Attachment B - Non-Disclosure Agreement.pdf

PDF 256 KB Posted

Attached to
Non-emergency Medical Transportation Program for Shinnecock
Solicitation number
75H70424Q00034
Issued by

About this file

This document is a Contractor Non-Disclosure Agreement related to a federal contract opportunity for Shinnecock Service Unit Transportation Services, Solicitation Number 75H70424Q00034.

The agreement states that the contractor will have access to sensitive information, such as personally identifiable information (PII), non-public information, confidential information, and/or Controlled Unclassified Information (CUI) from the Department of Health and Human Services (HHS). The contractor agrees to not release, publish, or disclose such information to unauthorized personnel, and to protect the information in accordance with relevant laws and regulations. The contractor affirms that they have received a briefing on their responsibilities under this agreement, and understands that a violation may subject them to criminal and civil penalties. The agreement must be signed by the contractor and witnessed.

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Text version

Title: Shinnecock Service Unit Transportation Services; Solicitation Number 75H70424Q00034 Attachment B

Contractor Non-Disclosure Agreement

Information Technology Systems Security Contractor Non-Disclosure Agreement

Access to sensitive information (such as personally identifiable information [PII]), non-public information, confidential information, and/or Controlled Unclassified Information (CUI) from the files of the Department of Health and Human Services (HHS) is required in the performance of my official duties, under contract number between (HHS/IHS) and my employer (Employer’s Name) .

I agree that I shall not release, publish, or disclose such information to unauthorized personnel, and I shall protect such information in accordance with relevant laws and regulations available for research and review at any Law Library. Among these laws may be various provisions of:

a. 18 U.S.C. 641 (Criminal Code: Public Money, Property or Records);

b. 18 U.S.C. 1905 (Criminal Code: Disclosure of Confidential Information); and

c. 44 U.S.C. Chapter 35, Subchapter I (Paperwork Reduction Act).

I affirm that I have received a written and/or verbal briefing by my company concerning my responsibilities under this agreement. I understand that violation of this agreement may subject me to criminal and civil penalties.

Signed:

Type or Print Name:

Date:

Witnessed by:

Date:

Copies are to be retained by: IHS Contracting Officer Representative Contractor’s Contract Management Individual Signatory

Contractor Non-Disclosure Agreement

File details come from the government source that posted it. Updated .