Attachment_C_-_Non-Disclosure_Agreement.pdf

Attachment C – Non-Disclosure Agreement

Contractor Non-Disclosure Agreement

Information Technology Systems Security Contractor Non-Disclosure Agreement

Access to sensitive information (such as personally identifiable information [PII]), 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/HRSA) 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 federal laws, regulations, and guidelines.

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 Contracting Officer Representative

Contractor’s Contract Management

Individual Signatory