dated April 12, 1990, issued by the Governor of Indiana, the
Contractor hereby covenants and agrees to make a good faith effort to provide and maintain a drug-free
workplace. The Contractor will give written notice to the State within ten (10) days after receiving actual
notice that the Contractor, or an employee of the Contractor in the State of Indiana, has been convicted of a
criminal drug violation occurring in the workplace. False certification or violation of this certification may
result in sanctions including, but not limited to, suspension of contract payments, termination of this Contract
and/or debarment of contracting opportunities with the State for up to three (3) years.
In addition to the provisions of the above paragraph, if the total amount set forth in this Contract is in excess
of $25,000.00, the Contractor certifies and agrees that it will provide a drug-free workplace by:
A. Publishing and providing to all of its employees a statement notifying them that the unlawful
manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in
the Contractor's workplace, and specifying the actions that will be taken against employees for
violations of such prohibition;

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 B. Establishing a drug-free awareness program to inform its employees of (1) the dangers of drug
abuse in the workplace; (2) the Contractor's policy of maintaining a drug-free workplace; (3) any
available drug counseling, rehabilitation and employee assistance programs; and (4) the penalties
that may be imposed upon an employee for drug abuse violations occurring in the workplace;
C. Notifying all employees in the statement required by subparagraph (A) above that as a condition of
continued employment, the employee will (1) abide by the terms of the statement; and (2) notify the
Contractor of any criminal drug statute conviction for a violation occurring in the workplace no later
than five (5) days after such conviction;
D. Notifying the State in writing within ten (10) days after receiving notice from an employee under
subdivision (C)(2) above, or otherwise receiving actual notice of such conviction;
E. Within thirty (30) days after receiving notice under subdivision (C)(2) above of a conviction, imposing
the following sanctions or remedial measures on any employee who is convicted of drug abuse
violations occurring in the workplace: (1) taking appropriate personnel action against the employee,
up to and including termination; or (2) requiring such employee to satisfactorily participate in a drug
abuse assistance or rehabilitation program approved for such purposes by a federal, state or local
health, law enforcement, or other appropriate agency; and
F. Making a good faith effort to maintain a drug-free workplace through the implementation of
subparagraphs (A) through (E) above.

18.

Employment Eligibility Verification

As required by IC §22-5-1.7, the Contractor swears or affirms under the penalties of perjury that the
Contractor does not knowingly employ an unauthorized alien. The Contractor further agrees that:
A. The Contractor shall enroll in and verify the work eligibility status of all his/her/its newly hired
employees through the E-Verify program as defined in IC §22-5-1.7-3. The Contractor is not required
to participate should the E-Verify program cease to exist. Additionally, the Contractor is not required
to participate if the Contractor is self-employed and does not employ any employees.
B. The Contractor shall not knowingly employ or contract with an unauthorized alien. The Contractor
shall not retain an employee or contract with a person that the Contractor subsequently learns is an
unauthorized alien.
C. The Contractor shall require his/her/its subcontractors, who perform work under this Contract, to
certify to the Contractor that the subcontractor does not knowingly employ or contract with an
unauthorized alien and that the subcontractor has enrolled and is participating in the E-Verify
program. The Contractor agrees to maintain this certification throughout the duration of the term of a
contract with a subcontractor.
D. The State may terminate for default if the Contractor fails to cure a breach of this provision no later
than thirty (30) days after being notified by the State.

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 19.

Employment Option

Deleted by mutual agreement of the Parties.

20.

Force Majeure

In the event that either party is unable to perform any of its obligations under this Contract or to enjoy any of
its benefits because of natural disaster or decrees of governmental bodies not the fault of the affected party
(hereinafter referred to as a "Force Majeure Event"), the party who has been so affected shall immediately or
as soon as is reasonably possible under the circumstances give notice to the other party and shall do
everything possible to resume performance. Upon receipt of such notice, all obligations under this Contract
shall be immediately suspended. If the period of nonperformance exceeds thirty (30) days from the receipt
of notice of the Force Majeure Event, the party whose ability to perform has not been so affected may, by
giving written notice, terminate this Contract

21.

Funding Cancellation

When the Director of the State Budget Agency makes a written determination that funds are not appropriated
or otherwise available to support continuation of performance of this Contract, this Contract shall be
canceled. A determination by the Director of State Budget Agency that funds are not appropriated or
otherwise available to support continuation of performance shall be final and conclusive.

22.

Governing Law

This Contract shall be governed, construed, and enforced in accordance with the laws of the State of Indiana,
without regard to its conflict of laws rules. Suit, if any, must be brought in the State of Indiana.

23.

HIPAA Compliance

Deleted by mutual agreement of the Parties

24.

Indemnification

Unless expressly contrary to law of the state of Indiana, the Contractor shall have no liability for any
consequential, incidental, exemplary, indirect damages, loss, or expenses of any similar kind even if the
Contractor has been advised of the possibility of such damages, losses, or expenses. In no event shall the
Contractor be liable for any damages caused by the State’s direct failure to carry out its obligations under
this Contract. The Contractor’s aggregate liability to the State under this Contract, whether arising out of or
related to breach of contract, tort (including negligence), indemnification obligations or otherwise shall in no
event exceed the greater of Ten Thousand Dollars ($10,000.00) or the total amount of monthly or annual
service fees paid by the State to the Contractor pursuant to this Contract in the twelve month period
preceding the event giving rise to the claim.

25.

Independent Contractor; Workers' Compensation Insurance

The Contractor is performing as an independent entity under this Contract. No part of this Contract shall be
construed to represent the creation of an employment, agency, partnership or joint venture agreement
between the parties. Neither party will assume liability for any injury (including death) to any persons, or
damage to any property, arising out of the acts or omissions of the agents, employees or subcontractors of
the other party. The Contractor shall provide all necessary unemployment and workers' compensation
insurance for the Contractor's employees, and shall provide the State with a Certificate of Insurance
evidencing such coverage prior to starting work under this Contract.

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 26.

Information Technology Enterprise Architecture Requirements

If the Contractor provides any information technology related products or services to the State, the
Contractor shall comply with all IOT standards, policies and guidelines, which are online at
http://iot.in.gov/architecture/. The Contractor specifically agrees that all hardware, software and services
provided to or purchased by the State shall be compatible with the principles and goals contained in the
electronic and information technology accessibility standards adopted under Section 508 of the Federal
Rehabilitation Act of 1973 (29 U.S.C. 794d) and IC 4-13.1-3. Any deviation from these architecture
requirements must be approved in writing by IOT in advance. The State may terminate this Contract for
default if the Contractor fails to cure a breach of this provision within a reasonable time.

27.

Insurance

Deleted by mutual agreement of the Parties.

28.

Key Person(s)

Deleted by mutual agreement of the Parties.

29.

Licensing Standards

The Contractor, its employees and subcontractors shall comply with all applicable licensing standards,
certification standards, accrediting standards and any other laws, rules, or regulations governing services to
be provided by the Contractor pursuant to this Contract. If any license, certification or accreditation expires
or is revoked, or any disciplinary action is taken against an applicable license, certification, or accreditation,
the Contractor shall notify the State immediately and the State, at its option, may immediately terminate this
Contract.

30.

Merger & Modification

This Contract constitutes the entire agreement between the parties. No understandings, agreements, or
representations, oral or written, not specified within this Contract will be valid provisions of this Contract.
This Contract may not be modified, supplemented, or amended, except by written agreement signed by all
necessary parties.

31.

Minority and Women's Business Enterprises Compliance

Deleted by mutual agreement of the Parties.

32.

Nondiscrimination

Pursuant to the Indiana Civil Rights Law, specifically including IC §22-9-1-10, and in keeping with the
purposes of the federal Civil Rights Act of 1964, the Age Discrimination in Employment Act, and the
Americans with Disabilities Act, the Contractor covenants that it shall not discriminate against any employee
or applicant for employment relating to this Contract with respect to the hire, tenure, terms, conditions or
privileges of employment or any matter directly or indirectly related to employment, because of the
employee's or applicant's race, color, national origin, religion, sex, age, disability, ancestry, status as a
veteran, or any other characteristic protected by federal, state, or local law ("Protected Characteristics").
Contractor certifies compliance with applicable federal laws, regulations, and executive orders prohibiting
discrimination based on the Protected Characteristics in the provision of services. Breach of this paragraph
may be regarded as a material breach of this Contract, but nothing in this paragraph shall be construed to
imply or establish an employment relationship between the State and any applicant or employee of the
Contractor or any subcontractor.

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 The State is a recipient of federal funds, and therefore, where applicable, Contractor and any subcontractors
shall comply with requisite affirmative action requirements, including reporting, pursuant to 41 CFR Chapter
60, as amended, and Section 202 of Executive Order 11246 as amended by Executive Order 13672.

33.

Notice to Parties

Whenever any notice, statement or other communication is required under this Contract, it shall be sent by
first class mail or via an established courier / delivery service to the following addresses, unless otherwise
specifically advised.
Notices to the State shall be sent to:
Robert Scott, Director of Contract Management
Indiana Bureau of Motor Vehicles
100 N Senate, Rm. N430
Indianapolis, IN 46204
Telephone: 317-232-7629
RoScott@bmv.in.gov
Steve Leak, Executive Director of Credential Programs
Indiana Bureau of Motor Vehicles
100 N Senate, Rm. N440
Indianapolis, IN 46204
Telephone: 317-234-5305
SLeak@bmv.in.gov
Notices to the Contractor shall be sent to:
Hal Gallos, Director of Contracts Administration
AAMVA
4401 Wilson Blvd., Suite 700
Arlington, VA 22203
Telephone: 703-908-8286
HGallos@aamva.org
As required by IC §4-13-2-14.8, payments to the Contractor shall be made via electronic funds transfer in
accordance with instructions filed by the Contractor with the Indiana Auditor of State.

34.

Order of Precedence; Incorporation by Reference

Any inconsistency or ambiguity in this Contract shall be resolved by giving precedence in the following order:
(1) this addendum, (2) the form contract, (3) attachments prepared by the State, (4) RFQ6977, (5)
Contractor's response to RFQ6977, and (6) attachments prepared by the Contractor. All attachments, and
all documents referred to in this paragraph, are hereby incorporated fully by reference.

35.

Ownership of Documents and Materials
A. All documents, records, programs, applications, data, algorithms, film, tape, articles, memoranda,
and other materials (the “Materials”) not developed or licensed by the Contractor prior to execution of
this Contract, but specifically developed under this Contract shall be considered “work for hire” and
the Contractor hereby transfers and assigns any ownership claims to the State so that all Materials
will be the property of the State. If ownership interest in the Materials cannot be assigned to the
State, the Contractor grants the State a non-exclusive, non-cancelable, perpetual, worldwide royaltyfree license to use the Materials and to use, modify, copy and create derivative works of the
Materials.

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 B. Use of the Materials, other than related to contract performance by the Contractor, without the prior
written consent of the State, is prohibited. During the performance of this Contract, the Contractor
shall be responsible for any loss of or damage to the Materials developed for or supplied by the State
and used to develop or assist in the services provided while the Materials are in the possession of
the Contractor. Any loss or damage thereto shall be restored at the Contractor’s expense. The
Contractor shall provide the State full, immediate, and unrestricted access to the Materials and to
Contractor’s work product during the term of this Contract.

36.

Payments
A. All payments shall be made 35 days in arrears in conformance with State fiscal policies and
procedures and, as required by IC §4-13-2-14.8, the direct deposit by electronic funds transfer to the
financial institution designated by the Contractor in writing unless a specific waiver has been
obtained from the Indiana Auditor of State. No payments will be made in advance of receipt of the
goods or services that are the subject of this Contract except as permitted by IC §4-13-2-20.
B. The State Budget Agency and the Contractor acknowledge that the Contractor is being paid in
advance pursuant to IC §4-13-2-20(b), then the Contractor agrees that if services provided under this
Contract are terminated, upon receipt of written notice from the State, it shall promptly refund the
consideration paid, pro-rated through the date of non-performance.

37.

Penalties/Interest/Attorney's Fees.

The State will in good faith perform its required obligations hereunder and does not agree to pay any
penalties, liquidated damages, interest or attorney's fees, except as permitted by Indiana law, in part, IC §517-5, IC §34-54-8, IC §34-13-1 and IC § 34-52-2-3.
Notwithstanding the provisions contained in IC §5-17-5, any liability resulting from the State's failure to make
prompt payment shall be based solely on the amount of funding originating from the State and shall not be
based on funding from federal or other sources.

38.

Progress Reports

The Contractor shall submit progress reports to the State upon request. The report shall be oral, unless the
State, upon receipt of the oral report, should deem it necessary to have it in written form. The progress
reports shall serve the purpose of assuring the State that work is progressing in line with the schedule, and
that completion can be reasonably assured on the scheduled date.

39.

Public Record

The Contractor acknowledges that the State will not treat this Contract as containing confidential information,
and will post this Contract on its website as required by Executive Order 05-07. Use by the public of the
information contained in this Contract shall not be considered an act of the State.

40.

Renewal Option

This Contract may be renewed under the same terms and conditions, subject to the approval of the
Commissioner of the Department of Administration and the State Budget Director in compliance with IC §522-17-4. The term of the renewed contract may not be longer than the term of the original contract.

Indiana BMV

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 41.

Severability

The invalidity of any section, subsection, clause or provision of this Contract shall not affect the validity of the
remaining sections, subsections, clauses or provisions of this Contract.

42.

Substantial Performance

This Contract shall be deemed to be substantially performed only when fully performed according to its terms
and conditions and any written amendments or supplements.

43.

Taxes

The State is exempt from most state and local taxes and many federal taxes.
responsible for any taxes levied on the Contractor as a result of this Contract.

44.

The State will not be

Termination for Convenience

This Contract may be terminated, in whole or in part, by the State, which shall include and is not limited to
IDOA and the State Budget Agency whenever, for any reason, the State determines that such termination is
in its best interest. Termination of services shall be effected by delivery to the Contractor of a Termination
Notice at least thirty (30) days prior to the termination effective date, specifying the extent to which
performance of services under such termination becomes effective. For the purposes of this paragraph, the
Parties stipulate and agree that the IDOA shall be deemed to be a party to this agreement with authority to
terminate the same for convenience when such termination is determined by the Commissioner of IDOA to
be in the best interests of the State.

45.

Termination for Default
A. With the provision of thirty (30) days' notice to the Contractor, the State may terminate this Contract
in whole or in part if the Contractor fails to:
1.

Correct or cure any breach of this Contract; the time to correct or cure the breach may be
extended beyond thirty (30) days if the State determines progress is being made and the
extension is agreed to by the parties;

2. Deliver the supplies or perform the services within the time specified in this Contract or any
extension;
3. Make progress so as to endanger performance of this Contract; or
4. Perform any of the other provisions of this Contract.
B. Deleted by mutual agreement of the Parties
C. Deleted by mutual agreement of the Parties
D. The rights and remedies of the State in this clause are in addition to any other rights and remedies
provided by law or equity or under this Contract.

46.

Travel

No expenses for travel will be reimbursed.

47.

Indiana BMV

Indiana Veteran's Business Enterprise Compliance.

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GULaw Privacy FR

 Deleted by mutual agreement of the Parties

48.

Waiver of Rights

No right conferred on either party under this Contract shall be deemed waived, and no breach of this
Contract excused, unless such waiver is in writing and signed by the party claimed to have waived such right.
Neither the State's review, approval or acceptance of, nor payment for, the services required under this
Contract shall be construed to operate as a waiver of any rights under this Contract or of any cause of action
arising out of the performance of this Contract, and the Contractor shall be and remain liable to the State in
accordance with applicable law for all damages to the State caused by the Contractor's negligent
performance of any of the services furnished under this Contract.

49.

Work Standards

The Contractor shall execute its responsibilities by following and applying at all times the highest
professional and technical guidelines and standards. If the State becomes dissatisfied with the work product
of or the working relationship with those individuals assigned to work on this Contract, the State may request
in writing the replacement of any or all such individuals, and the Contractor shall grant such request.

50.

State Boilerplate Affirmation Clause

I swear or affirm under the penalties of perjury that I have not altered, modified, or changed the State's
Boilerplate clauses (as defined in the 2016 OAG/ IDOA Professional Services Contract Manual) in any way
except for the following clauses which are named below:
A.
B.
C.
D.
E.
F.
G.
H.
I.
J.
K.
L.
M.
N.
O.
P.
Q.
R.
S.

Indiana BMV

Section 6 of the Addendum, entitled Assignment of Antitrust Claims, is deleted.
Section 11 of the Addendum, entitled Condition of Payment, is deleted.
Section 12 of the Addendum, entitled Confidentiality of State Information, is modified.
Section 13 of the Addendum, entitled Continuity of Services, is modified.
Section 14 of the Addendum, entitled Debarment and Suspension, is modified.
Section 16 of the Addendum, entitled Disputes, is modified.
Section 19 of the Addendum, entitled Employment Option, is deleted.
Section 24 of the Addendum, entitled Indemnification, is modified.
Section 27 of the Addendum, entitled Insurance, is deleted.
Section 28 of the Addendum, entitled Key Person(s), is deleted.
Section 29 of the Addendum, entitled Licensing Standards, is modified.
Section 31 of the Addendum, entitled Minority and Women’s Business Enterprise Compliance, is
deleted.
Section 33 of the Addendum, entitled Notice to Parties, is modified.
Section 34 of the Addendum, entitled Order of Precedence; Incorporation by Reference, is modified.
Section 36 of the Addendum, entitled Payments, is modified.
Section 44 of the Addendum, entitled Termination for Convenience, is modified.
Section 45 of the Addendum, entitled Termination for Default, is modified.
Section 46 of the Addendum, entitled Travel, is modified.
Section 47 of the Addendum, entitled Indiana Veteran’s Business Enterprise Compliance, is deleted

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 Non-Collusion and Acceptance
The undersigned attests, subject to the penalties for perjury, that the undersigned is the Contractor, or that
the undersigned is the properly authorized representative, agent, member or officer of the Contractor.
Further, to the undersigned’s knowledge, neither the undersigned nor any other member, employee,
representative, agent or officer of the Contractor, directly or indirectly, has entered into or been offered any
sum of money or other consideration for the execution of this Contract other than that which appears upon
the face hereof. Furthermore, if the undersigned has knowledge that a state officer, employee, or
special state appointee, as those terms are defined in IC 4-2-6-1, has a financial interest in the
Contract, the Contractor attests to compliance with the disclosure requirements in IC 4-2-6-10.5.
Agreement to Use Electronic Signatures
I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the
secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I
understand that my signing and submitting this Contract in this fashion is the legal equivalent of having
placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that
by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the
information contained therein. I understand that this Contract will not become binding on the State until it
has been approved by the Department of Administration, the State Budget Agency, and the Office of the
Attorney General, which approvals will be posted on the Active Contracts Database:
https://hr85.gmis.in.gov/psp/pa91prd/EMPLOYEE/EMPL/h/?tab=PAPP_GUEST
In Witness Whereof, Contractor and the State have, through their duly authorized representatives, entered
into this Contract. The parties, having read and understood the foregoing terms of this Contract, do by their
respective signatures dated below agree to the terms thereof.
AAMVA

By:

Anne
Ferro

Title:

Date:

Indiana Bureau of Motor Vehicles

Digitally signed by Anne
Ferro
DN: dc=ad, dc=aamva,
ou=User Accounts,
ou=Staff, cn=Anne Ferro,
email=AFerro@aamva.org
Date: 2017.08.16 11:45:47
-04'00'

By:
Title:

Peter
L. Lacy

Date:

Digitally signed by
Peter L. Lacy
DN: cn=Peter L.
Lacy, o, ou,
email=placy@bmv.i
n.gov, c=US
Date: 2017.08.17
11:01:49 -04'00'

Electronically Approved by:
Indiana Office of Technology

Electronically Approved by:
Department of Administration

By:
(for)
Dewand Neely, Chief Information Officer
Refer to Electronic Approval History found after the final page of
the Executed Contract for details.

By:
(for)
Jessica Robertson, Commissioner
Refer to Electronic Approval History found after the final page of
the Executed Contract for details.

Electronically Approved by:
State Budget Agency

Electronically Approved as to Form and Legality:
Office of the Attorney General

By:
(for)
Jason D. Dudich, Director
Refer to Electronic Approval History found after the final page of
the Executed Contract for details.

By:
(for)
Curtis T. Hill, Jr., Attorney General
Refer to Electronic Approval History found after the final page of
the Executed Contract for details.

Indiana BMV

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AAMVA

 

 

 

American Association of
Motor Vehicle Administrators

 

Digital Image Access and Exchange
Participation Agreement

Indiana BMV

102895 Privacy FR

1. Statement of Purpose and Scope of the Digital Image Access and Exchange
Participation Agreement
The chief Administrators of official motor vehicle agencies in several states have joined in
the Digital Image Access and Exchange Participation Agreement (Agreement) to be
administered by the American Association of Motor Vehicle Administrators (AAMVA), to
deter license fraud and identity theft by any person seeking to transfer the privilege to obtain and
to hold a motor vehicle operator’s license or identification card from a former state of residence to
a new state of residence. The Agreement is also intended to enable jurisdictions to begin
implementation of certain provisions of the Real ID Act or other, similar requirements imposed by
federal law to enhance the security of state-issued motor vehicle operator’s licenses and
identification cards.
In furtherance of these purposes, this Agreement is made and entered into by and
between the Bureau of Motor Vehicles (BMV) of the State of Indiana, acting herein by Peter L.
Lacy, its Commissioner, duly authorized, and the American Association of Motor Vehicle
Administrators (AAMVA), for the purpose of facilitating the Agreement for jurisdictional
members of AAMVA to provide and to obtain access to electronic, digital images of the holders of
driver’s licenses and identification cards. Such digital images are captured and maintained on file
by each of the members that are electing to participate in the Agreement, and each such member
has entered into a substantially identical agreement with AAMVA. By entering into this
Agreement, the BMV represents that it (1) has the legal authority to participate in the Agreement,
(2) has the legal authority to take all actions necessary to comply fully with all of the terms and
conditions of this Agreement, and (3) intends to work cooperatively and to communicate directly
with each of the other participating members, to the extent necessary to administer and to
accomplish the purposes of the Agreement. This Agreement shall become effective when signed
by both parties.
2. Basic Design of Program
(a) The Agreement will utilize available secure technology to allow a driver licensing
official in the applicant’s new state of residence (State of Inquiry, or SOI) to electronically
request and temporarily access the applicant’s digital image and certain personal, identifying
information regarding the applicant from the state of former residence (State of Record, or SOR).
The temporary access to such digital image and other information is intended to help to ensure
that the applicant claiming to have a valid license from the former state of residence is the
individual who holds a license issued by that other state, and is not fraudulently using the
personal identification information of another individual, or is not presenting a counterfeit license
purporting to have been issued by the other state. The information transmitted will also disclose if
an existing license is suspended or revoked. If the record maintained by the SOR contains
information indicating the data subject is deceased it shall also transmit that information to the
SOI.
(b) AAMVA agrees that, unless expressly requested and permitted by the BMV, no
employee or agent of AAMVA will have access to any digital image or any other personal
information (defined below) from an official motor vehicle record that is being exchanged in
accordance with the provisions of the Agreement.
3. Compliance with Terms of the Agreement
The BMV agrees that its employees, agents, and contractors shall be made subject to
and bound by the terms of this Agreement. The BMV further agrees that it shall provide
necessary and reasonable methods, controls and procedures to ensure compliance. The
AAMVA will maintain and will make available to all AAMVA member jurisdictions the current list of

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 all jurisdictions participating in the Agreement. If a jurisdiction fails to substantially comply with
any term or condition of the Agreement, then the AAMVA, acting with the approval of a majority of
the other participating jurisdictions, may terminate the Agreement with such jurisdiction and notify
such jurisdiction that it is no longer entitled to participate in the Agreement. Such termination
shall be effective on the date set forth in the notice.
4. Continuing Responsibility to Protect Personal Information
(a) The BMV acknowledges its role in the Agreement as a guardian of the “personal
information” and “highly restricted personal information” (hereinafter “Personal Information”) of
individual licensees entrusted to its agency and agree that such Personal Information is subject to
prohibitions, restrictions and conditions concerning authorized use and disclosure imposed by
federal law, pursuant to the provisions of the Federal Driver Privacy Protection Act (DPPA), 18
USC § 2721 et seq. The BMV also acknowledges its responsibility to maintain compliance with
similar, applicable laws respecting privacy and security protection that are in effect in its
jurisdiction. The parties agree that the exchange of Personal Information between driver
licensing authorities to deter license fraud and help prevent identity theft is authorized by the
provisions of 18 USC § 2721(b)(1) to the extent that the licensing authorities are sharing and
exchanging such information to carry out their governmental functions.
(b) The BMV agrees that all of the other participating jurisdictions are entitled to expect
that the digital image and Personal Information that is conveyed in an electronic transmission to
another participating state will be protected from disclosure by that receiving state to at least the
degree of protection afforded by the DPPA.
(c) To the extent permitted by law, the BMV further agrees that it shall provide at least the
standard of security and protection from disclosure and unauthorized use of digital images and
Personal Information as required by the law of the jurisdiction from which the digital image was
received. With reference to each participating jurisdiction that makes a request for a digital image
and its accompanying Personal Information, the BMV, acting as the SOI, shall furnish a copy or
summary of its relevant laws, to the extent that such laws impose different standards or
requirements than the DPPA.
5. Proper Use and Safeguarding of Digital Images and Personal Information Acquired as SOI
(a) The BMV shall ensure that a digital image and the Personal Information received
therewith in an electronic transmission from a participating state is used solely by the motor
vehicle agency (or the agency of which it is a part) and only for the purposes identified in this
Agreement. Therefore, the BMV agrees that no portion of the information received may be
accessed by or disclosed to any other person, agency, or public or private organization, nor shall
the BMV permit any use of a digital image or Personal Information acquired in the jurisdiction’s
capacity as an SOI that is not expressly authorized by the terms of this Agreement.
(b) A digital image and its accompanying Personal Information as received from an SOR
shall not be separated by the SOI for display or storage purposes but shall remain together so
that the digital image is clearly connected to the accompanying Personal Information and so that
the SOR, which transmitted the information, can be clearly identified.
(c) The SOI may not download, format, print or otherwise use a received digital image
and/or the Personal Information accompanying it for any purpose other than the visual
identification of a license applicant. As used herein, “visual identification” may include the use of
facial recognition technology.
(d) An SOI shall not use a digital image acquired from an SOR as an image on its own
manufactured license nor shall it resize or reconfigure the digital image in any manner to alter the
appearance of the depicted individual.

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 6. Limited Law Enforcement Use
The BMV agrees to provide a briefing for the law enforcement agencies and officers in its
jurisdiction engaged in detecting and prosecuting license fraud and related violations. The
briefing shall include a description of the nature of this Agreement and its limitations. A digital
image and Personal Information received from a SOR may be used for purposes of investigation
and prosecution of any individual who is reasonably believed to have fraudulently attempted to
obtain a license by using the Personal Information of another individual whose digital image
and/or Personal Information has been received from the SOR, or who is reasonably believed to
have engaged in acts or conduct of a similar nature that constitute a violation of law. Except as
may be required by law, the BMV shall not permit a digital image or Personal Information
obtained from an SOR to be accessed or used by a law enforcement agency or personnel of such
an agency for any other purpose.
7. Digital Image & Personal Information to Remain Property of SOR
(a) The BMV agrees that any digital image and the Personal Information conveyed
therewith that is transmitted, in whatever form, to another participating state, shall not be
downloaded into a general database of the SOI.
(b) When the SOI has received the digital image and Personal Information from the SOR
and is satisfied that the applicant is the same individual, the SOI shall cause the digital image and
Personal Information of the received record, in whatever format it may be in or may have been
converted to, to be safely and securely discarded, unless the SOI is required by law to retain such
digital image and Personal Information. If a retention schedule is applicable, the SOI shall safely
and securely discard such digital image and Personal Information as soon as the retention
schedule authorizes such action.
(c) If the SOI is not satisfied that the applicant is the same individual whose digital image
and Personal Information has been received from the SOR, it may retain the digital image and
Personal Information in a secure, temporary file until such time as the SOI either confirms the
identity of the applicant or refers the file to the appropriate person or agency for further
investigation. If identity is confirmed, and except as provided in subparagraph (d) of this section,
the digital image and Personal Information shall be disposed of as required by the provisions of
subparagraph (b) of this paragraph.
(d) The SOI who has reason to believe that a license applicant in the SOI is using the
digital image and/or Personal Information from the record of another individual as received from
the SOR shall promptly refer the matter to the appropriate law enforcement agency or official in
the SOI. If investigation and/or prosecution are pursued, the digital image and Personal
Information may be shared with such investigating and/or prosecuting law enforcement agencies
and officials, consistent with the limitations concerning use imposed by the provisions of
paragraph 6, above.
8. Responsibility for Notifying Individual who is the Subject of Fraud or Misrepresentation
The BMV, when acting in the capacity of SOR, agrees to assume the responsibility to
promptly notify each individual whose digital image and/or Personal Information has been
improperly used by an applicant in another participating jurisdiction to obtain or attempt to obtain
a driver’s license or identification card, or for any other unlawful purpose, that is known to the
SOR.
The SOR shall provide sufficient information to the individual who is a victim or apparent
victim of fraud or identity theft to allow such person to identify and contact the agency or agencies
that have charge of the investigation and/or prosecution of the matter.

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GULaw Privacy FR

 The SOR shall inform the individual to whom the record relates to contact all major credit
bureaus to obtain such person’s credit reports to determine if credit has been wrongfully obtained
using such person’s Personal Information.
9. Public Notice of Agreement
The BMV agrees to make public disclosure of its participation in the Agreement on its
website and/or in other appropriate media, and shall describe and explain that the goal of the
Agreement is to deter license fraud and identity theft.
ACKNOWLEDGED AND AGREED
On behalf of the Bureau of Motor Vehicles of the State of Indiana as a participant in the
Digital Image Access and Exchange Participation Agreement, I agree to be bound by and to
honor the terms of this agreement.
Signature:

DO NOT SIGN HERE

Printed Name:
Title:
Date:
Address:
P.O. Box:
City/Town:
State:

Zip:

Tel:
Fax:
E-Mail:
ACCEPTED:
AAMVA
By: DO NOT SIGN HERE
Anne S. Ferro, President and CEO
Date of Acceptance:

Indiana BMV

Page 19 of 24
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 ATTACHMENT A
DATA/INFORMATION SECURITY POLICY FOR CONTRACTORS
Revised 5/1/2017
The disclosure of personal information collected and/or obtained by the Indiana Bureau of Motor
Vehicles or the Indiana Bureau of Motor Vehicles Commission (“BMV/C”) is subject to the federal
Driver's Privacy Protection Act of 1994 (18 U.S.C. 2721 et seq.) (“DPPA”) as implemented under
state law at Indiana Code (“IC”) §9-14-13. Except as agreed to between BMV/C and Contractor
and as permitted by and in accordance with the DPPA and IC §9-14-13, a Contractor of the
BMV/C, or an officer or employee or subcontractor of the Contractor, shall not knowingly,
accidentally disclose or otherwise make available personal information, including highly restricted
personal information, obtained in connection with a motor vehicle record.
I.

Definitions
"Disclose" shall mean to engage in a practice or conduct to make available and make
known personal information contained in a motor vehicle record about a person to
another person by any means of communication.
"Highly restricted personal information" shall mean the following information that identifies
an individual:
(1) Digital photograph or image.
(2) Social Security number.
(3) Medical or disability information.
"Record" shall mean means any information, books, papers, photographs, photostats,
cards, films, tapes, recordings, electronic data, printouts, or other documentary materials,
regardless of medium, that are created or maintained by the BMV.
“Personal Information” shall mean information that identifies a person, including an
individual's:
(1) digital photograph or image;
(2) Social Security number;
(3) driver's license or identification document number;
(4) name;
(5) address (but not the 5-digit zip code);
(6) telephone number; or
(7) medical or disability information.

II.

Confidentiality of BMV/C Information
Contractors of the BMV/C shall follow all requirements of BMV/C Standard Operating
Procedure regarding the protection of personal information (“PI”), including highly
restricted personal information, and BMV/C data systems. It is the Contractor’s
responsibility to ensure all Contract staff and/or subcontractors with any access to BMV/C

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GULaw Privacy FR

 data systems and/or PI understand these policies and that access to and/or use of
BMV/C data systems and/or PI is limited only to those staff/subcontractors whose access
to and/or use of this information is essential for the purpose of carrying out the
Contractor’s or subcontractor’s obligations governed by this Contract.
Pursuant to 18 U.S.C. §2721(c) of the DPPA and IC §9-14-13-10, upon termination of a
contract, a Contractor who resells or rediscloses PI pursuant to its contract with the
BMV/C shall maintain for a period of five (5) years all records identifying each person or
entity that receives information and the permitted purpose for which the information will
be used and must make these records available to the BMV/C upon request. At the end
of five (5) years, a Contractor who resells or rediscloses PI pursuant to its contract with
the BMV/C shall securely return or destroy any PI in a commercially reasonable manner,
including contracting with a third party for destruction of said PI, and provide to the
BMV/C a certificate of destruction. If any PI is stored in a data format proprietary to the
Contractor, the Contractor shall provide the BMV/C with a copy of the PI in a
standardized format (e.g. PDF, TIF, JPG, GIF, etc.). The Contractor will ensure that any
subcontractor shall promptly securely return any PI upon termination of the Contract.
Those Contractors that are NOT AUTHORIZED to resell or redisclose PI pursuant to their
contract with the BMV/C shall either securely return or destroy any PI in a commercially
reasonable manner and provide to the BMV/C a certificate of destruction upon
termination or expiration of their Contract.
III.

Access to BMV/C Data Systems
Contract staff and/or subcontractors may not be allowed access to BMV/C data systems
without prior individual approval from BMV/C, which may include but is not limited to
periodic background checks. BMV/C must be notified immediately each time an approved
individual leaves employment or the subcontract for an approved subcontractor is
cancelled or when these individuals are reassigned to duties that do not involve access to
BMV/C data systems. No agent of a contractor will be permitted access to Social Security
Administration (SSA) data until he/she has completed all required forms and executed
the required agreements for such access.
Any contractor, and their agents/users, who receives access to SSA data through the
Information Exchange Agreement (Agreement) between the BMV and SSA through the
Social Security On Line Verification (SSOLV) process agrees to be bound by the terms
and conditions concerning the access, use or disclosure of SSA data under the
Agreement, including the penalties associated with loss or disclosure.

IV.

Personal Information Disclosure Incident Report
Unless subject to IC §24-4.9, Contract staff members and/or subcontractors shall
complete the Contractor’s Personal Information Disclosure Report (“Report”) each time
an unauthorized disclosure of a customer’s personal information occurs. Within 24 hours
of the incident, the Contractor must email the Report to the BMV/C Legal Department at
BMVLegal@bmv.in.gov. If the Report cannot be emailed, the Contractor must contact the
BMV/C Legal Department to determine how to send the Report. The Report type (i.e.
Contractor’s Personal Information Disclosure Incident Report), the location where the
personal information disclosure occurred and the date on which the disclosure occurred
must be specified in the subject line of the email. Upon receipt of the Report, the BMV/C
Legal Department will review, investigate and make any necessary reports to the
appropriate state and/or federal agencies.

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GULaw Privacy FR

 V.

Social Security Administration (“SSA”)-Provided Personal Information Disclosure
Incident Report
Contract staff and/or subcontractors who experience or suspect a breach or loss of PI
that contains SSA-provided personally identifiable information shall immediately complete
the Personal Information Disclosure Report. The Contractor must immediately notify by
direct telephone contact and email the completed incident report to the BMV/C
designated SSA Incident Point of Contact:
BMV Legal
BMVLegal@bmv.in.gov
Steve Leak
Telephone: 317-234-3392
Email: sleak@bmv.in.gov
Charles Hampton
Telephone: 317-233-2013
Email: ChaHampton@bmv.in.gov
The email subject line shall read “SSA-Provided Information Incident.” The Contractor
and/or subcontractor acknowledges that time is of the essence in reporting suspected
breaches or loss of PI that contains SSA-provided PI and shall not delay the reporting
thereof.
The Contractor and/or subcontractor must also immediately email the Report to the
BMV/C Legal Department at BMVLegal@bmv.in.gov. If the Report cannot be emailed,
the Contractor and/or subcontractor must contact the BMV/C Legal Department to
determine how to send the report. The Report type (i.e. Contractor’s Personal Information
Disclosure Incident Report), the location where the personal information disclosure
occurred and the date on which the disclosure occurred must be specified in the subject
line of the email. Upon receipt of the Report, the BMV/C Legal Department will review,
investigate and make any necessary reports to the appropriate state and/or federal
agencies.
THE REMAINDER OF THIS PAGE HAS BEEN INTENTIONALLY LEFT BLANK.

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 INDIANA BUREAU OF MOTOR VEHICLES &
INDIANA BUREAU OF MOTOR VEHICLES COMMISSION
CONTRACTOR’S PERSONAL INFORMATION DISCLOSURE REPORT
TO:

BMV/C Legal Department – BMVLegal@bmv.in.gov

FROM:
Name and job title of individual completing this form
Name of Contractor
LOCATION:
Location at which the incident occurred
DATE OF REPORT:
INSTRUCTIONS:
Please respond to each of the questions below. When complete, e-mail a saved copy of this
document as an attachment to BMVLegal@bmv.in.gov. Contact the BMV Legal Department by
telephone if the report is unable to be e-mailed.
1.

Date and time of the disclosure:
DATE:

2.

TIME:

Name and address of individual(s) whose personal information was disclosed:
NAME:
ADDRESS:

3.

What personal information was disclosed? (Indicate YES or NO for each item)
a. Name
YES / NO
b. Address
YES / NO
c. Telephone #
YES / NO
d. SSN
YES / NO
e. DLN/ID#
YES / NO
f. Photo
YES / NO
g. Medical/Disability Information
YES / NO
h. Other (Describe):

4.

Name and address of individual(s) who received unauthorized personal information:
NAME:
ADDRESS:

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GULaw Privacy FR

 Indiana BMV

5.

Detailed description of what happened:

6.

Has the individual been informed of the disclosure?

YES / NO

a.

If Yes, when and how was the customer informed (if in writing, please attach copy)

b.

If no, please explain why they have not been informed and if they will be informed

7.

Was the customer offered credit monitoring or any other assistance?

8.

Name of the individual who made the disclosure: NAME:

9.

What corrective actions did the Contractor take?

Page 24 of 24
102904

YES / NO

GULaw Privacy FR

 2

S003602

Jones,Sandy E

08

3

R224315

Paglia,Robert

08

4

S004382

Redding,Sandra D

08

5

M225528

Hempel,Mark Alan

08

6

C292947

Sharp,Cara Alycia

08

7

A233897

Davidson,Alice A

08

8

D050916

Sembroski,Donna Stolz

09

Indiana BMV

102905

GULaw Privacy FR