RFP 47PK0123R0003 Amendment 2.pdf
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- Solicitation number
- 47PK0123R0003
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This amendment to a solicitation modifies an existing request for proposals for 24/7 HVAC system design and installation services at the 11000 Wilshire Federal Building in Los Angeles, California. The General Services Administration seeks to provide a new rooftop chiller system and cooling equipment to service dedicated IT rooms, with electrical work, roof repairs, and installation of a BACnet control system. The amendment adds security registration requirements for attending an in-person pre-proposal conference and site visit, with a limit of three attendees per offeror. It also confirms the revised proposal due date of April 20, 2023.
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1. CONTRACT ID CODE PAGE OF PAGES
AMENDMENT OF SOLICITATION / MODIFICATION OF CONTRACT
2. AMENDMENT / MODIFICATION NO. 3. EFFECTIVE DATE 4. REQUISITION / PURCHASE REQ. NO. 5. PROJECT NO. (If applicable)
6. ISSUED BY CODE 7. ADMINISTERED BY (IF OTHER THAN ITEM 6) CODE
GENERAL SERVICES ADMINISTRATION
ACQUISITION MANAGEMENT DIVISION
401 W. WASHINGTON ST., ROOM 210
PHOENIX, AZ 85003
8. NAME AND ADDRESS OF CONTRACTOR (NO., STREET, COUNTRY, STATE, ZIP CODE) 9A. AMENDMENT OF SOLICITATION/RFP
X
9B. DATED (SEE ITEM 11)
10A. MODIFICATION OF CONTRACT / ORDER NO.
10B. DATED (SEE ITEM 13)
CODE FACILITY CODE
11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS
X The above numbered solicitation is amended as set forth in item 14. The hour and date specified for receipt of offers is extended X is not extended
Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended by one of the following methods: (a) By completing items 8 and 15, and returning two (2) copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGEMENT TO BE RECEIVED AT THE PLACE DESIGNATED
FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER.
If by virtue of this amendment you desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.
12. ACCOUNTING AND APPROPRIATION DATA (If required)
13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS / ORDERS,
IT MODIFIES THE CONTRACT / ORDER NO. AS DESCRIBED IN ITEM 14.
A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE
CONTRACT ORDER NO. IN ITEM 10A.
B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).
C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF :
D. OTHER (Specify type of modification and authority)
E. IMPORTANT: Contractor is not, is required to sign this document and return copies to the administering office.
14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)
SEE ATTACHMENT TO SF 30 FOR DESCRIPTION OF AMENDMENT
Except as provided herein, all terms & conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force & effect.
15A. Name and Title of Signer (type or print) 16A. Name and Title of Contracting Officer (type or print)
DAN MAKOWSKI
15B. Contractor / Offeror 15C. Date Signed 16B. United States of America 16C. Date Signed
(Authorized signature) (Signature of Contracting Officer)
REVISED STANDARD FORM 30 (2-93)
2 3/29/2023
11000 WILSHIRE FEDERAL BUILDING
3/16/2023
47PK0123R0003
LOS ANGELES, CA
"11000 WILSHIRE 24/7 HVAC"
“11000 WILSHIRE 24/7 HVAC” RFP NO. 47PK0123R0003
11000 WILSHIRE BLVD. FEDERAL BUILDING
LOS ANGELES, CA AMENDMENT NO. 2 (03/29/2023)
ATTACHMENT TO STANDARD FORM 30
ITEM 14, DESCRIPTION OF AMENDMENT
Amendment No. 2 – 03/29/2023
THIS AMENDMENT IS ISSUED TO ADD OR CHANGE THE FOLLOWING ITEMS IN REQUEST FOR
PROPOSALS NO. 47PK0123R0003:
1. The registration requirements and detailed instructions for attending the Pre-Proposal conference and site visit are attached to this amendment as “Security Guidance for Potential Bidders”. Also attached is the associated
“FBI Limited Escorted Access Request (LAR) Completion Guide”. Determination of eligibility for the site visit will be made by FBI.
The conference will take place on Wednesday, April 5, 2023, 10:00 am (PDT). Offerors are to meet on the 5th floor, in the GSA conference room, Suite 521. The site visit will follow immediately after the conference.
Due to agency security limitations, there is a limit of three (3) participants per offeror.
2. The proposal closing date and time for this solicitation remains THURSDAY, APRIL 20, 2023, 4:00 PM
(PDT).
ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED.
***** YOU MUST ACKNOWLEDGE RECEIPT OF THIS AND ALL AMENDMENTS AS INDICATED
IN BLOCK 11 SHOWN ABOVE. FAILURE TO DO SO MAY RESULT IN REJECTION OF YOUR
OFFER. *****
Security Guidance for Potential Bidders
P a g e | 1 March 2023
11000 Wilshire Federal Building 24/7 HVAC System Design
SECURITY GUIDANCE
FOR POTENTIAL BIDDERS
The purpose of this document is to provide information and to guide potential bidders through the Agency’s security procedures to enter the 11000 Wilshire Federal Building. The Agency might require potential bidders to submit additional information not listed on this document at their discretion during the security screening process. The security procedures must be completed prior to visiting the site.
P a g e | 2 March 2023
Table of Contents
Security Guidance Cover Sheet
Table of Contents
Project Information and Points of Contact
Agency’s Security Instructions
Security Clearance Check List…………
P a g e | 3 March 2023
Project Information and Points of Contact
Project Name:
➢ 24/7 HVAC System Design Project - Wilshire Federal Building
Project Address:
➢ 11000 Wilshire Boulevard
Los Angeles, CA 90024
GSA Contracting Officer:
➢ Dan Makowski dan.makowski@gsa.gov
GSA Project Manager:
➢ Gary Kaplowitz gary.kaplowitz@gsa.gov
Agency Security Specialist:
➢ Jose Camarero jacamarero@fbi.gov
FBILAR.LA@fbi.gov
P a g e | 4 March 2023
Agency’s Security Instructions
The following instructions apply to all individuals that enter the Wilshire Federal Building. Due to the sensitive nature of documents required to be submitted, everyone must email them directly to the
Agency Security Specialist. See additional instructions below.
Please follow these instructions to complete the FBI Limited Escorted Access Request (LAR) Standard
Form 85:
1. Carefully read the instructions on the LAR form before completing it.
2. Fill out the LAR form, including the “Sensitive Information Nondisclosure Agreement” (pgs. 13 –
14). Provide the name in pg. #13 and signature, date, and Organization in pg. #14.
3. Please provide a copy of the driver’s license.
4. If the applicant has been naturalized or is a Legal Permanent Resident, please provide a copy of the green card or naturalization certificate/passport.
5. Please provide all the signatures that are needed on the form.
6. Submit the LAR form and its applicable documents via email to jacamarero@fbi.gov (Agency
Security Specialist) and cc FBILAR.LA@fbi.gov. Please use 11000 WILSHIRE - 24/7 HVAC ROOF PROJECT as the email subject line.
It takes a minimum of 48hrs to process each LAR form. Once the LAR is reviewed and approved, the
Agency Security Specialist will contact the respective individual to coordinate the fingerprint process.
Fingerprints are required to enter the Wilshire Federal Building (including for the site visit). This is the final step in the LAR process. Please coordinate accordingly prior to the site visit (April 5, 2023).
If you have any questions about the LAR form, please email the Agency Security Specialist directly.
P a g e | 5 March 2023
Security Clearance Check List
The following need to be completed and provided to the Agency Security Specialist.
☐FBI Limited Escorted Access Request (LAR) Standard Form 85.
☐Copy of Driver’s License.
☐Copy of Green Card or naturalization certificate/passport (If the applicant has been naturalized or is a
Legal Permanent Resident).
☐Complete fingerprint process. Agency Security Specialist will email instructions after The LAR Standard
Form 85 has been submitted and approved.
FBI Limited Escorted Access Request (LAR) Completion Guide
Please read and follow these instructions when completing the Standard Form 85 (SF 85).
Only provide the information requested in this checklist.
QUESTION NUMBER INSTRUCTIONS
1. Full Name Last, First Middle
• Provide full middle name
• If no middle name, put “NMN” or “NONE”
2. Date of Birth MM/DD/YYYY format
3. Place of Birth
• If born in the U.S. list City and State
• If born outside the U.S. list City and Country
4. Social Security Number ###-##-#### format
5. Other Names Used Alias’s , AKA’s, Maiden Names, nicknames
• Full Name
• Dates used MM/YY to MM/YY format
6. Sex Male or Female
7. Citizenship
Answer the question according to the form as applicable to you. NOTE: If you have been naturalized or are a Legal Permanent Resident (i.e. green card), provide a copy of your naturalization certificate or green card.
8. Where You Have Lived (Residence)
Provide complete address information for your current residence only.
10. Your Employment Activities
Provide complete information for your current employer only.
14. Illegal Drugs Respond to this question accurately use MM/YY format for dates.
Continuation Space
List any current or recent criminal charges within the previous one year from the date you sign this form.
Name of Charge:
Date of Charge:
Law Enforcement Agency or Department involved:
Court Involved:
Disposition and Date:
Additional Details:
Authorization for Release of Information
Complete all fields.
• The release MUST be signed.
• Use N/A if no other names are used.
• Make sure you provide the date signed and not your date of birth.
Photo ID
Provide a copy of your state issued ID or Driver’s License.
Guía para Completar la Solicitud de Acceso Escoltado Limitado (LAR) al FBI
Favor de leer y seguir estas instrucciones para llenar la Forma 85 (SF 85).
Solo se debe proporcionar la información solicitada en esta lista.
NÚMERO DE PREGUNTA INSTRUCCIONES
1. Nombre Completo Apellido, Nombre, Segundo Nombre
• Proporcionar Segundo Nombre completo
• Si no hay Segundo nombre poner “NO HAY”
2. Fecha de Nacimiento Formato MES/DÍA/AÑO
3. Lugar de Nacimiento
• Si nació en los EE.UU. escriba la ciudad y el estado
• Si nació fuera de los EE.UU. escriba la ciudad y el país
4. Número Seguro Social ###-##-#### formato
5. Otros Nombres Usados Alias(es), Nombre de Soltera, Sobrenombres
• Nombre Completo
• Usar formato de MES/AÑO a MES/AÑO para las fechas
6. Sexo Hombre o Mujer
7. Nacionalidad
Conteste la pregunta de acuerdo a la forma que le corresponda a usted. NOTAR: Si usted fue naturalizado o usted es residente permanente legal (por ejemplo, tarjeta de residencia permanente), proporcione una copia de su certificado de naturalizacion o tarjeta de residencia permanente.
8. Dónde usted ha vivido (Residencia)
Proporcionar sólo la dirección completa correspondiente a su domicilio actual.
10. Sus Empleos Proporcionar sólo la información completa correspondiente al empleo actual.
14. Drogas Ilícitas Conteste esta repuesta exactamente utilizando el formato de MES/AÑO para las fechas.
Espacio Adicional
Listar cualquier cargo penal actual o cualquier cargo penal que se le haya formulado dentro del período de un año a partir de la fecha en que usted firmó esta forma.
Tipo de Cargo:
Fecha del Cargo:
Autoridad Policíaca Involucrada:
Tribunal Involucrado:
Disposición y Fecha:
Detalles Adicionales:
Autorización para Proporcionar Información
Llenar todos los espacios.
• La autorización DEBE estar firmada.
• Usar “N/A” si no se utilizan otros nombres.
• Asegúrese de proporcionar la fecha en que firmó y no su fecha de nacimiento.
Identificacion Fotografica: Proporcione una copia de su tarjeta de identificacion o licencia de conducir
LIMITED ACCESS REQUEST
SECURITY BRIEFING
1. DISQUALIFICATIONS
You will be disqualified from working on this project if you are currently on parole/probation, or if you have been charged with a felony, have outstanding warrants or have been denied access to an FBI facility in the last year. You will also be disqualified if you have been convicted of a felony in the past three years, with the exception of a “crime of violence” felony in the past 10 years. Please discuss any concerns with one of the LA Security representatives.
NOTE: It is your sole responsibility to update your supervisor as to the reason you have been denied.
2. INFORMATION RESTRICTIONS
This project should only be referred to, or discussed as, the “GSA Project.” DO NOT discuss this project by name or the details of this project once you leave the work site, even among co-workers. You never know who is listening. All working drawings must stay at the construction site and all drawings must be returned to GSA at the end of the project.
3. SITE RESTRICTIONS
No alcohol, drugs, or weapons are permitted on the construction site. You will be immediately, and permanently, removed from the site/project if you are found in possession of any of these items, or under the influence. NOTE:
Possession of, or the use of, Marijuana is a felony under federal law.
Mobile phones, radios, pagers, cameras, or other portable/mobile electronic devices are not permitted on the construction site (with the exception of approved and designated Trade Supervisors). Found devices will be confiscated and searched. You are not guaranteed that the device will be returned or that it will be returned in working order.
Reasons for immediate removal from the project include, but are not limited to: fighting, inappropriate language, use of prohibited items, and being disrespectful of co-workers, supervisors, or government representatives.
No Wi-Fi or Bluetooth are allowed. No photography is allowed. NOTE: If photos are needed/required for project-related purposes, an FBI Security representative will coordinate taking the photograph(s), sanitizing them, and disseminating them to the appropriate individuals.
4. IDENTIFICATION RESTRICTIONS
You will be required to wear a project provided photo ID badge while on site. You are required to check in with the escort upon arrival, present a photo ID (driver’s license or other government issued ID) to verify identification. The escort will exchange your ID for a construction site ID that will be worn above the waist at all times while on site.
You will exchange the construction site ID for your ID at the end of the workday. No guest or workers that have not completed the Limited Access Request (LAR) and have been approved for access will be allowed on the construction site.
Print Date
Signature
FD-857a (9-9-2016)
SENSITIVE INFORMATION
NONDISCLOSURE AGREEMENT
An Agreement between _________________________________________________________ and the Federal Bureau of Investigation (FBI) regarding the following activities:
1. Intending to be legally bound, I hereby accept the obligations contained in this Agreement in consideration of my being granted access to FBI controlled facilities as required to perform my duties. While I have not been granted access to sensitive information, I acknowledge that I could inadvertently become exposed to sensitive information in the course of my duties. As used in this Agreement, sensitive information is marked or unmarked information, including, but not limited to, oral communications, the disclosure of which may compromise, jeopardize or subvert any investigation. Sensitive information also includes information relating to closed investigations, the disclosure of which might compromise, jeopardize or subvert other law enforcement activities or investigations. I understand and accept that by being granted access to FBI controlled facilities, special confidence and trust shall be placed in me by the FBI.
2. I hereby acknowledge that I have received an indoctrination concerning the nature and protection of sensitive information, including the procedures to be followed in the event that I am inadvertently exposed to sensitive information, ascertaining whether other persons to whom I contemplate disclosing this information have been approved for access to it, and that I understand these procedures.
3. I have been advised that the unauthorized access, unauthorized disclosure, unauthorized retention, or negligent handling of sensitive information may cause irreparable damage to FBI investigations and that I will never divulge sensitive information to anyone unless (a) I have officially verified that the recipient has been properly authorized by the FBI to receive it; or (b) I have been given prior written notice of authorization from the FBI that such disclosure is permitted. I understand that if I am uncertain as to the sensitive nature or status of information, I am required to confirm from an authorized official that the information may be disclosed prior to disclosure of this information.
4. I have been advised that any breach of this Agreement may result in the termination of my relationship with the FBI and access to FBI controlled facilities. In addition, I have been advised that any unauthorized disclosure of information by me may constitute a violation or violations of United States criminal laws, including Title 18, United States Code, or may lead to criminal prosecution for obstruction of lawful government functions. I realize that nothing in this Agreement constitutes a waiver by the United States of the right to prosecute me for any statutory violation.
5. I understand that all sensitive information to which I may be exposed to by signing this agreement is now and will remain the property of, or in the control of the FBI unless otherwise determined by an authorized official or final ruling in a court of law. I agree that I shall return all sensitive materials which have or may come into my possession: (a) upon demand by an authorized representative of the United States Government; (b) upon discovery that the materials contain sensitive information; or (c) upon the conclusion of my relationship with the FBI, whichever occurs first.
6. I understand that these restrictions are consistent with and do not supersede, conflict with, or otherwise alter my obligations, rights, or liabilities created by Executive Order No. 12958; Section 7211 of Title 5, U.S.C.
(governing disclosures to Congress); Section 1034 of Title 10, United States Code, as amended by the Military Whistleblower Protection Act (governing disclosure to Congress by members of the military); section 2302(b)(8) of Title 5, United States Code, as amended by the Whistleblower Protection Act (governing disclosures of illegality, waste, fraud, abuse or public health or safety threats); the FBI Whistleblower Protection Act (5 U.S.C. 2303, 28 C.F.R. Part 27) (governing disclosures of illegality, waste, fraud, abuse or public health or safety threats); the Intelligence Identities Protection Act of 1982 (50 U.S.C. 421 et seq.) (governing disclosures that could expose confidential government agents); and the statutes which protect against disclosure that may compromise the national security, including Sections 641, 793, 794, 798, and 952 of Title 18, United States Code, and Section 4(b) of the Subversive Activities Act of 1950 (50 U.S.C. 783(b)). The definitions, requirements, obligations, rights, sanctions, and liabilities created by said Executive Order and listed statutes are incorporated into this agreement and are controlling. I further understand, however, that any such information that is disclosed pursuant to applicable federal law continues to be subject to this agreement for all other purposes, and disclosure to the appropriate entities provided by federal law does not constitute public disclosure or declassification, if applicable, of such information.
7. Unless and until I am released in writing by an authorized representative of the FBI, I understand that all conditions and obligations imposed upon me by this Agreement apply during the time I am granted access to FBI controlled facilities and at all times thereafter.
8. Each provision of this Agreement is severable. If a court should find any provision of this Agreement to be unenforceable, all other provisions of this Agreement shall remain in full force and effect.
9. I understand that the United States Government may seek any remedy available to it to enforce this Agreement including, but not limited to, application for a court order prohibiting disclosure of information in breach of this agreement. I hereby assign to the United States Government all royalties, remunerations, and emoluments that have resulted, will result or may result from any disclosure, publication, or revelation of sensitive information not consistent with the terms of this Agreement.
10. I have read this Agreement carefully and my questions, if any, have been answered.
Signature ________________________________________________________ Date __________________
Organization (if contractor, provide name and address):
The briefing and execution of this Agreement was witnessed by __________________________________________
(Type or Print Name)
Signature ________________________________________________________ Date ________________________
SECURITY DEBRIEFING ACKNOWLEDGMENT
I reaffirm that the provisions of the Federal criminal laws applicable to the safeguarding of sensitive information; that I have returned all sensitive information in my custody; that I will not communicate or transmit sensitive information to any unauthorized person or organization; that I will promptly report to the FBI any attempt by an unauthorized person to solicit sensitive information, and that I have received a debriefing regarding the security of sensitive information.
Signature ______________________________________________________ Date __________________
Name of Witness (Type or Print) __________________________________________________________
Signature of Witness _____________________________________________ Date __________________
| SF30 - AMENDMENT 2 |
| attach to sf30 - AMEND 2 |
| Security Guidance for Potential Bidders |
| LAR |
| FD-857a.pdf |
| FD-857a (9-9-2016) |
| SENSITIVE INFORMATION |
| NONDISCLOSURE AGREEMENT |
| An Agreement between _________________________________________________________ |
| and the Federal Bureau of Investigation (FBI) regarding the following activities: |
| 1. Intending to be legally bound, I hereby accept the obligations contained in this Agreement in consideration of my being granted access to FBI controlled facilities as required to perform my duties. While I have not been granted access to sensitive information, I acknowledge that I could inadvertently become exposed to sensitive information in the course of my duties. As used in this Agreement, sensitive information is marked or unmarked information, including, but not limited to, oral communications, the disclosure of which may compromise, jeopardize or subvert any investigation. Sensitive information also includes information relating to closed investigations, the disclosure of which might compromise, jeopardize or subvert other law enforcement activities or investigations. I understand and accept that by being granted access to FBI controlled facilities, special confidence and trust shall be placed in me by the FBI. |
| 2. I hereby acknowledge that I have received an indoctrination concerning the nature and protection of sensitive information, including the procedures to be followed in the event that I am inadvertently exposed to sensitive information, ascertaining whether other persons to whom I contemplate disclosing this information have been approved for access to it, and that I understand these procedures. |
| 3. I have been advised that the unauthorized access, unauthorized disclosure, unauthorized retention, or negligent handling of sensitive information may cause irreparable damage to FBI investigations and that I will never divulge sensitive information to anyone unless (a) I have officially verified that the recipient has been properly authorized by the FBI to receive it; or (b) I have been given prior written notice of authorization from the FBI that such disclosure is permitted. I understand that if I am uncertain as to the sensitive nature or status of information, I am required to confirm from an authorized official that the information may be disclosed prior to disclosure of this information. |
| 4. I have been advised that any breach of this Agreement may result in the termination of my relationship with the FBI and access to FBI controlled facilities. In addition, I have been advised that any unauthorized disclosure of information by me may constitute a violation or violations of United States criminal laws, including Title 18, United States Code, or may lead to criminal prosecution for obstruction of lawful government functions. I realize that nothing in this Agreement constitutes a waiver by the United States of the right to prosecute me for any statutory violation. |
| 5. I understand that all sensitive information to which I may be exposed to by signing this agreement is now and will remain the property of, or in the control of the FBI unless otherwise determined by an authorized official or final ruling in a court of law. I agree that I shall return all sensitive materials which have or may come into my possession: (a) upon demand by an authorized representative of the United States Government; (b) upon discovery that the materials contain sensitive information; or (c) upon the conclusion of my relationship with the FBI, whichever occurs first. |
| 6. I understand that these restrictions are consistent with and do not supersede, conflict with, or otherwise alter my obligations, rights, or liabilities created by Executive Order No. 12958; Section 7211 of Title 5, U.S.C. (governing disclosures to Congress); Section 1034 of Title 10, United States Code, as amended by the Military Whistleblower Protection Act (governing disclosure to Congress by members of the military); section 2302(b)(8) of Title 5, United States Code, as amended by the Whistleblower Protection Act (governing disclosures of illegality, waste, fraud, abuse or public health or safety threats); the FBI Whistleblower Protection Act (5 U.S.C. 2303, 28 C.F.R. Part 27) (governing disclosures of illegality, waste, fraud, abuse or public health or safety threats); the Intelligence Identities Protection Act of 1982 (50 U.S.C. 421 et seq.) (governing disclosures that could expose confidential government agents); and the statutes which protect against disclosure that may compromise the national security, including Sections 641, 793, 794, 798, and 952 of Title 18, United States Code, and Section 4(b) of the Subversive Activities Act of 1950 (50 U.S.C. 783(b)). The definitions, requirements, obligations, rights, sanctions, and liabilities created by said Executive Order and listed statutes are incorporated into this agreement and are controlling. I further understand, however, that any such information that is disclosed pursuant to applicable federal law continues to be subject to this agreement for all other purposes, and disclosure to the appropriate entities provided by federal law does not constitute public disclosure or declassification, if applicable, of such information. |
| 7. Unless and until I am released in writing by an authorized representative of the FBI, I understand that all conditions and obligations imposed upon me by this Agreement apply during the time I am granted access to FBI controlled facilities and at all times thereafter. |
| 8. Each provision of this Agreement is severable. If a court should find any provision of this Agreement to be unenforceable, all other provisions of this Agreement shall remain in full force and effect. |
| 9. I understand that the United States Government may seek any remedy available to it to enforce this Agreement including, but not limited to, application for a court order prohibiting disclosure of information in breach of this agreement. I hereby assign to the United States Government all royalties, remunerations, and emoluments that have resulted, will result or may result from any disclosure, publication, or revelation of sensitive information not consistent with the terms of this Agreement. |
| 10. I have read this Agreement carefully and my questions, if any, have been answered. |
| Signature ________________________________________________________ Date __________________ |
| Organization (if contractor, provide name and address): |
| The briefing and execution of this Agreement was witnessed by __________________________________________ |
| (Type or Print Name) |
| Signature ________________________________________________________ Date ________________________ |
| -------------------------------------------------------------------------------------------------------------------------------------------- |
| SECURITY DEBRIEFING ACKNOWLEDGMENT |
| I reaffirm that the provisions of the Federal criminal laws applicable to the safeguarding of sensitive information; that I have returned all sensitive information in my custody; that I will not communicate or transmit sensitive information to any unauthorized person or organization; that I will promptly report to the FBI any attempt by an unauthorized person to solicit sensitive information, and that I have received a debriefing regarding the security of sensitive information. |
| Signature ______________________________________________________ Date __________________ |
| Name of Witness (Type or Print) __________________________________________________________ |
| Signature of Witness _____________________________________________ Date __________________ |
| Name: |
| Date: |
| Type or Print Name: |
| Date_2: |
| Date_3: |
| Name of Witness (Type or Print): |
| Date_4: |
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