J.11_Non_Disclosure_Statement.docx

NON-DISCLOSURE STATEMENT

References: 48 CFR (Federal Acquisition Regulation) Sections 3.104, 5.401, and relevant corresponding sections of the Health and Human Services Acquisition Regulation.

Non-disclosure of proprietary/confidential data

Certain information of a proprietary or confidential nature (i.e., Information from other CMS contractors) will be provided to you by the government and/or its contractors. While performing under ____________________________ (insert Contract number) employees and any Subcontractors agree to use and examine this information exclusively in the performance of this contract and to take the necessary steps to prevent disclosure of such information to any party outside the government, as long as it remains proprietary/confidential.

Additionally, the contractor and any subcontractors agree to indoctrinate their affiliates who will have access to this information as to the proprietary nature of the information and the relationship under which they have possession of the information. Affiliates will also be informed that they may not engage in any other actions, venture or employment where this information will be used for the profit of any party other than the party furnishing this information. The contractor and subcontractors will restrict access to proprietary information to the minimum number of employees necessary for performance of this contract.

Affirmation

I, the undersigned, recognize that information provided by the government and/or its contractors may be proprietary and confidential. Further, I do understand the requirements of the nondisclosure statement and agree to refrain from discussing or disclosing any sensitive data or information obtained or generated under this contract. I further understand that if I have any questions concerning this matter, I should consult the CMS Contracting Officer assigned to ____________________________ (insert Contract Number TBD).

Printed Name and Title