ATTACHMENT D Statement of Confidentiality.pdf

This document is a Statement of Confidentiality form issued by the State of Colorado Department of Revenue, Colorado Lottery Division for contract DQ DOR160011-ADS. The form establishes confidentiality obligations for employees, officers, staff members, temporary employees, and subcontractors of contractors working with the department. Signatories acknowledge that they may have access to State of Colorado Department of Revenue and Lottery computer systems information and records, and must maintain the confidentiality of all such information at all times. The form requires acknowledgment that computer systems and financial record information will not be distributed, sold, or shared with any third party, nor used except as expressly authorized by the State.

The form stipulates that disclosure of confidential information may result in legal action against the individual signatory, the contractor, and any involved third party, with the State bearing no responsibility for defense costs or related expenses. Signatories must confirm compliance with all State and Federal laws and contractual terms and conditions pertaining to the security and confidentiality of the Lottery's computer systems. The document requires signature, date, printed name, title, and company name from each individual required to execute the confidentiality agreement.