Attachment B - Disclosure Exemption Affidavit~1.docx
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- Solicitation number
- S-13700-00012751
- Issued by
- Oregon
About this file
This is a Disclosure Exemption Affidavit template submitted by an applicant to the State of Oregon in response to Request for Grant Application (RFGA) S-13700-00012751 for Mediation and Parenting Plan Support Services. The affidavit permits applicants to identify specific information within their grant applications that they believe qualifies for exemption from public disclosure under Oregon's Public Records Law (ORS 192.311 through 192.478) or the Uniform Trade Secrets Act (ORS 646.461 through 646.475). The affiant, who must be an authorized employee of the applicant organization, certifies under penalty of perjury that designated information constitutes trade secrets or otherwise qualifies for exemption based on specific statutory provisions referenced in Exhibit A accompanying the affidavit.
The affidavit identifies two categories of information eligible for exemption protection: formulas, plans, patterns, processes, tools, mechanisms, compounds, procedures, production data, or compilations of information that are not patented, known only to certain individuals within the organization, used in the applicant's business operations, possess actual or potential commercial value, and provide competitive advantage; and information including drawings, cost data, customer lists, formulas, patterns, compilations, programs, devices, methods, techniques, or processes that derive independent economic value from not being generally known and are subject to reasonable efforts to maintain secrecy. Applicants must complete the affidavit before a notary public and submit it with their application, acknowledging that final determination of exemption status may depend on official or judicial review in accordance with applicable public records law.
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ATTACHMENT B — disclosure exemption AFFIDAVIT ____________________ (Affiant), being first duly sworn under oath, and representing [insert Applicant Name] (hereafter “Applicant”), hereby deposes and swears or affirms under penalty of perjury that:
I am an employee of the Applicant, I have knowledge of the Request for Applications referenced herein, and I have full authority from the Applicant to submit this affidavit and accept the responsibilities stated herein.
I am aware that the Applicant has submitted an Application, dated on or about [insert date] (the “Application”), to the State of Oregon (State) in response to Request for Applications S-13700-00012751, for Mediation and Parenting Plan Support Services, and I am familiar with the contents of the RFP and Application.
I have read and am familiar with the provisions of Oregon’s Public Records Law, Oregon Revised Statutes (“ORS”) 192.311 through 192.478, and the Uniform Trade Secrets Act as adopted by the State of Oregon, which is set forth in ORS 646.461 through ORS 646.475. I understand that the Application is a public record held by a public body and is subject to disclosure under the Oregon Public Records Law unless specifically exempt from disclosure under that law.
I have reviewed the information contained in the Application. The Applicant believes the information listed in Exhibit A is exempt from public disclosure (collectively, the “Exempt Information”), which is incorporated herein by this reference. It is my opinion that the Exempt Information is exempt from disclosure under Oregon’s Public Records Law under the specifically designated sections as set forth in Exhibit A or constitutes “Trade Secrets” under either the Oregon Public Records Law or the Uniform Trade Secrets Act as adopted in Oregon because that information is either:
A formula, plan, pattern, process, tool, mechanism, compound, procedure, production data, or compilation of information that:
is not patented, is known only to certain individuals within the Applicant’s organization and that is used in a business the Applicant conducts, has actual or potential commercial value, and gives its user an opportunity to obtain a business advantage over competitors who do not know or use it.
or Information, including a drawing, cost data, customer list, formula, pattern, compilation, program, device, method, technique or process that:
Derives independent economic value, actual or potential, from not being generally known to the public or to other persons who can obtain economic value from its disclosure or use; and Is the subject of efforts by the Applicant that are reasonable under the circumstances to maintain its secrecy.
I understand that disclosure of the information referenced in Exhibit A may depend on official or judicial determinations made in accordance with the Public Records Law.
Affiant’s Signature State of ___________) ) ss:
County of ________) Signed and sworn to before me on ___________ (date) by ______________________ (Affiant’s name).
Notary Public for the State of _________________ Mediation and Parenting Plan Support Services RFGA S-13700-00012751 Att B
My Commission Expires: _________
| RFP [###-####-##] – [RFP title] | Page 1 of 3 |
| DAS Procurement Services, Version 4.0 – March 25, 2018 | Page 1 of 3 |
EXHIBIT A TO ATTACHMENT B
Applicant identifies the following information as exempt from public disclosure under the following designated exemption(s):
File details come from the government source that posted it. Updated .