Attachment J7 - FDA Form 3398 Commitment to Protect Non-Public Information .pdf
PDF 273 KB Posted
- Attached to
- NCTR Road & Drainage Improvements Federal contract opportunity
- Solicitation number
- FDA-RFP-75F40120R00012
About this file
This document contains an employee agreement and commitment to protect non-public information form required for a federal contract for road and drainage improvements at the National Center for Toxicological Research. The form outlines an agreement for employees to not disclose non-public information from the Food and Drug Administration as required in the performance of official duties under Contract Number 75F40120R00012. The form requires the employee's signature and date, as well as a witness signature and date, to acknowledge understanding of relevant laws governing confidentiality of non-public information and potential criminal penalties for violations. The related federal contract opportunity is for road and drainage improvements at the specified location, with the solicitation issued by the Department of Health and Human Services Food and Drug Administration Office of Acquisition and Grant Services. A site visit is scheduled and attendees are required to wear face coverings per CDC guidelines.
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Text version
COMMITMENT TO PROTECT NON-PUBLIC INFORMATION
EMPLOYEE AGREEMENT
Whereas access to non-public information from the files of the Food and Drug Administration (FDA) is required in the performance of my official duties, under Contract Number between FDA and my employer
I, on this day of , 200 hereby agree that I shall not further release, publish or disclose such information and that I shall protect such information in accordance with the provisions of 21 U.S.C. 331(j), 21 U.S.C. 360(j), 18 USC. 1905 and other pertinent laws and regulations governing the confidentiality of non-public information.
I understand the provisions of 21 U.S.C. 331(j), 21 U.S.C. 360(j), 18 USC. 1905 and that I am subject to criminal penalties prescribed by law for any violation(s) thereof.
Signature: Date:
Type or Print Name:
Witnessed by: Date:
Type or Print Name:
DESCRIPTION OF INFORMATION RELEASED:
FORM FDA 3398 (10/03)
DEPARTMENT OF HEALTH AND HUMAN SERVICES
FOOD AND DRUG ADMINISTRATION
PSC Graphics (301) 443-1090 EF
COMMITMENT TO PROTECT NON-PUBLIC INFORMATION
EMPLOYEE AGREEMENT
Whereas access to non-public information from the files of the Food and Drug Administration (FDA) is required in the performance of my official duties, under Contract Number between FDA and my employer I, on this day of , 200 hereby agree that I shall not further release, publish or disclose such information and that I shall protect such information in accordance with the provisions of 21 U.S.C. 331(j), 21 U.S.C. 360(j), 18 USC. 1905 and other pertinent laws and regulations governing the confidentiality of non-public information.
I understand the provisions of 21 U.S.C. 331(j), 21 U.S.C. 360(j), 18 USC. 1905 and that I am subject to criminal penalties prescribed by law for any violation(s) thereof.
Signature:
Date:
Type or Print Name:
Witnessed by:
Date:
Type or Print Name:
DESCRIPTION OF INFORMATION RELEASED:
FORM FDA 3398 (10/03)
DEPARTMENT OF HEALTH AND HUMAN SERVICES
FOOD AND DRUG ADMINISTRATION
PSC Graphics (301) 443-1090
EF
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