ATTACHMENT 4 Non-Disclosure and Statement of Financial Interests.pdf

ATTACHMENT 4

CERTIFICATE OF NON-DISCLOSURE AND STATEMENT OF FINANCIAL INTEREST

I understand that I may have access to information received in confidence from non-Federal entities including, but not limited to, technical approaches, past performance information, trade secrets, inventions, discoveries, financial and technical reports, and cost or pricing-related information. I may also have access to other procurement information such as the names, identities, and number of non- Federal entities under consideration and the methods, procedures, standards, and ratings used in the evaluation process.

I understand that information gained during the procurement process may constitute “source selection information” and “contractor bid and proposal information” as those terms are defined in FAR §§ 2.101 and 3.104-1. I also understand that federal law (41 U.S.C. § 423, as implemented by FAR §§ 3.104-2, 3.104-3, 3.104-4, 3.104-7, and 3.104-8) prohibits the unauthorized disclosure of such information. I agree not to disclose such information to any individual outside of the acquisition team without authorization from the Contracting Officer or Legal Advisor. I also understand that my obligation not to disclose such information does not terminate with the award of a contract or any other contract action. Finally, I understand that my unauthorized disclosure of such information could result in termination of my employment and/or disciplinary action, including criminal prosecution.

I have examined the list of offerors dated that the Contracting Officer has provided to me.

I have reviewed my personal and financial interests, as well as those of my spouse, my dependents, and members of my household. To the best of my knowledge and belief, I affirm that those interests are not likely to create a real or apparent conflict of interest with my participation in this acquisition. I will immediately notify the Contracting Officer if a proposal is received from a firm in which I, my spouse, my dependent(s), or any member(s) of my household has a personal or financial interest. I acknowledge that a personal or financial interest may require my removal from further participation in this source selection.

Check One:

I HAVE a current Confidential Financial Disclosure Report (OGE Form 450) on file with MSC.

I DO NOT HAVE an OGE Form 450 on file with MSC. I will complete one and submit it to the

Contracting Officer prior to participating in this procurement.

With respect to the foregoing, I understand that these provisions are consistent with and do not supersede, conflict with, or otherwise alter the employee obligations, rights, or liabilities created by existing statute or Executive order relating to (1) classified information, (2) communications to Congress, (3) the reporting to an Inspector General of a violation of any law, rule, or regulation, or mismanagement, a gross waste of funds, an abuse of authority, or a substantial and specific danger to public health or safety, or (4) any other whistleblower protection. The definitions, requirements, obligations, rights, sanctions, and liabilities created by controlling Executive orders and statutory provisions are incorporated into this agreement and are controlling.

(Printed Name) (Signature and Date)

Counsel Review:

I find no actual or apparent conflict of interest exists with any of the offerors. I find a conflict of interest exists as follows:

(Printed Name) (Signature and Date)