8-Cert Destruction-Return of Data - Attachment B 12.6.21.docx

DOCX document 20 KB Posted

Attached to
RFP 26024BDC Grades 6-12 Digital Courseware
Solicitation number
RFP 26024BDC
Issued by
Clark County, Nevada

About this file

This is a Certificate of Data Destruction/Return form issued by a Nevada school district for RFP 26024BDC regarding Grades 6-12 Digital Courseware services under a Data Sharing Agreement. The document serves as an attestation by an authorized supplier representative confirming compliance with data handling requirements upon contract completion. The form is designed to document either the destruction or return of district data provided to or generated by the supplier during performance of the agreement, with provisions for identifying any district-approved subcontractors involved in data handling activities. The certificate requires specification of destruction or return dates, subcontractor names where applicable, and authorized signature with printed name, title, contact information, and date of certification.

The document contains two alternative completion paths: Part A addresses data destruction with dated confirmation of when district data was destroyed in accordance with agreement requirements, while Part B addresses data return with dated confirmation of when data was returned to the district. If the district elects data return, Part A must also be completed. The form accommodates both direct supplier actions and those performed by approved subcontractors, with separate line items for certifying compliance at each level. This certificate version was created on December 6, 2021, and represents a standard administrative requirement for contract closeout ensuring proper handling and security of sensitive educational data.

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Text version

To: Supplier, Data Sharing Agreement RFP 26024BDC Amendment 1 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 .