25 - Contractor Confidentiality Certificate.pdf
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- X1DB--VA Outpatient Clinic, Rolla, Missouri
- Solicitation number
- 36C10F22R0047
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REQUEST FOR LEASE
December 2022
RLP No. 36C10F22R0047
PROPOSALS (RLP)
Veterans Affairs (VA) Community-Based Outpatient Clinic (CBOC)
Rolla, MO
CONFIDENTIALITY CERTIFICATE
VA Contractor
Lessor __________ Gov’t. __________ __________ of __________ Pages
VA Project Title VA Contract Number
The Physical Security Design Standards Data Definitions are for Official Use Only. I certify that I will not disclose the contents of these documents nor transmit electronically or in hard copy the documents to any other persons or firms. A limited numbers of other members of your firm, directly involved on this VA contract, can request access to these documents. Prior to receipt of these documents, they must provide justification and their signed Confidentiality Certificate to the VA Project Manager for approval.
I also certify that appropriate precautions are in place to protect these documents from theft or inadvertent disclosure, and access is limited to the person signing the Certificate
Contractor’s Name
Contractor Employee Name Signature Title Date
Contact information: Address/telephone/email address
Fax number
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