HomeMy WebLinkAboutConsent Plate Search Data for junk vehicles 615 Sheridan Street
6 Port Townsend, WA 98368
6 e etwn www.JeffersonCountyPublicHealth.org
Consent Agenda
Ca
Public Healt
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Mark McCauley, County Administrator
FROM: Pinky Feria Mingo, Environmental Health and Water Quality Director
Alisa Hasbrouck, Environmental Public Health Manager
DATE:
SUBJECT: Agenda item — Contracted Plate Search Data Sharing Agreement between
Washington Department of Licensing and Jefferson County Public Health;
January 1, 2025 to December 31, 2029; $0.
STATEMENT OF ISSUE:
Jefferson County Public Health, Environmental Health Division, requests Board approval of the
Contracted Plate Search Data Sharing Agreement with Washington Department of Licensing. The
agreement is required in order to access information needed to complete junk vehicle affidavits in
association with solid waste code enforcement activities. The existing agreement expires December 31,
2024.
ANALYSIS/STRATEGIC GOALS/PROS and CONS:
This agreement is required in order to access information needed to complete junk vehicle affidavits in
association with solid waste code enforcement activities.
FISCAL IMPACT/COST BENEFIT ANALYSIS:
No fiscal impact.
RECOMMENDATION:
JCPH management requests approval of Contracted Plate Search Data Sharing Agreement between
Washington Department of Licensing and Jefferson County Public Health; January 1, 2025 to December
31, 2029; $0.
REVIEWED BY:
01
g�PexK
Mark McCauley, C&Aliy Administrator Date
Community Health Environmental Public Health
Developmental Disabilities 360-385-9444
360-385-9400 (f) 360-379-4487
360-385-9401 (f) Always working for a safer and healthier community
EH-24-092
CONTRACT REVIEW FORM Clear Form
(INSTRUCTIONS ARE ON THE NEXT PAGE)
CONTRACT WITH: Washington Dept.of Licensing Contract No: EH-24-092
Contract For: Contracted Plate Search Term: 1/1/2025 - 12/31/2029
COUNTY DEPARTMENT: Environmental Health
Contact Person: Alisa Hasbrouck
Contact Phone: #489
Contact email: ahasbrouck@co.jefferson.wa.us
AMOUNT: -0- PROCESS: Exempt from Bid Process
Revenue: Cooperative Purchase
Expenditure: Competitive Sealed Bid
Matching Funds Required: Small Works Roster
Sources(s) of Matching Funds Vendor List Bid
Fund # RFP or RFQ
Munis Org/Obj Other:
APPROVAL STEPS:
STEP 1: DEPARTMENT CERTIFIES COMF�1skN�CE W 01 3. .080 AND CHAPTER 42.23 RCW.
CERTIFIED: El N/A:®■ -/i�y�_. i Nov. 19, 2024
Signa ure Date
STEP 2: DEPARTMENT CERTIFIES THE PERSON PROPOSED FOR CONTRACTING WITH THE
COUNTY (CONTRACTOR) HAS NOT BEEN DEBARRED BY ANY FEDERAL, STATE, OR LOCAL
AGENCY.
CERTIFIED: El N/A: Eil
/, `� Nov. 19,2024
ignature Date
STEP 3: RISK MANAGEMENT REVIEW (will be added electronically through LaserBche):
Electronically approved by Risk Management on 11/21/2024.
State agreement - cannpt change.
STEP 4: PROSECUTING ATTORNEY REVIEW(will be added electronically through Laserfiche):
Electronically approved as to form by PAO on 11/21/2024.
State language -- cannot change.
STEP 5: DEPARTMENT MAKES REVISIONS & RESUBMITS TO RISK MANAGEMENT AND
PROSECUTING ATTORNEY(IF REQUIRED).
STEP 6: CONTRACTOR SIGNS
STEP 7: SUBMIT TO BOCC FOR APPROVAL
1
WASHINGION STATE OEPAATNENT OF
ti
ALICENSING Contracted Plate Search (CPS) Application
Use this form to renew your access to the Contracted Plate Search (CPS) service. Businesses and organizations use
CPS for 24/7 access to vehicle and vessel records. Submit your completed, signed application by email or mail and allow
14 business days for processing.
Email (quickest) Mail
dataservices@dol.wa.gov Data Management Office
Print and scan or upgrade to Department of Licensing
Adobe Reader XI or above PO Box 9020
to fill it in and save it. Olympia,WA 98507-9020
Do not use this form for personal or individual record requests.
Use the Vehicle or Boat Record Request forms located at dol.wa.govlforms/iorrnspd. Aml
We are committed to protecting personal information. Records and personal information are released in compliance with
the federal Driver Privacy Protection Act of 1994 (DPPA), and Washington State laws.These laws restrict redisclosure
of personal information obtained from vehicle and vessel records, and protect owners from unsolicited business contact.
Authorized recipients may only redisclose information as permitted by law.There is no guarantee your request will be
approved. See Authorities at the bottom of Page 2 of this application.
If you currently have a CPS number, enter it here 838268
Company/Agency name Website
Jefferson County Public Health www.jeffersoncountypublichealth.org
Contact name.Primary applicant and contract manager (Area code)Phone number Email(required)
Pinky Feria Mingo (360) 379-4476 pmingo@co.jefferson.wa.us
Contact name 2(if applicable) (Area code)Phone number Email(required)
Becca Maurer (360) 379-4467 bmaurer@co.jefferson.wa.us
Physical address of business(number and street)
615 Sheridan St
city State ZIP code
Port Townsend WA 98368
Mailing address of business(if different)
city State ZIP code
Provide one of Taxpayer Identification Number(TIN) Employer Identification Number(EIN) WA Unified Business Identifier(UBI)
these identifiers 91-6001322 II
Answer the following
Provide a detailed explanation of your primary business activity (exactly what your business or agency does and how
you will use the vehicle and vessel records).
Contracted plate search is used to obtain information needed to complete junk vehicle affidavits in association with
solid waste code enforcement activities.
Will you contact the owner for any purpose, provide the registration record information to an attorney or private
investigator, or to any other persons or businesses? Use this space to describe how you will contact the owner or
disclose the information or state that you will not disclose it and will not contact the owner.This is required information.
Owner may be contacted in association with the junk vehicle affidavit process,to provide an opportunity to move the
vehicle before it gets towed.
RPD-224-002(FU3/20)WA Page 1 of 3
JeffCo:EH-24-092
You may not use the personal information contained in a vehicle or vessel registration record for unsolicited business
contact. Unsolicited business contact means a contact that is intended to result in, or promote,the sale of any goods or
services to a person named in the disclosed information.Disclosure of names and addresses of individual owners
—RCW 46.12.635(1)(c).
When disclosing a vehicle or vessel registration record to a private investigator or an attorney, you must provide a notice to
the owner,to whom the information applies, that the request was granted.The notice must comply with RCW 46.12.635(4)
(a)(b)(c), describing you as the disclosing entity, and must be mailed to the owner within 5 working days of disclosure.
You may not use DOL's name, logo, addresses, telephone numbers, email addresses or the State seal in your notification
letter.You must retain a copy of the notification letters for three years from the date of disclosure, or from the date of
termination of your contract, whichever occurs first, and produce copies of the letters upon a request by the DOL. Failure
to send a notification letter is a violation of your contract and Washington State laws.Contact dataserv_icesQdol.wa gov_to
request a sample notification letter.
The sale or other distribution of any vehicle or vessel owner name or address to another person not disclosed in
your request or application is a gross misdemeanor punishable by a fine not to exceed ten thousand dollars, or by
imprisonment in a county jail for 364 days, or by both such fine and imprisonment for each violation. Disclosure violations,
penalties—RCW 46.12.640.
Knowingly making a false statement or concealing a material fact required in this application or making false
representation to obtain any personal information from an individual's motor vehicle record is also subject to federal
criminal fines under the DPPA.
CPS RECORD FEES:There is a 4-cent fee per record search, and businesses must pay an additional$2 for each record
accessed.Government entities are exempt from the $2 fee.Contract holders are invoiced monthly.
Submit the following documentation with your application:
• Washington State business—Attach a legible copy of your current business license
• Business outside Washington State—Attach a legible copy of one of the following:
• Your current business license or
• A letter signed by the owner or authorized representative indicating you are their agent.The letter must include your
Federal Employer Identification Number(EIN) or Federal Tax Identification Number(TIN)
• Non-profit organization or corporation—Attach a legible copy of one of the following:
• Your Articles of Incorporation,filed with the Secretary of State or
• Your Tax Exempt Status, (501)(c)(3), from the Internal Revenue Service
• Attorney—Attach a legible copy of your current bar card, or proof of current/active bar status in your state.
• Private investigator—Attach a legible copy of your current private investigator license.
By signing or typing your name, you are certifying under penalty of perjury under the law of Washington that the foregoing
is true and correct.
Pinky Feria Mingo
PRIN rTYPE)Nam�,
11/18/2024 Jefferson County Washington X
�1 (
Date and place(county)signed Signatu a of buslnes or organization ropr o o t{w
JEFFERSON COUNTY WASHINGTON
Authorities: Board of County Commissioners
Federal Driver Privacy Protection Act of 1994(DPPA) 18 U.S.C.§2721 through §2725
Revised Code of Washington (RCW)42.56, RCW 46.12.630, 635, 640; RCW 88.02 By:
Washington Administrative Code (WAG) 308-10-075, 308-93-087 Kate Dean,Chair
Appro ed � form only:
� � for 11/21/2024
Philip C.Hunsucker, Date
Chief Civil Deputy Prosecuting Attorney
RPD-224-002(R/3/20)WA Page 2 of 3
Subscriber Roster(Data brokers/resellers applying for CPS must complete and return this section)
Each data broker or reseller must:
• Maintain a legible Subscriber Roster and complete all fields
• Record all subscribers
• Document the specific permissible use qualification for each subscriber
• Retain Subscriber Roster and notification letters sent by subscribers for the term of the Contract and for three (3) years
from the date of disclosure or termination of the contract, whichever occurs first.
Your contract and/or CPS access may be terminated if you do not maintain a complete and legible Subscriber Roster.
In the Subscriber's permissible use box, describe the DPPA defined permissible purpose for access to personal
information contained in the records. For example, "information is used in the processing of insurance claims
investigations"A vague answer, such as, "check who owns the vehicle," is unacceptable.
Legal business name Contact name Email (Area code)Phone number
Address,City,State,Zip code Subscriber's permissible use
Does the subscriber provide information to
an attorney or private investigator? ❑ Yes ❑ No
Legal business name Contact name Email (Area code)Phone number
Address,City,State,Zip code Subscriber's permissible use
Does the subscriber provide information to
an attorney or private investigator? ❑Yes ❑ No
Legal business name Contact name Email (Area code)Phone number
Address,City,State,Zip code Subscriber's permissible use
Does the subscriber provide information to
an attorney or private investigator? ❑Yes ❑ No
Legal business name Contact name Email (Area code)Phone number
Address,City,State,Zip code Subscriber's permissible use
Does the subscriber provide information to
an attorney or private investigator? ❑Yes ❑ No
Legal business name Contact name Email (Area code)Phone number
Address,City,State,Zip code Subscriber's permissible use
Does the subscriber provide information to
an attorney or private investigator? ❑ Yes ❑ No
Legal business name Contact name Email (Area code)Phone number
Address,City,State,Zip code Subscriber's permissible use
Does the subscriber provide information to
an attorney or private investigator? ❑ Yes ❑ No
Legal business name Contact name Email (Area code)Phone number
Address,City,State,Zip code Subscriber's permissible use
Does the subscriber provide information to
an attorney or private investigator? ❑ Yes ❑ No
Use additional copies of this page, if needed.You may create your own Subscriber Roster as long as it contains all of
the data fields on this form.
RPD-224-002(R/3/20)WA Page 3 of 3