Attachment 2 Document Registration and Disclaimer Form (Rev 12 Dec).pdf

Attachment 2

Document Registration and Disclaimer Form

MILSATCOM ANTENNA SUPPORT TOWER (AST) AND HIGH ALTITUDE ELECTRO-MAGNETIC PULSE

(HEMP) SHIELDED ENCLOSURE (HSE) SHELTER Document Registration and Disclaimer Form

Any information obtained from AFNWC/PZH will be used for the sole purpose of:

Assisting_________________________________(Company Name), (hereafter referred to as the company), in refining the Government’s cost/capability analysis, acquisition strategy, and responding to the Sources Sought Synopsis/Request for Information for a government test aircraft.

The company is responsible for assuring that the information received will not be used for any purpose(s) other than stated above and that the information shall be destroyed by the company when work is completed.

The company guarantees that the provided information, and/or any modified version thereof, will not be published in any manner or offered for sale. It will not be sold or given to any other firm without receipt of a non-disclosure agreement along with this form identifying the prospective subcontractor or supplier forwarded to the Government. It will be considered and treated as Controlled Unclassified Information (CUI) material.

The company understands that the information is for domestic use only. The information shall not be provided to any foreign Government, foreign personnel, or used in any type of contract with a foreign government.

I _____________________________________ (Name, Title, Position), as a representative of the

Company listed below, understand and agree to the above-mentioned rules.

Individual Email Address

Individual Phone Number

Company Name

Company CAGE Code

Company Facility Clearance

Company Address (including name and Mailstop of individual cleared to receive CUI)

Company Address

Company Address

Individual Signature & Date