CONTRACT 3926 Vender AgreementSTATE OF CALTORNIA 39 2 6 e • +
STANDARD AGREEMENT
STD 213 (Rev 06/03)
AGREEMENT NUMBER
C0800215
REGISTRATION NUMBER
1. This Agreement is entered into between the State Agency and the Contractor named below:
STATE AGENCY'S NAME
Franchise Tax Board
CONTRACTOR'S NAME
City of El Segundo
2. The term of this
Agreement is: June 1, 2009 through December 31, 2011
3 The maximum amount $ 0.00
of this Agreement is: NON - FINANCIAL
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
2 pages
Exhibit C* — General Terms and Conditions
GTC307
Exhibit D - Special Terms and Conditions
3 pages
Exhibit E — City Record Format Specifications
2 pages
Exhibit F — FTB Record Layout Specifications
2 pages
Exhibit G — Confidentiality Statement
1 page
/terns 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 vzoviti - ols rigs Ca gOv(Stanc/ard ±Lanquage%iefault. htin
IN WITNESS WHEREOF, this Agreement has been executed by the parties hereto.
CONTRACTOR California Department of General
Services Use Only
CONTRACTOR'S NAME (f other than an individual, state whether a corporation, partnership, etc )
City of El Segundo
BY (Au ignatur) DATE SIGN D(Do not type)
P D NAME A ?D3PTLE OF PERSON SIGNING /
JACK WAYTGG, CITY MANAGER
ADDRESS
350 Main Street, El Segundo, CA 90245
STATE OF CALIFORNIA
AGENCY NAME
Franchise Tax Board
BY (Au on d SignSture) DATE $I ED(�o not type)
ivy♦ . nA.'.At Lt/ A /n 9
PRINTEYNAME AND TITLE OF PERSON SIGNING r
® Exempt per SCM 4.04.5 b.
Lisa Garrison, Chief Financial Officer
ADDRESS
P.O. Box 2086, Rancho Cordova, CA 95741 -2086
City of El Segundo Agreement #C0800215
EXHIBIT A
SCOPE OF WORK
This Agreement is entered into by and between the Franchise Tax Board, herein referred to as
(FTB) and the City of El Segundo, herein after referred to as the City.
Purpose:
This Agreement allows FTB and the City to enter into a reciprocal agreement to exchange tax
data specific to city business license information for tax administration purposes. By entering
into a reciprocal agreement, each party agrees to bare their own costs of providing the data and
the City is precluded from obtaining reimbursement.
Both parties will abide by the legal and confidential provisions of this Agreement. Exhibits A, C,
D, E, F, and G attached hereto and incorporated by reference herein, sets forth additional terms
to which the parties agree to be bound.
Legal Authority:
California Revenue and Taxation Code Section 19551.5 authorize a reciprocal agreement for
the exchange of city business tax and income tax information between a City and FTB.
City Responsibilities:
1. The City agrees that the information provided by FTB will be used exclusively to administer
the City's business tax program.
2. The City agrees that information obtained under this Agreement will not be reproduced,
published, sold or released in original or in any other form for any purpose; and only
accessed by City employees.
3. The City agrees to provide FTB with tax information pursuant to Exhibit E, Format
Specifications, which shall include but is not limited to the following:
• Business or owner's name.
• Business or residence address.
• Federal employer identification number or social security number.
• North American Industry Classification Code or Standard Industry Classification Code.
4. The City agrees to extract and provide City data to FTB annually in June for each tax year
that the Agreement is in place, June 2009, 2010, and 2011.
5. The City agrees to submit the records to FTB using FTB's Secure Web Internet File Transfer
(SWIFT).
6. The City agrees to submit the records to FTB in ASCII fixed length format, .txt, per the
Format Specifications, Exhibit E.
The City agrees to resubmit data in the event data is initially submitted with errors. The
resubmission of data must be within 30 days of notification. If data is not submitted
accurately and timely, the City forfeits its rights to FTB data for that year.
City of El Segundo
EXHIBIT A
SCOPE OF WORK (continued)
Agreement #C0800215
8. The City agrees that each City employee having access to FTB data shall sign a
Confidentiality Statement, Exhibit G. The signed statement is to be retained by the City and
produced to FTB upon request.
9. The City agrees to submit to FTB a completed safeguard questionnaire prior to receiving
FTB data. The safeguard questionnaire is valid for the duration of the Agreement.
10. The City agrees to provide a copy of the resolution, order, motion, or ordinance of the local
governing body, authorizing the execution of the Agreement.
FTB Responsibilities:
1. FTB agrees that information provided by the City will be used for tax administration and non -
tax programs that FTB administers and may be shared with other state /federal agencies as
authorized by law.
2. FTB agrees that information obtained under this Agreement will not be reproduced,
published, sold or released in original or in any other form for any purpose.
FTB agrees to provide the City data extracted from the Taxpayer Information (TI) and
Business Entity Tax System (BETS). FTB will provide the City records for taxpayers within
the city's jurisdiction who indicate a business on their personal or corporation income tax
return. The Record Layout, Exhibit F shall include, but is not limited to:
• Taxpayer name.
• Taxpayer address.
• Taxpayer social security number or federal employer identification number.
• Principal business activity code.
4. FTB agrees to match the data provided by the City using the social security number or
federal employer identification number against FTB's data with a yes or no indicator on the
Record Layout, Exhibit F.
5. FTB agrees to provide the City an annual extraction in December 2009 for tax year 2008,
December 2010 for tax year 2009, and December 2011 for tax year 2010 via SWIFT.
6. FTB agrees to register the City for a SWIFT account, allowing for the secure electronic
transmission of data.
7. FTB agrees to provide the City a unique City Business Tax Number to be used for reporting
purposes only.
8. FTB agrees to allow the City to resubmit data within 30 days of notification, in the event data
is initially submitted with errors.
City of El Segundo
EXHIBIT A
SCOPE OF WORK (continued)
Project Coordinators:
3926 • . . 4
The project coordinators during the term of this Agreement will be:
Franchise Tax Board
Erica Gonzales
Data Resources and Services Section
P.O. Box 1468, Mailstop A181
Sacramento, CA 95812 -1468
Phone: (916) 845 -6556
Fax: (916) 855 -5695
Return executed agreement to:
Franchise Tax Board
Procurement & Asset Management
Attention: Nel Bohling
P.O. Box 2086, Mailstop A374
Rancho Cordova, CA 95741 -2086
Phone: (916) 845 -7870
Fax: (916) 845 -3599
Agreement #C0800215
City of El Segundo
Steve Jones
Business Services Manager
350 Main Street
El Segundo, CA 90245
Phone: (310) 524 -2332
GTC 307
EXHIBIT C
GENERAL TERMS AND CONDITIONS
4
1. APPROVAL: This Agreement is of no force or effect until signed by both parties and
approved by the Department of General Services, if required. Contractor may not commence
performance until such approval has been obtained.
2. AMENDMENT: No amendment or variation of the terms of this Agreement shall be valid
unless made in writing, signed by the parties and approved as required. No oral understanding or
Agreement not incorporated in the Agreement is binding on any of the parties.
3. ASSIGNMENT: This Agreement is not assignable by the Contractor, either in whole or in
part, without the consent of the State in the form of a formal written amendment.
4. AUDIT: Contractor agrees that the awarding department, the Department of General Services,
the Bureau of State Audits, or their designated representative shall have the right to review and
to copy any records and supporting documentation pertaining to the performance of this
Agreement. Contractor agrees to maintain such records for possible audit for a minimum of three
(3) years after final payment, unless a longer period of records retention is stipulated. Contractor
agrees to allow the auditor(s) access to such records during normal business hours and to allow
interviews of any employees who might reasonably have information related to such records.
Further, Contractor agrees to include a similar right of the State to audit records and interview
staf f in any subcontract related to performance of this Agreement. (Gov. Code §8546.7, Pub.
Contract Code §10115 et seq., CCR 'Title 2, Section 1896).
5. INDEMNIFICATION: Contractor agrees to indemnify, defend and save harmless the State, its
officers, agents and employees from any and all claims and losses accruing or resulting to any
and all contractors, subcontractors, suppliers, laborers, and any other person, firm or corporation
furnishing or supplying work services, materials, or supplies in connection with the performance
of this Agreement, and from any and all claims and losses accruing or resulting to any person,
firm or corporation who may be injured or damaged by Contractor in the performance of this
Agreement.
6. DISPUTES: Contractor shall continue with the responsibilities under this Agreement during
any dispute.
7. TERMINATION FOR CAUSE: The State may terminate this Agreement and be relieved of
an}, payments should the Contractor fail to perform the requirements of this Agreement at the
time and in the manner herein provided. In the event of such termination the State may proceed
with the work in any manner deemed proper by the State. All costs to the State shall be deducted
From any sum due the Contractor under this Agreement and the balance, if any, shall be paid to
the Contractor upon demand.
3926 - . .,
8. INDEPENDENT CONTRACTOR: Contractor, and the agents and employees of Contractor.
in the performance of this Agreement, shall act in an independent capacity and not as officers or
employees or agents of the State.
9. RECYCLING CERTIFICATION: The Contractor shall certify in writing under penalty of
perjury, the minimum, if not exact, percentage of post consumer material as defined in the Public
Contract Code Section 12200, in products, materials, goods, or supplies offered or sold to the
State regardless of whether the product meets the requirements of Public Contract Code Section
12209. With respect to printer or duplication cartridges that comply with the requirements of
Section 12156(e), the certification required by this subdivision shall specify that the cartridges so
comply (Pub. Contract Code § 12205).
10. NON - DISCRIMINATION CLAUSE: During the performance of this Agreement. Contractor
and its subcontractors shall not unlawfully discriminate, harass, or allow harassment against any
employee or applicant for employment because of sex, race, color, ancestry, religious creed.
national origin, physical disability (including HIV and AIDS), mental disability, medical
condition (cancer), age (over 40), marital status, and denial of family care leave. Contractor and
subcontractors shall insure that the evaluation and treatment of their employees and applicants
for employment are free from such discrimination and harassment. Contractor and subcontractors
shall comply with the provisions of the Fair Employment and Housing Act (Gov. Code § 12990
(a -f) et seq.) and the applicable regulations promulgated thereunder (California Code of
Regulations. Title 2, Section 7285 et seq.). The applicable regulations of the Fair Employment
and Housing Commission implementing Government Code Section 12990 (a -f), set forth in
Chapter 5 of Division 4 of Title 2 of the California Code of Regulations, are incorporated into
this Agreement by reference and made a part hereof as if set forth in full. Contractor and its
subcontractors shall give written notice of their obligations under this clause to labor
organizations with which they have a collective bargaining or other Agreement.
Contractor shall include the nondiscrimination and compliance provisions of this clause in all
subcontracts to perform work under the Agreement.
11. CERTIFICATION CLAUSES: The CONTRACTOR CERTIFICATION CLAUSES
contained in the document CCC 307 are hereby incorporated by reference and made a part of this
Agreement by this reference as if attached hereto.
12. TIMELINESS: Time is of the essence in this Agreement.
13. COMPENSATION: The consideration to be paid Contractor, as provided herein, shall be in
compensation for all of Contractor's expenses incurred in the performance hereof; including
travel, per diem, and taxes, unless otherwise expressly so provided.
14. GOVERNING LAW: This contract is governed by and shall be interpreted in accordance
with the laws of the State of California.
15. ANTITRUST CLAIMS: The Contractor by signing this agreement hereby certifies that if
these services or goods are obtained by means of a competitive bid, the Contractor shall comply
with the requirements of the Government Codes Sections set out below.
a. The Government Code Chapter on Antitrust claims contains the following definitions:
1). "Public purchase" means a purchase by means of competitive bids of goods, services, or
materials by the State or any of its political subdivisions or public agencies on whose behalf the
Attorney General may bring an action pursuant to subdivision (c) of Section 16750 of the
Business and Professions Code.
2). "Public purchasing body" means the State or the subdivision or agency making a public
purchase. Government Code Section 4550.
b. In submitting a bid to a public purchasing body, the bidder offers and agrees that if the bid is
accepted, it will assign to the purchasing body all rights, title, and interest in and to all causes of
action it may have under Section 4 of the Clayton Act (15 U.S.C. Sec. 15) or under the
Cartwright Act (Chapter 2 (commencing with Section 16700) of Part 2 of Division 7 of the
Business and Professions Code), arising from purchases of goods, materials, or services by the
bidder for sale to the purchasing body pursuant to the bid. Such assignment shall be made and
become effective at the time the purchasing body tenders final payment to the bidder.
Government Code Section 4552.
c. If an awarding body or public purchasing body receives, either through judgment or
settlement, a monetary recovery for a cause of action assigned under this chapter, the assignor
shall be entitled to receive reimbursement for actual legal costs incurred and may, upon demand,
recover from the public body any portion of the recovery, including treble damages, attributable
to overcharges that were paid by the assignor but were not paid by the public body as part of the
bid price, less the expenses incurred in obtaining that portion of the recovery. Government Code
Section 4553.
d. Upon demand in writing by the assignor, the assignee shall, within one year from such
demand, reassign the cause of action assigned under this part if the assignor has been or may
have been injured by the violation of law for which the cause of action arose and (a) the assignee
has not been injured thereby, or (b) the assignee declines to file a court action for the cause of
action. See Government Code Section 4554.
16. CHILD SUPPORT COMPLIANCE ACT: "For any Agreement in excess of $100,000, the
contractor acknowledges in accordance with Public Contract Code 7110, that:
a). The contractor recognizes the importance of child and family support obligations and shall
fully comply with all applicable state and federal laws relating to child and family support
enforcement, including, but not limited to, disclosure of information and compliance with
earnings assignment orders, as provided in Chapter 8 (commencing with section 5200) of Part 5
of Division 9 of the Family Code; and
b) The contractor, to the best of its knowledge is fully complying with the earnings assignment
orders of all employees and is providing the names of all new employees to the New Hire
Registry maintained by the California Employment Development Department."
17. UNENFORCEABLE PROVISION: In the event that any provision of this Agreement is
unenforceable or held to be unenforceable, then the parties agree that all other provisions of this
Agreement have force and effect and shall not be affected thereby.
18. PRIORITY HIRING CONSIDERATIONS: If this Contract includes services in excess of
$200,000, the Contractor shall give priority consideration in filling vacancies in positions funded
by the Contract to qualified recipients of aid under Welfare and Institutions Code Section 11200
in accordance with Pub. Contract Code § 10353.
S \ADMIN \I IOMF.PAG13 \G "I'C- 307.doc
City of El Segundo
EXHIBIT D
SPECIAL TERMS AND CONDITIONS
Agreement #C0800215
1. DATA OWNERSHIP: The classified confidential tax information being provided to the City
under this Agreement remains the exclusive property of FTB. The City shall have the right
to use and process the disclosed information for the purposes stated in this Agreement,
which right shall be revoked and terminated immediately upon completion of this
Agreement.
2. STATEMENT OF CONFIDENTIALITY: The Franchise Tax Board has tax return
information and other data in its custody, which is confidential data. Unauthorized
inspection or disclosure of state tax return information or other confidential data is a
misdemeanor (Revenue and Taxation Code Section 19542 and 19542.1).
3. USE OF INFORMATION: The City and FTB agree that the information furnished or secured
pursuant to this Agreement shall be used solely for the purposes described by this
Agreement. The information obtained by FTB shall be used for tax administration and non -
tax programs that FTB administers and may be shared with other state /federal agencies as
authorized by law. The City and FTB further agree that information obtained under this
Agreement will not be reproduced, published, sold or released in original or in any other
form for any purpose other than identified in this Agreement or as authorized by law.
4. EMPLOYEE ACCESS TO INFORMATION: Both FTB and the City agree that the
information obtained will be kept in the strictest confidence and shall make information
available to its own employees only on a "need to know" basis. The "need to know"
standard is met by authorized employees who need information to perform their official
duties in connection with the uses of the information authorized by this Agreement. Both
parties recognize their responsibilities to protect the confidentiality of this information as
provided by law and ensures such information is disclosed only to those individuals and of
such purpose, as authorized by the Revenue and Taxation Code.
DISCLOSURE OF CONFIDENTIAL INFORMATION: Any unwarranted disclosure or use of
state tax return information or any willful unauthorized inspection of the return information is
an act punishable as a misdemeanor. Inspection is defined to mean any examination of
confidential information. No one other than authorized employees may have access, use,
and view or manipulate the data being transmitted to the City under this Agreement. The
City, in recognizing the confidentiality of state tax return information, agrees to take all
appropriate precautions to protect from unauthorized disclosure of the confidential
information obtained pursuant to this Agreement. The City will conduct oversight of its
users with access to the confidential information provided under this Agreement, and will
promptly notify FTB of any suspected violations of security or confidentiality by its users.
The City and each of the City's employees who may have access to the confidential data of
FTB will be required to sign a Confidentiality Statement, Exhibit G, attesting to the fact that
he /she is aware of the confidential data and the penalties for unauthorized disclosure
thereof. The signed statement shall be retained by the City and furnished to FTB upon
request.
City of El Segundo
3926
EXHIBIT D
SPECIAL TERMS AND CONDITIONS (continued)
Agreement #C0800215
6. INCIDENT REPORTING: All unauthorized or suspected unauthorized access; use and /or
disclosure (incidents) of FTB data shall be reported to FTB's contact, Erica Gonzales at
(916) 845 -6556, immediately upon discovery of the incident. The incident report shall
contain the following: date, time, employee name, description of the incident or
circumstances, and means of discovery. Upon discovery of any such incident, FTB will
make the appropriate notification to affected California Resident(s) pursuant to the
requirements of Civil Code Section 1798.29.
INFORMATION SECURITY: Information security is defined as the preservation of the
confidentiality, integrity, availability, authenticity, and utility of information. A secure
environment is required to protect the confidential information obtained from FTB pursuant
to this Agreement. The City will store information so that it is physically secure from
unauthorized access. The records received by the City will be securely maintained and
accessible only by employees of the city business license program who are committed to
protect the data from unauthorized access, use, or disclosure.
DESTRUCTION OF RECORDS: All records received by the City from FTB and any
database(s) created, copies made, or files attributed to the records received will be
destroyed within three years of receipt. The records shall be destructed in a manner to be
deemed unusable or readable and to the extent that an individual record can no longer be
reasonably ascertained. FTB will destroy City data in accordance with the Department's
data retention policies.
9. INDEMNIFICATION: Both parties agree to indemnify, defend, and save harmless each
other, its officers, agents and employees from any and all claims and losses accruing or
resulting from any breach of confidentiality by either party and /or its employees.
10. SETTLEMENT OF DISPUTES: In the event of a dispute, the City shall file a "Notice of
Dispute" with the Assistant Executive Officer of the Franchise Tax Board within ten (10)
days of discovery of the problem. Within ten (10) days, the Assistant Executive Officer or
his /her designee shall meet with the City and the FTB contact for purposes of resolving the
dispute. The decision of the Assistant Executive Officer shall be final.
11. SAFEGUARD QUESTIONAIRE and REVIEW: Prior to sending data to the City, FTB
requires the City to submit a safeguard questionnaire certifying the protection and
confidentiality of FTB data. The FTB retains the right to conduct an on -site safeguard
review of the City. The City will be provided a minimum of seven (7) days notice prior to a
safeguard review being conducted by the FTB Disclosure Office. The safeguard review will
examine the adequacy of information security controls established by the City in
compliance with the confidentiality requirements pursuant to this Agreement. The City will
take appropriate disciplinary actions against any user determined to have violated security
or confidentiality requirements.
12. LIMITED WARRANTY: Either party does not warrant or represent the accuracy or content
of the material available through this Agreement, and expressly disclaims any express or
implied warranty, including any implied warranty of fitness for a specific purpose.
City of El Segundo
EXHIBIT D
SPECIAL TERMS AND CONDITIONS (continued)
. f
Agreement #C0800215
13. CANCELLATION: Either party may terminate this Agreement, in writing for any reason,
upon thirty days (30) prior written notice. This Agreement may be terminated by either party
in the event of any breach of the terms of this Agreement. Both parties agree that in the
event of a breach to the terms of this Agreement, it shall destroy all records and any
databases created, copies made, or files attributed to the records received. The records
shall be destructed in a manner to be deemed unusable or readable and to the extent that
an individual record can no longer be reasonably ascertained, upon destruction.
14. NO THIRD PARTY LIABILITY: Nothing contained in this Agreement or otherwise shall
create any contractual relation between either party and any other party, and no party shall
relieve the City or FTB of its responsibilities and obligations hereunder. Both parties agree
to be fully responsible for the acts and omissions of its third parties and of persons either
directly or indirectly employed by any of them as it is for the acts and omissions of persons
directly employed by the City or FTB. Both parties shall have no obligation to pay or to see
the payment of any monies to any party or persons either directly or indirectly employed by
the City or FTB.
City of El Segundo 3 9 2 6 •W `- Agreement #C0800215
EXHIBIT E
CITY RECORD FORMAT SPECIFICATIONS
Data Element Name
Start
End
Field
Usage
Description
Pos.
Pos.
Size
SOCIAL SECURITY NUMBER
1
9
9
AN
Must be present unless FEIN is
(SSN)
provided. Fill unused field with
blanks.
FEDERAL EMPLOYER
10
18
9
AN
Must be present unless SSN is
ID NUMBER (FEIN)
provided. Fill unused field with
blanks.
OWNERSHIP TYPE
19
19
1
AN
Must be present: S = Sole
Proprietorship, P = Partnership, C =
Corporation, T = Trust,
L = LLC.
OWNERS LAST NAME
20
34
15
AN
Must be present if Ownership Type
in position 19 = S.
OWNERS FIRST NAME
35
45
11
AN
Must be present if Ownership Type
in position 19 = S.
OWNERS MIDDLE INITIAL
46
46
1
AN
May be blank.
BUSINESS NAME
47
86
40
AN
Enter if business is operating under
a fictitious name (Doing Business
As (DBA).
BUSINESS ADDRESS
87
126
40
AN
Address of the business location or
NUMBER - AND - STREET
the residence of the owner if sole
proprietorship.
CITY
127
166
40
A
Must be present.
STATE
167
168
2
A
Enter standard state abbreviation.
ZIP
169
177
9
AN
Enter the valid ZIP Code (nine or
five - digit) assigned by the U.S.
Postal Service. If only the first five -
digits are know, left- justify
information and fill the unused
positions with blanks.
BUSINESS START DATE
178
185
8
N
Enter the eight -digit (MMDDCCYY).
Zero fill if not known.
BUSINESS CEASE DATE 186 193 8 N Enter the eight -digit date
(MMDDCCYY) if out of
business. Zero fill if not known or
not out of business.
� V
City of El Segundo Agreement #C0800215`
EXHIBIT E
CITY RECORD FORMAT SPECIFICATIONS
Data Element Name Start End Field Usage Description
Pos. Pos. Size
CITY- BUSINESS -TAX-
NUMBER
NORTH- AMERICAN-
INDUSTRY-CLASSIFICATION-
SYSTEM ( NAICS)
STANDARD -I NDUSTRIAL-
CLASSIFICATION (SIC)
194
196
3 N
197
202
6 N
203 206 4 N
TOTAL RECORD LENGTH 206
Enter three -digit number assigned
by FTB.
Enter the six -digit NAICS code. Fill
unused fields with zeros.
Enter the 2 -4 digit SIC code. Left
justify (example 99 will be 9900).
Fill unused fields with zeros.
City of El Segundo
EXHIBIT F
Agreement #C0800215
FRANCHISE TAX BOARD RECORD LAYOUT SPECIFICATIONS
Field Name Length Start Description
Pos.
ENTITY TYPE
1
1
"P" — personal income tax record;
"B" — business tax record
SSN or FEIN
9
2
For "P" records, primary taxpayers social
security number; For "B" records, federal
employer identification number.
LAST NAME
40
11
For "P" records, the primary taxpayer's last
name; For "B" records, business name.
FIRST NAME
11
51
For "P" records ONLY.
MIDDLE INITIAL
1
62
For "P" records ONLY.
SPOUSE SSN
9
63
For "P" records filed with a joint return.
SPOUSE LAST NAME
17
72
For "P" records filed with a joint return.
SPOUSE FIRST NAME
11
89
For "P" records filed with a joint return.
SPOUSE MIDDLE INITIAL
1
100
For "P" records filed with a joint return.
PBA CODE
6
101
For "P" records, principal business activity
(PBA) code.
ADDRESS NUMBER
10
107
PRE - DIRECTIONAL DIRECTOR
2
117
Postal Service term (i.e., N, S. E, W. NE,
NW, SE, SW).
STREET NAME
28
119
STREET SUFFIX
4
147
POST DIRECTIONAL INDICATOR
2
151
Postal Service term (i.e., N, S, E, W, NE,
NW, SE, SW).
STREET SUFFIX 2
4
153
APARTMENT /SUITE NUMBER
10
157
CITY
13
167
STATE
2
180
Standard state abbreviation
ZIP CODE
5
182
The valid ZIP Code (nine or five- digit)
assigned by the U.S. Postal Service.
ZIP CODE SUFFIX
4
187
Provided if known.
CBT MATCH
1
191
"N" — No match per CBT data. "Y" — Yes:
CBT matched to state tax return filed.
City of El Segundo
EXHIBIT G
CONFIDENTIALITY STATEMENT
State of California
L
Agreement #C0800215
Franchise Tax Board
Confidential tax return information is protected from disclosure by law, regulation, and
policy. Information security is strictly enforced. Violators may be subject to disciplinary,
civil, and /or criminal action. Protecting confidential tax return information is in the
public's interest, the state's interest, and the city's interest.
A city employee is required to protect the following types of information received from
the Franchise Tax Board:
• Taxpayer name
• Taxpayer address
• Taxpayer social security number or taxpayer identification number
• Principal business activity code
A city employee is required to protect confidential information by:
• Accessing or modifying information only for the purpose of performing official duties.
• Never accessing or inspecting information for curiosity or personal reasons.
• Never showing or discussing confidential information to or with anyone who does not
have the need to know.
• Placing confidential information only in approved locations.
• Never removing confidential information from your work site without authorization.
As a city employee, you are required to know whether information is protected. If you have any
question regarding whether particular information is confidential, check with your department's
project coordinator.
Unauthorized inspection, access, use, or disclosure of confidential tax return information
is a crime under state laws, including but not limited to Sections 19542 and 19552 of the
California Revenue and Taxation Code and Section 502 of the Penal Code. Unauthorized
access, inspection, use, or disclosure may result in either or both of the following:
• State criminal action
• State and /or taxpayer civil action
You are reminded that these rules are designed to protect everyone's right to privacy, including
your own.
i certify that / have read the confidentiality statement printed above. / further certify and
understand that unauthorized access, inspection, use, or disclosure of confidential
information may be punishable as a crime and may result in disciplinary and /or civil
action being taken against me.
Name
Signature Date