Attachment F - Non-Disclosure Agreement.pdf
PDF 108 KB Posted
- Attached to
- National Maternal Mental Health Hotline
- Solicitation number
- 75R60223Q00222
About this file
This document contains a non-disclosure agreement template for contractors supporting the Department of Health and Human Services. The template requires contractors and their employees with access to privileged agency information to agree not to release, publish, or disclose such information to unauthorized personnel, and to protect it in accordance with relevant laws regarding confidentiality of privileged data. Signatories acknowledge understanding criminal penalties for violations under certain statutes governing privacy of government information. The template must be signed by contractors and witnessed upon award of the related contract.
The associated federal contract opportunity is a solicitation from the Health Resources and Services Administration to establish a National Maternal Mental Health Hotline providing counseling and referral services for pregnant and postpartum individuals experiencing mental health conditions.
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Text version
ATTACHMENT F - NON-DISCLOSURE AGREEMENT
This NDA is to be completed by a contractor upon award of contract.
Information Technology Systems Security Contractor Non-Disclosure Agreement
The following statement is to be completed by all contractor employees who may be involved in the performance of contract work.
Access to privileged information from HHS information technology systems is required in the performance of my official duties under Contract # XXXXX between the Department of Health and Human Services (HHS) and my employer (XXXXX).
I, _________________________________, ON THIS _____DAY __________ OF ____, hereby agree that I shall not release, publish, or disclose such information to unauthorized personnel, and I shall protect such information in accordance with the provision of 18 U.S.C. 641, 18 U.S.C. 1905, 18 U.S.C. 2071, Public Law 96-511, and other pertinent laws and regulations governing the confidentiality of privileged information.
I understand the provision of 18 U.S. C. 641, 18 U. S. C. 1905, 18 U. S. C. 2071 and Public law 96-511, and that I am subject to criminal penalties prescribed by law for any violations thereof.
Signed: ___________________
Date: ___________________
Witnessed by: ___________________
Date: ___________________
Cc:
Contracting Specialist
COR
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