Attachment_2_-_Contractor_Non-Disclosure_Agreement_rev1_3November2016.pdf

Contractor Non-Disclosure Agreement

NOTE: To be completed by a contractor upon award of contract.

Information Technology Systems Security Contractor Non-Disclosure Agreement

Access to sensitive information, non-public information, confidential information, and/or Controlled

Unclassified Information (CUI) from the files of the Department of Health and Human Services (HHS) is required in the performance of my official duties, under contract number ______________between

(HHS I/C Name or Component) ____________________________________________________ and my employer (Employer’s Name) __________________________________________. I agree that I shall not release, publish, or disclose such information to unauthorized personnel, and I shall protect such information in accordance with relevant laws and regulations available for research and review at any Law Library. Among these laws may be various provisions of:

a) 18 U.S.C. 641 (Criminal Code: Public Money, Property or Records)

b) 18 U.S.C. 1905 (Criminal Code: Disclosure of Confidential Information)

c) Public Law 96-511 (Paperwork Reduction Act)

d) 5 U.S.C. 552a (Privacy Act)

I affirm that I have received a written and/or verbal briefing by my company concerning my responsibilities under this agreement. I understand that violation of this agreement may subject me to criminal and civil penalties.

Signed: ________________________________________________________________

Type or Print Name: _____________________________________________________

Date: ______________________________________

Witnessed by: __________________________________________________________

Date: ______________________________________

Copies are to be retained by: HHS Project Officer

Contractor’s Contract Management

Individual Signatory