04 Attachment B - OVR Contractor Personnel Confidentiality Form.pdf
PDF 587 KB Posted
- Attached to
- Johnstown OVR Enhanced Driving/Anc Svcs
- Solicitation number
- 6100064892
- Issued by
- Carbon County, Pennsylvania
About this file
This is a Confidentiality Agreement Form (OVR-142) issued by the Pennsylvania Department of Labor & Industry, Office of Vocational Rehabilitation (OVR), for contractor personnel providing driving services. The form requires drivers to sign an agreement acknowledging their obligation to maintain strict confidentiality regarding all information obtained through their duties, including information about persons applying for or receiving vocational rehabilitation services, employees, and customers of the OVR. The confidentiality requirements apply to information in any form—written, verbal, or observed—and cover all matters related to OVR operations. The agreement explicitly prohibits solicitation, disclosure, receipt, or use of confidential information, whether directly or indirectly derived from contract execution. Breach of confidentiality obligations may result in contract termination.
This confidentiality form is associated with the Johnstown OVR Enhanced Driving and Ancillary Services contract, a supplement solicitation to IFB 6100061271 reserved for small businesses and limited to Cambria County services in Pennsylvania. The procurement addresses non-emergency transportation needs for OVR employees and passengers with disabilities who are unable to drive safely, encompassing both ambulatory and non-ambulatory transport services. Transportation services are expected to originate from the Johnstown BVRS/BBVS OVR District office or the employee's assigned headquarters to locations where Commonwealth business is conducted. Eligible bidders must attach a Small Business Certificate to be deemed qualified for this set-aside procurement. All drivers and contractor personnel must complete and sign the confidentiality form as a condition of contract performance.
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Text version
OVR-142
7/10 ALL Department of Labor & Industry
Office of Vocational Rehabilitation
I, (Print name.)
agree that I will not solicit, disclose, receive or make use of any information concerning, persons applying for or receiving vocational rehabilitation services, directly or indirectly derived from the execution of my duties as a Driver pursuant to contract # .
I understand that I must not divulge this information to any person or entity. Breach of this confidentiality may result in termination of the contract.
Further, I agree to maintain the confidentiality of information obtained in the course of my duties with respect to all matters relating to employees and customers of the Pennsylvania Office of Vocational Rehabilitation, whether such information is written, verbal or observed.
Driver Signature Date
OVR Staff Signature Date
Auxiliary aids and services are available upon request to individuals with disabilities. Equal Opportunity Employer/Program
Refers to Numbered Memo 10-100.02
CONFIDENTIALITY
CONFIDENTIALITY
Sherrie Bruegman
OVR-142
7/10
ALL
Department of Labor & Industry Office of Vocational Rehabilitation I, (Print name.)
agree that I will not solicit, disclose, receive or make use of any information concerning, persons applying for or receiving vocational rehabilitation services, directly or indirectly derived from the execution of my duties as a Driver pursuant to contract # I understand that I must not divulge this information to any person or entity. Breach of this confidentiality may result in termination of the contract.
Further, I agree to maintain the confidentiality of information obtained in the course of my duties with respect to all matters relating to employees and customers of the Pennsylvania Office of Vocational Rehabilitation, whether such information is written, verbal or observed.
Driver Signature Date OVR Staff Signature Date Auxiliary aids and services are available upon request to individuals with disabilities. Equal Opportunity Employer/Program Refers to Numbered Memo 10-100.02
CONFIDENTIALITY
| Print or Type the driver's name.: |
| Type or Print the Contract number.: |
| Resets the form: |
| Prints the form.: |
File details come from the government source that posted it. Updated .