ICU_Boom_Attachment_Number_6.pdf

Attachment ICU Nursing and Respiratory Boom Contractor Non-

6: Disclosure Agreement

Contractor Non-Disclosure Agreement

NOTE: To be completed by a contractor upon award of contract.

Information Technology Systems Security Contractor Non-Disclosure Agreement

Access to sensitive information, non-public information, confidential information, and/or Controlled

Unclassified Information (CUT) from the files of the Department of Health and Human Services (MIS) is required in the performance of my official duties, under contract number between

(HEIS TIC Name or Component) 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 Infollnation)

c) Public Law 96-511 (Paperwork Reduction Act)

d) 5 U.S.C. 552a (Privacy Act)

I affinn 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: HHS Project Officer Contractor's Contract Management Individual Signatory