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CHECKLIST FOR AI USE This checklist must be completed each time before an AI product is implemented. Attach any technical information that answers the questions in the checklist. Date: Department: Form Completed By: Department Head Signature: 1. Purpose & Benefits a. What does this AI tool do? b. How will it help staff and the community? c. Does it follow City AI principles (fairness, security, transparency)? Y N 2. Data & Privacy a. What kind of data does the AI use? b. Does it connect to other City systems? Y N c. Does it handle sensitive or personal data? Y N 3. Fairness & Ethics a. Has the AI been tested for fairness? Y N b. Does it work equally well for all people? Y N c. Could it negatively impact the community? Y N 4. Security & Oversight a. Is the data protected from hacking or misuse? Y N b. Who is responsible for monitoring and managing the AI system? Y N SIGN ---PAGE BREAK--- c. Can humans override AI decisions if needed? Y N 5. Training & Awareness a. Who needs to be informed that AI was used? b. Will staff be trained on how to use it properly? Y N 6. Performance & Maintenance a. How will we check if AI is working correctly? b. Is there a plan to fix issues or update the system? Y N 7. Backup Plan a. What happens if the AI system fails or makes a mistake? b. Who will handle problems or errors? 8. Future Growth a. Can this AI system handle more users or data in the future? Y N b. Are there plans to improve or upgrade the system over time? Y N Please submit completed form to IT Department. Updated 4/22/25 IT Department Use: Date Approved: Yes____ Approved Date Sent to Legal Sent Legal Department Use: Date Received:____________________Reviewed Legal final approval this