Attachment H-2 FAA Major Systems NDA and COI Form_FINAL.pdf

Contractor Employee Non-Disclosure and Conflict of Interest Acknowledgements | 1 AAQ-200, April 2023

CONTRACTOR EMPLOYEE NON-DISCLOSURE AND CONFLICT OF INTEREST

ACKNOWLEDGEMENTS

FOR SINGLE SOURCE / NON-COMPETITIVE AAQ-200 PROCUREMENTS

This document serves as notice of your duties and obligations as someone working on behalf of a Government Contractor seeking access to certain information or data as well as the potential penalties if you fail to safeguard information or data. This acknowledgement also confirms your continuing obligation to disclose conflicts of interest.

NON-DISCLOSURE ACKNOWLEDGEMENTS

1. I have been assigned to work on the _______________________ procurement or I am requesting access to information or data on ____________________ as part of the performance of my duties pursuant to my employer’s contract with the FAA.

2. I acknowledge I may be part of the procurement team, as the Federal Aviation Administration (FAA) Acquisition Management System (AMS) Policy, in Appendix C, defines the procurement team as “the contracting officer, legal counsel, program officials and other supporting staff responsible for the successful completion of a specific procurement.”

3. The terms “information” and “data” are defined as, but not limited to, proprietary information, procurement-sensitive information, source-selection-sensitive information, sensitive unclassified information, defense critical infrastructure security information, sensitive security information, privacy information, and all other information of a confidential nature. Examples of such information include, but are not limited to, program strategies, plans, recommendations, and analyses;

budgeting information; technical analyses; technical data; statements of work; source selection plans, source selection evaluation memoranda or reports; acquisition plans; contractor bid and proposal information; independent government cost estimates; and cost or pricing data. Information may be produced by the United States government, other governments, or private entities. Information may be in any medium or format, including but not limited to, oral, written, graphic, numeric, cartographic, narrative, electronic, or machine-readable, and may or may not be specifically designated as protected.

4. Per AMS Guidance T.3.1.6, I acknowledge that I may encounter proprietary, procurement sensitive, confidential information, and/or other sensitive data and information. I agree to comply with the Procurement Integrity Act, 41 U.S.C. § 2102 et seq., as applicable to the FAA1.

5. Per AMS Clause 3.13-15 Confidentiality of Data and Information, I have received formal training from my company which made me aware of the requirement to maintain confidentiality of data and information.

1 49 U.S.C. § 40110(d)(3) states that 41 U.S.C. § 2101, Definitions, and 41 U.S.C. § 2106, Reporting information believed to constitute evidence of offense, do not apply to the AMS.

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6. Per AMS Clause 3.13-15 Confidentiality of Data and Information, I have signed a Non- Disclosure Agreement (NDA) with my company that states that I agree to abide by any restrictive use conditions and will not, during employment or anytime thereafter, disclose or use for current or future benefit of any party any of the data (to include any form of Sensitive Unclassified Information (SUI) described in FAA Order 1600.75 or subsequent order) or information not publicly available that I received in connection with the work under the contract.

7. Per AMS Guidance T3.1.6, I acknowledge that I have reported and will continue to report any suspected or actual improper disclosures of procurement sensitive information to the System Contracting Officer(s).

8. I acknowledge that the following non-exhaustive list of federal laws provide for criminal and civil penalties for improper disclosure: 5 U.S.C. § 552a and 18 U.S.C. §§ 641, 1832, and 1905. This form does not alter any remedies under my employer’s contract with the FAA.

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CONFLICT OF INTEREST ACKNOWLEDGEMENT

1. Per AMS Policy 3.1.5 and AMS Guidance T3.1.3 and T3.1.5, I understand that the integrity of the procurement process requires that as a member of the procurement team and/or someone who has access to the information or data requested I am held to the same standards as Government employees when it comes to conflicts of interest.

2. Per AMS Guidance T3.1.3 and T3.1.5, I confirm that the procurement and/or access to the information or data requested will not affect the financial interests of my household. Neither I nor my spouse, or any of my dependent children, or other blood relatives who are residents of my household (hereinafter “I”), now own any bonds, stocks, or stock options, or have any other financial interest, including but not limited to current or future employment or contract rights, in or with respect to any of the companies listed on Appendix A.2 “I” do not have any financial commitments to any of the companies listed on Appendix A. “I” am not currently serving as an officer, director, trustee, general partner or employee of any of the companies listed on Appendix A.

3. I confirm that neither I, nor to the best of my knowledge and belief, my spouse or any of my minor children have any intention or expectation of obtaining employment with, contracting with, or acquiring stocks, stock options, or bonds in or with respect to any of the companies listed on Appendix A.

4. Per AMS Guidance T3.1.5, I will disclose to the System Contracting Officer(s) any relevant facts that might make a reasonable person question my impartiality.

5. Per AMS Guidance T3.1.5, I confirm that if any new information arises, such as a company is added to Appendix A or if “I” have a change in my financial, business or employment relationship, I will notify the System Contracting Officer(s) and update the disclosure statement.

2 If Appendix A is not filled out, then “Appendix A” refers to the major system contractor, its subsidiaries, and its subcontractors.

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6. I will follow the System Contracting Officer(s) direction on the scope of my participation while there is a pending decision on my involvement due to an apparent or actual conflict.

7. I confirm that I have read this document carefully, and my questions, if any have been answered to my satisfaction by the System Contracting Officer(s).

Signature of Contractor Employee Date

Print Name of Contractor Employee

Name of Contractor

Contractor Employee’s Email and Telephone Number

Print Name of System Contracting Officer

System Contracting Officer’s Email and Telephone Number

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APPENDIX A

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