Attachment 10 FDA Non Disclosure Agreement Site Visit .pdf

COMMITMENT TO PROTECT NON-PUBLIC INFORMATION

EMPLOYEE AGREEMENT

Whereas access to non-public information from the files of the Food and Drug Administration (FDA) is required in the performance of my official duties, under Contract Number between FDA and my employer

I, on this day of , 20 hereby agree that I shall not further release, publish or disclose such information and that I shall protect such information in accordance with the provisions of 21 U.S.C. 331(j), 21 U.S.C. 360j(c), 18 U.S.C. 1905 and other pertinent laws and regulations governing the confidentiality of non-public information.

I understand the provisions of 21 U.S.C. 331(j), 21 U.S.C. 360j(c), 18 U.S.C. 1905 and that I am subject to criminal penalties prescribed by law for any violation(s) thereof.

Signature: Date:

Type or Print Name:

Witnessed by: Date:

Type or Print Name:

DESCRIPTION OF INFORMATION RELEASED:

FORM FDA 3398 (10/10)

DEPARTMENT OF HEALTH AND HUMAN SERVICES

FOOD AND DRUG ADMINISTRATION

PSC Graphics (301) 443-1090 EF

COMMITMENT TO PROTECT NON-PUBLIC INFORMATION

EMPLOYEE AGREEMENT

Whereas access to non-public information from the files of the Food and Drug Administration (FDA) is required in the performance of my official duties, under Contract Number between FDA and my employer I, on this day of , 20 hereby agree that I shall not further release, publish or disclose such information and that I shall protect such information in accordance with the provisions of 21 U.S.C. 331(j), 21 U.S.C. 360j(c), 18 U.S.C. 1905 and other pertinent laws and regulations governing the confidentiality of non-public information.

I understand the provisions of 21 U.S.C. 331(j), 21 U.S.C. 360j(c), 18 U.S.C. 1905 and that I am subject to criminal penalties prescribed by law for any violation(s) thereof.

Signature:

Date:

Type or Print Name:

Witnessed by:

Date:

Type or Print Name:

DESCRIPTION OF INFORMATION RELEASED:

FORM FDA 3398 (10/10)

DEPARTMENT OF HEALTH AND HUMAN SERVICES

FOOD AND DRUG ADMINISTRATION

PSC Graphics (301) 443-1090

EF

Department of Health and Human Services Food and Drug Administration Commitment to Protect Non-Public Information Employee Agreement

FDA-3398

Text3: I understand that I will be provided access to non-public and confidential information under above Solicitation from FDA which could provide undue advantage to vendors and create potential security breach to FDA network, and I shall not participate, share, represent, release, publish, contribute, or disclose such information to anyone who has not signed this FDA NDA.

The information/details include but are not limited to:

1- FDA contracts, correspondence, and briefings 2- FDA enterprise architecture, software license data, network data, test data or any other details shared 3- Any details shared/gathered/exposed under this Solicitation.

FOR SITE VISIT TO FDA LOSDO ON SOLICITATION 75F40124R00001 - Irvine Operation and Maintenance Requirement posted in SAM.GOV. *** Please understand this is not for a Contract but for a Solicitation named above.

Please sign, print name, contractor information, and return for SITE VISIT to the Contract Specialist, Patricia Natividad, email: Patricia.Natividad@fda.hhs.gov, Include Phone number, address, title, and UEI number from SAM.gov in the email.