9-DSA Attachment B Cert Destruction-Return of Data 12.6.21.docx
DOCX document 19 KB Posted
- Attached to
- Biology and Honors Biology Textbook Adoption
- Solicitation number
- RFP 27004TLH
- Issued by
- Clark County, Fish Springs CDP, Nevada
About this file
This is a Certificate of Data Destruction/Return attachment document for a Biology and Honors Biology Textbook Adoption contract with a Nevada school district (Course Code 27004TLH). The document serves as a formal certification form that an authorized representative of the supplier must complete upon conclusion of the agreement to verify proper handling of district data according to contract requirements. The supplier must initial applicable sections to confirm either destruction or return of all district data provided during contract performance, with specific dates of completion required. If subcontractors were utilized in the agreement, the supplier must also certify the destruction or return of district data provided to those approved subcontractors, including listing subcontractor names.
The certificate requires the authorized representative to provide a signature, printed name and title, completion date, email address, and phone number to validate the certification. This document establishes accountability for sensitive district information and ensures compliance with data handling protocols specified in the primary agreement. The form was created on December 6, 2021, and applies to the one-year Biology and Honors Biology course adoption that integrates science and engineering practices with core biological concepts and includes laboratory experiences required for high school science graduation credit.
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Text version
To: Supplier, Biology and Honors Biology, 27004TLH 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 .