1.
COMPLETE & SIGN TO RECEIVE INDIANA DRIVER RECORD INFORMATION.
2.
FAX COMPLETED FORM TO:
216-450-5249 ATTN: MVR COMPLIANCE . Account Number
ADDENDUM TO IIX SUBSCRIPTION AGREEMENT FOR INDIANA MOTOR VEHICLE REPORTS
This Addendum supplements the existing Subscription Agreement between Customer and Insurance Information Exchange (“iiX”).
Customer hereby requests Indiana BMV Records and agrees to follow and be bound by the following terms and conditions:
Definitions- For purposes of this addendum, the following definition applies:
“BMV Record” has the meaning set forth in Ind. Code § 9-14-3.5-4. This Agreement is intended to regulate BMV Records
where Personal Information is requested as part of the disclosure. If Customer requests a BMV Record without Personal
Information, this Agreement shall not be construed so as to violate Indiana’s Access to Public Records Act, Ind. Code § 5-14-3.
Additions- Treatment of BMV Records: The following is added to the Subscription Agreement as regards Indiana Driver License
Records:
I.
Customer warrants and represents that it is satisfied that it has sufficient personnel access security procedures and sufficient
system and data security procedures to adequately protect BMV Records containing Personal Information from unauthorized
access and/or disclosure.
II.
Customer will permanently destroy all BMV Records obtained pursuant to this Agreement once the information contained in
those BMV Records has been put to its intended use. As required by Ind. Code § 24-4.9-3-3.5 (c), Customer shall not dispose
of records or documents containing unencrypted and un-redacted personal information of Indiana residents without shredding,
incinerating, mutilating, erasing, or otherwise rendering the personal information illegible or unusable. Such destruction shall be
verified to the State upon request.
III.
Customer’s systems and data security procedures shall be fully adequate to protect the BMV Records containing Personal
Informat
ion from unauthorized access and/or disclosure.
IV.
Customer will not disseminate BMV records containing Personal Information except within the Customer’s organization (or to
the em
ployer if one of the Customers is an employment screening entity) and only by a secure means.
V.
Customer shall agree to indemnify iiX from all losses damages, judgments, liabilities, costs and expenses (including, but not
li
mited to cost of notice), that arise out of the Customer’s misuse, misappropriation, or any other act or omission with respec
t to
la
ws restricting access to and/or disclosure of BMV Records containing Personal Information. The State shall be an intend
ed
beneficiary of this indemnity obligation.
VI.
ALL WARRANTIES, INCLUDING THE ACCURACY OR COMPLETENESS OF INFORMATION PROVIDED,
MER
CHANTABILITY, OR FITNESS FOR ANY PARTICULAR PURPOSE ARE HEREBY DISCLAIMED. THE STATE O
F
IN
DIANA, ITS AGENCIES AND POLITICAL SUBDIVISIONS, AND INDIANA INTERACTIVE, LLC SHALL NOT BE LIABLE
FOR ANY ERRORS IN, OR OMISSIONS FROM, INFORMATION OBTAINED PURSUANT TO THIS AGREEMENT, NOR
SHALL THEY BE LIABLE FOR ANY SPECIAL, INCIDENTAL, INDIRECT OR CONSEQUENTIAL DAMAGES WHATSOEVER
ARISING OUT OF THIS AGREEMENT OR THE BMV RECORDS PROVIDED HEREUNDER.
This Addendum does not modify, alter, expand or delete any other terms or conditions of the Subscription Agreem
ent.
C
ustomer certifies that it has read, understands, and agrees to the terms and conditions described in this Addendum.
Company Name
Signature
O
wner or Officer or Legally Authorized Representative
Name (Printed)
Date
Created on 10/01/09
Version IN2009.1
