WCMBP_Section_J_Attachment_5_-_Non-Disclosure_Agreement_Template_123013FD.doc

United States Department of Labor

(DOL)

Workers’ Compensation Medical Bill Process (WCMBP)

Non-Disclosure Agreement Template December 30, 2013 Office of Workers’ Compensation Programs (OWCP)

U.S. DEPARTMENT OF LABOR

CONTRACTOR EMPLOYEE NON-DISCLOSURE AGREEMENT

I understand that as part of my official duties on the Central Bill Process contract, I may come in contact with Government procurement sensitive information. I, as an official Government contractor employee, will not disclose, publish, divulge, release, or make known, in any manner or to any extent, to any individual other than an appropriate or authorized Government employee, the content of any procurement sensitive information provided during the course of my employment.

I understand that, for the purpose of this agreement, procurement sensitive information includes procurement data, contract information, plans, and strategies and dollars cost. I will use proprietary business information only for official purposes in the performance of my contract with the Department of Labor or one of its Agencies and will disclose such information only to those individuals who have a specific need to know the information in the performance of official Government duties.

I am specifically prohibited from disclosing any such information to employees of my company or any other contractor employees who have not signed this non-disclosure agreement. I will take all reasonable precautions to prevent the unauthorized disclosure and use of such information. If I become aware of any disclosure, I am required to report it to [name of designated DOL Agency official].

I will comply with DOL policies, regulations, and guidelines regarding access to, protection, handling, processing, transmission, distribution, and destruction of sensitive information (including but no limited to that designated “For Official Use Only” and “Classified”). This includes, but is not limited to, protection from unauthorized access, disclosure, modification, misuse, damage, or theft of information or information systems.

I will not copy or remove copies of software licensed to DOL without proper authorization nor will I import or use unauthorized software, firmware, or hardware in the work environment.

I will protect all authentication devices (including, but not limited to, passwords) issued to me. I understand that password sharing or the use of another user’s ID and password is prohibited. I will change my passwords when required by the system and whenever I suspect that they may have been compromised.

I will report all security incidents, including password compromises, violations of software licensing agreements, and computer viruses, to the designated DOL Agency official at the bottom of this form and to my employer.

I will immediately notify the designated DOL Agency official at the bottom of this form when I no longer require access to the network because of transfer, completion of project, etc., and of any changes in my work location or telephone number.

I will use any network connection only for the processing, transmission, and storage of official U.S. Government-related or authorized work only. I will conform at all times to the DOL policies and procedures for the appropriate use of computers.

I will not knowingly introduce any malicious code into the network nor will I attempt to bypass or circumvent network security features or mechanisms.

I will not relocate DOL network equipment or software without proper authorization.

Any computer and/or system connected to DOL networks or systems must be a standalone computer and/or system and must not be connected to any other network, computer, or system without prior authorization.

I, (name of the contractor employee), understand that failure to comply with any or all of the above security requirements could result in the loss of my system and/or network privileges, subject me to civil or criminal penalties, and/or result in removal of my access to DOL facilities and/or sensitive information and information systems. I hereby certify that I have read the non-disclosure agreement described above and I am familiar with the directives and policies governing the disclosure of procurement sensitive information. I will fully and completely comply with this directive and will not disclose such information to any unauthorized person, or use any information obtained for private use or gain at any time, including subsequent to the performance of duties under my contract.

PRINTED NAME OF CONTACTOR EMPLOYEE

COMPANY NAME

SIGNATURE OF CONTRACTOR EMPLOYEE

DATE SIGNED

PRINTED NAME OF DESIGNATED DOL AGENCY OFFICIAL

TELEPHONE NUMBER