8-Attachment B.docx
DOCX document 20 KB Posted
- Solicitation number
- RFP 27009BDC
- Issued by
- Clark County, Fish Springs CDP, Nevada
About this file
This is a Certificate of Data Destruction/Return document issued by the Clark County School District in Nevada for RFP 27009BDC, a Data Sharing Agreement related to a Family Engagement, Student Progress, and School-to-Home Communication Application. The certificate serves as an attestation form to be completed by an awarded supplier's authorized representative upon contract conclusion. The document requires the supplier to certify the disposition of District data according to the agreement's requirements, with options for either destruction or return of data, or both if selected by the District.
The certificate contains two primary sections allowing suppliers to document compliance with data handling obligations. Part A addresses data destruction, requiring the supplier to certify the date District data was destroyed and to identify any District-approved subcontractors whose data was similarly destroyed. Part B addresses data return, permitting the supplier to certify the date District data was returned and to document the return of data generated by subcontractors. The form requires signature, printed name and title, date, and contact information from an authorized representative of the supplier, with version notation indicating creation on December 6, 2021.
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Other files
| File | Type | Posted |
|---|---|---|
| 12-RFP 27009BDC Family Engagement, Student Progress, School to Home Communication.doc | DOC document | |
| 9-Attachment A.docx | DOCX document | |
| 1-Customer Reference Form.docx | DOCX document | |
| 7-Public Disclosure Form.docx | DOCX document | |
| 6-Supplier Federal 2 CFR 200 Certification Form.docx | DOCX document | |
| 10-Appendix B - System Matrix.xlsx | XLSX spreadsheet | |
| 11-Appendix A - Pricing Sheet.docx | DOCX document | |
| 5-Supplier Contact List Designation Form.doc | DOC document | |
| 4-Supplier Application Update Form.doc | DOC document | |
| 2-W-9.pdf | ||
| 13-Amendment 1 Data Sharing Amendment.docx | DOCX document | |
| 3-Proposal Submittal Form.doc | DOC document |
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Text version
Awarded Supplier’s name will go here, Data Sharing Agreement RFP 27009BDC Attachment B Certificate of Data Destruction/Return
I the undersigned serving in the capacity as an authorized representative of the Supplier do hereby represent and warrant (initial next to applicable Parts in sections A and/or B):
Part A – Destruction:
_____ The District Data provided to the Supplier in the performance of the subject Agreement was Destroyed on __________, 20___ in accordance with the Agreement’s requirements.
_____ The District Data provided by the Supplier to its District approved Subcontractor(s) (listed below) in the performance of the subject Agreement was Destroyed on____________, 20____ in accordance with the Agreement’s requirements.
Subcontractor Name(s):_____________________________________________________________________________
Part B – Return: (If selected by the District the Supplier shall also complete Part A) _____ The District Data provided to and/or generated by the Supplier in the performance of the subject Agreement was Returned on ____________, 20_____ in accordance with the Agreement’s requirements.
_____ The District Data provided to and/or generated by the Supplier’s Subcontractor(s) in the performance of the subject Agreement was Returned on _____________, 20_____ in accordance with the Agreement’s requirements.
Supplier:
Signature Authorized Representative:
Print Name and Title:
Date:
Email Address & Phone Number:
V-1 – created 12-6-2021
File details come from the government source that posted it. Updated .