Attachment 4 - NDA.pdf

National Transp ortation Safe ty Board O ffice of the Chie f Financial O ffice r

Washing ton, DC 20594

RFP 9531BM26R0015 Radiological Services

ATTACHMENT 4

NON-DISCLOSURE AGREEMENT

I, ______________________________ intending to be legally bound, hereby consent to the terms and conditions in this Agreement in consideration of my being granted conditional access to certain information that is owned by, produced by, or in the possession of the United States Government. I understand and acknowledge that I have been approved for access for the purpose of Radiological Services under [Contract Number to be entered at time of award].

I understand that I may gain access to information that has not been released to the public, and that such information is Confidential, Proprietary and/or Personally Identifiable Information (PII).

For purposes of this Agreement, "Confidential Information" includes, but is not limited to, any information the NTSB considers to be “investigative information” under 49 C.F.R. § 831.13(a), whether as physical evidence or in documentary form; physical components recovered by the NTSB from accident wreckage; any testing and/or scanning protocols developed as part of this Agreement; any images of accident components; descriptions of the NTSB’s existing, pending, or proposed work; NTSB opinions, analyses, and conclusions whether in draft or final forms;

compilations of data performed for the NTSB by contractors and third parties; correspondence that includes preliminary discussions or deliberations; any information relating to the NTSB’s ongoing accident investigations; and any other information, records, or data marked “Confidential” and supplied by the NTSB.

For purposes of this Agreement, “Proprietary Information” is third party information provided to the NTSB, which the third party considers to be trade secrets or protected commercial or financial information. Proprietary Information may include, but is not limited to, processes, know-how, and other protected technologies developed by that third party and exempt from release under the Freedom of Information Act, 5 United States Code (U.S.C.) § 552(b)(4).

For purposes of this Agreement, PII is defined as follows: “any information about an individual maintained by an agency, including, but not limited to (1) education, financial transactions, medical history, and criminal or employment history and (2) information which can be used to distinguish or trace an individual's identity, such as name, social security number, date and place of birth, mother’s maiden name, and biometric records, etc., including any other personal information which is linked or linkable to an individual.” Office of Management and Budget Memorandum, M-06-19 (July 12, 2006). I understand that PII is information that can be used to uniquely identify, contact, or locate a single person or can be used with other sources to uniquely identify a single individual, and may include, but is not limited to, pilot certificate numbers, mariner identification numbers, or commercial driver’s license numbers.

Be advised that all reports and/or written, electronic, and photographic items and data developed or acquired in the performance of work for or with the NTSB are, for the purpose of this agreement, the property of the United States and are, under 18 U.S.C. § 641, things of value. Be advised that 18 U.S.C. § 641 provides, in pertinent part, as follows:

Whoever...steals, purloins, or knowingly converts to his use or the use of another, or without authority, sells, conveys or disposes of any record...or thing of value of the United States or of any department or agency thereof...Shall be fined not more than $10,000 or imprisoned not more than one year, or both.

I understand that I am bound to maintain the confidentiality of any Confidential/Proprietary/PII information provided to me. I will honor and comply with any and all dissemination restrictions cited or verbally relayed to me by the NTSB or any other proper authority. In the event that I have access to, observe, or hear Personally Identifiable Information (PII) of any individual, I shall not disclose such information and will treat it as confidential information, in accordance with standards promulgated by the Office of Management and Budget. All Confidential/Proprietary/PII information shall not be disclosed to any third party and shall be protected with reasonable care. I acknowledge and understand that should I inadvertently receive materials for which the NTSB has not granted me access, I will promptly return the materials and not make copies of them in whole or in part.

ATTACHMENT 4

NON-DISCLOSURE AGREEMENT

RFP 9531BM26R0015 Radiological Services

I shall not alter or remove markings which indicate that information is Confidential/Proprietary/PII. I agree that if I use information from a Confidential/Proprietary document or other medium, I will carry forward any markings or other required restrictions to derivative products and protect them in the same manner as the original. I shall not use any Confidential/Proprietary information received from the NTSB except for purposes as may be stated in this Agreement.

This Agreement and the furnishing of Confidential/Proprietary/PII information as provided herein shall not be construed as establishing, either expressly or by implication, any grant of rights or licenses to me. By signing this form, I hereby agree to:

(1) Receive and hold all Confidential/Proprietary information in strict confidence;

(2) Safeguard such information from unauthorized use and from disclosure or release to unauthorized third parties, and report promptly to the appropriate official any loss, theft, misuse, misplacement, inadvertent access, unauthorized disclosure, or any other security violations I have knowledge of, whether or not I am personally involve; and

(3) Return all Confidential/Proprietary information to the NTSB:

(a) Upon demand by an authorized individual; and/or

(b) Upon conclusion of my duties, association, or support of the NTSB; and/or

(c) Upon determination that my official duties do not require further access to such information.

This Agreement is made and intended for the benefit of the United States and may be enforced by the United States Government or the NTSB contractor for whom I work. By granting me conditional access to information in this context, the United States Government may seek any remedy available to it to enforce this Agreement, including, but not limited to, application for a court order prohibiting disclosure of information in breach of this Agreement. I understand that if I violate the terms and conditions of this Agreement, such violation may result in the cancellation of my conditional access to information covered by this Agreement; termination of my participation; and I could be subject to administrative, disciplinary, civil or criminal action, as appropriate under the laws, regulations, directive or treaties applicable to the category of information involved. The United States Government and the NTSB contractor for whom I work have not waived any statutory or common law evidentiary privileges or protections that they may assert in any administrative or court proceeding to protect any Confidential/Proprietary/PII information to which I have been given conditional access under the terms of this Agreement.

Each provision of this Agreement is severable. If a court should find any provision of this Agreement to be unenforceable, all other provisions shall remain in full force and effect.

Signing this Agreement does not bar disclosure to Congress or to an authorized official of an Executive Agency or the Department of Justice that is essential to reporting a substantial violation of law.

The NTSB enters into this agreement with the below signed party as permitted under 49 U.S.C. § 1113(b)(1)(B).

The obligations contained in this Agreement are in consideration of being granted access to NTSB controlled confidential information, protected third party information, and PII that is in the possession of the NTSB. I acknowledge that all obligations imposed by this Non-Disclosure Agreement concerning the use and disclosure of NTSB Confidential Information apply for the duration of my participation and for a period of two years thereafter.

There are no time limits on the obligations to keep confidential PII and third party Proprietary Information.

I represent and warrant that I have the authority to enter into this Agreement.

AGREED:

Signature:_________________________________

Print Name:________________________________

ATTACHMENT 4

NON-DISCLOSURE AGREEMENT

RFP 9531BM26R0015 Radiological Services

Contractor Company Address:__________________________________Telephone:__________________

Date:____________________________

For the NTSB:

Signature:_________________________________

Print Name: Bryan J. Moy

Address: 490 L’Enfant Plaza, SW Washington, D.C. 20594 Telephone: 202.314.6282

Date: ______________________________

This form is not subject to the requirements of P.L. 104-13, “Paperwork Reduction Act of 1995,” 44 U.S.C., Chapter 35.