Attachment B_Commitment to Protect Non-Public Information (NPI) Employee Agreement_Form FDA 3398.pdf
PDF 287 KB Posted
- Attached to
- FDA Nationwide Ergonomic Services Federal contract opportunity
- Solicitation number
- 75F40126Q00019
About this file
This is a Commitment to Protect Non-Public Information Employee Agreement form (Form FDA 3398) issued by the Food and Drug Administration (FDA) under the Department of Health and Human Services. The form is a template agreement that contractor employees must execute when they require access to non-public information from FDA files in performance of official duties under a contract with the FDA. The employee signatory acknowledges understanding of and commitment to comply with confidentiality requirements established under 21 U.S.C. 331(j), 21 U.S.C. 360j(c), 18 U.S.C. 1905, and other applicable laws and regulations governing protection of confidential information. The signatory further acknowledges that violations of these provisions carry criminal penalties prescribed by law.
The agreement requires completion of standard identification fields including the FDA contract number, the employee's name and employer, execution date, employee signature, and a witness signature with date. The form includes a section for describing the specific non-public information being released. This is a standard FDA compliance document requiring employee acknowledgment of confidentiality obligations prior to accessing sensitive FDA records.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Attachment E_Questions and Answers.xlsx | XLSX spreadsheet | |
| 2026-02-05 RFQ 75F40126Q00019 Amendment 0001 Ergonomics.pdf | ||
| Attachment C_Past Performance Questionnaire.docx | DOCX document | |
| 2026-01-26 RFQ 75F40126Q00019 Ergonomics.pdf | ||
| Attachment A_Pricing Worksheet.xlsx | XLSX spreadsheet | |
| Attachment D_RFQ Question Submittal Form.xlsx | XLSX spreadsheet |
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
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: |
| TextField1: |
| DateTimeField1: |
File details come from the government source that posted it. Updated .