Attachment_4_-_FORM_FDA_3398.pdf
PDF 274 KB Posted
- Attached to
- Onsite Pathology Services Federal contract opportunity
- Solicitation number
- 15-223-SOL-00068
About this file
Attachment 4 FDA Form 3398
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| SF_30.pdf | ||
| Attachment_11_-_Mock_Protocol.pdf | ||
| Appendices1-5.pdf | ||
| Attachment_9_-_PPQ.doc | DOC document | |
| Attachment_1-Pathology_PWS.doc | DOC document | |
| Attachment_6_-_Conflict_of_Interest.doc | DOC document | |
| Attachment_12_-_Non-SCA_Exempt_Incumbent_Employees_Length_of_Service_Information.xlsx | XLSX spreadsheet | |
| Attachment_2_-_Wage_Determination.pdf | ||
| Attachment_3_-_FORM_FDA_3391.pdf | ||
| FDA-15-223-SOL-00068.pdf | ||
| Attachment_10_-_Question_Form.doc | DOC document | |
| Attachment_5_-_Data_Disclosure.doc | DOC document | |
| Attachment_7_-_Pricing_Schedule.xls | XLS spreadsheet | |
| Attachment_8_-_SAMPLE_CLIENT__LETTER.doc | DOC document |
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Text version
COMMITMENT TO PROTECT NON-PUBLIC INFORMATION
EMPLOYEE AGREEMENT
Whereas access to non-public information from the files of the Food and Drug Administration (FDA) is required in the performance of my official duties, under Contract Number between FDA and my employer
I, on this day of , 200 hereby agree that I shall not further release, publish or disclose such information and that I shall protect such information in accordance with the provisions of 21 U.S.C. 331(j), 21 U.S.C. 360(j), 18 USC. 1905 and other pertinent laws and regulations governing the confidentiality of non-public information.
I understand the provisions of 21 U.S.C. 331(j), 21 U.S.C. 360(j), 18 USC. 1905 and that I am subject to criminal penalties prescribed by law for any violation(s) thereof.
Signature: Date:
Type or Print Name:
Witnessed by: Date:
Type or Print Name:
DESCRIPTION OF INFORMATION RELEASED:
FORM FDA 3398 (10/03)
DEPARTMENT OF HEALTH AND HUMAN SERVICES
FOOD AND DRUG ADMINISTRATION
PSC Graphics (301) 443-1090 EF
COMMITMENT TO PROTECT NON-PUBLIC INFORMATION
EMPLOYEE AGREEMENT
Whereas access to non-public information from the files of the Food and Drug Administration (FDA) is required in the performance of my official duties, under Contract Number between FDA and my employer I, on this day of , 200 hereby agree that I shall not further release, publish or disclose such information and that I shall protect such information in accordance with the provisions of 21 U.S.C. 331(j), 21 U.S.C. 360(j), 18 USC. 1905 and other pertinent laws and regulations governing the confidentiality of non-public information.
I understand the provisions of 21 U.S.C. 331(j), 21 U.S.C. 360(j), 18 USC. 1905 and that I am subject to criminal penalties prescribed by law for any violation(s) thereof.
Signature:
Date:
Type or Print Name:
Witnessed by:
Date:
Type or Print Name:
DESCRIPTION OF INFORMATION RELEASED:
FORM FDA 3398 (10/03)
DEPARTMENT OF HEALTH AND HUMAN SERVICES
FOOD AND DRUG ADMINISTRATION
PSC Graphics (301) 443-1090
EF
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