J-11 FAA Non-Disclosure Agreement.pdf

J-11 FAA Non-Disclosure Agreement

Form Date May 19, 2016

AGREEMENT REGARDING NON-DISCLOSURE and CONFLICT OF INTEREST FOR Navigation Technical

Assistance Contract (NAVTAC) II

The purpose of this Agreement is to ensure that no information of a commercially sensitive or source selection sensitive nature, which is obtained by virtue of participation on the acquisition team, is disclosed by members of the team to other persons, companies or organizations; and that such information is not used by other persons, companies or organizations to obtain an unfair advantage.

I (full legal name), am employed by:

a support contractor

__________________________________________________________________(Company name), a federal employee____________

(agency & Company name)

NON-DISCLOSURE OF INFORMATION

I acknowledge the following:

1. I will be involved in activities related to the NAVTAC II acquisition. As a result, I understand that I may learn about and may have access to Information. For the purposes of this agreement, the term Information is defined as, but not limited to, proprietary information, sensitive unclassified information, procurement-sensitive information, source-selection-sensitive information, privacy information, and information of a confidential nature. Information includes, but is not limited to, program strategies, plans, and analyses;

budgeting information; technical analyses; technical data; statements of work; acquisition plans; contractor bid and proposal information; independent government cost estimates; and cost or pricing data. Information may be in any medium or format, including but not limited to, oral, written, graphic, electronic, or machine-readable and may or may not be specifically designated as protected.

2. I will not discuss, divulge, or disclose any Information to any person or entity. I will safeguard and prevent the unauthorized disclosure of Information in accordance with all applicable statutes, regulations, and orders. I will return all Information and all copies and reproductions thereof upon request of the Federal Aviation Administration (FAA). I understand that the unauthorized disclosure, use, or mishandling of Information may adversely affect the owner of the Information, the national interest, and the conduct of federal programs. I understand that federal and state laws and regulations provide for criminal and civil penalties for improper disclosure, including but not limited to:

For Federal Employees – 18 U.S.C. § 1905 For Contractors - 5 U.S.C. § 552a and 18 U.S.C. §§ 641, 1832, and 1905.3.

The restrictions described in paragraph 2 do not extend to Information that has become generally known or available to the public without breach of this agreement; is disclosed with the prior written approval of the appropriate FAA Contracting Officer; or is disclosed pursuant to court order after notification to the appropriate FAA Contracting Officer.

4.These provisions are consistent with and do not supersede, conflict with, or otherwise alter the employee obligations, rights, or liabilities created by existing statute or executive order relating to (1) classified information; (2) communications to Congress; (3) the reporting to an Inspector General of a violation of any law, rule, or regulation or of mismanagement, a gross waste of funds, an abuse of authority, or a substantial and specific danger to public health or safety; or (4) any other whistleblower protection. The requirements, obligations, rights, sanctions, and liabilities created by controlling executive orders and statutory provisions are incorporated into this agreement and are controlling.

My participation in NAVTAC II related activities constitutes direct involvement with procurement activities:

I will be serving as member of or advisor to, procurement and source selection activities for the

NAVTAC II acquisition.

I will be involved in the development of the NAVTAC II requirements, screening information requests, cost estimation, or source selection activities. Please list and describe your activities briefly in bullet form in as many bullets as you may need to list the extent of your involvement. If you need more space, please provide the information on an attachment sheet.

If not directly involved with procurement activities (involved in development of program concepts, requirements, and cost estimation) please acknowledge the following:

In the same manner as acknowledged above for direct involvement, I agree to not discuss or share any non-public NAVTAC II procurement related information provided to me, or any information or products developed by me based on this information, with anyone besides the Government official responsible for my tasking. I agree to immediately report to the Contracting Officer any potential or possible violation of this Agreement. Initials __

CONFLICT OF INTEREST

A procurement team member (e.g., program officials, contracting personnel, legal counsel, and others supporting a program), Office of Dispute Resolution for Acquisition (ODRA) member, or other Federal member who has a real or apparent conflict of interest, and who is a Federal employee, must withdraw from participation in the source selection process if law (18 U.S.C. 208) or regulation (5 CFR Part 2635) requires it. Considerations of equity and integrity of the procurement process require that non- Government members of a procurement team be held to the same standards.

If involved with procurement activities please acknowledge the following:

I am neither currently nor have I previously been employed by any person or organization with an actual or potential interest, interaction, and/or involvement in this procurement. If I have been, I will promptly disclose to the NAVTAC II Contracting Officer this employment. Additionally, I attest that neither I, my spouse, nor any of my dependent children or other relatives who are residents of my household 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 such entity; have any financial commitments to any such entity; or serve as an officer, director, trustee, general partner, or employee of any such entity. Neither I nor, to the best of my knowledge and belief, my spouse or any of my dependent children or other relatives who are residents of my household have any intention or expectation of obtaining employment with;

contracting with; or acquiring stocks, stock options, bonds, or any other financial interest in or with respect to such an entity. In the event that any of the facts underlying my certification of this paragraph change—i.e. I become aware of a conflict—I will immediately notify the NAVTAC II Contracting Officer.

I hereby agree to abide by the FAA Acquisition Management System and 5 CFR 2635, Standards of Ethical Conduct for Employees of the Executive Branch, 18 U.S.C. 201-209,216 and the provisions of The Procurement Integrity Act, 41 U.S.C. § 423. Further, I hereby certify to the following:

By signing this form, I agree to all of the above declarations and to abide by 5 CFR 2635, Standards of Ethical Conduct for Employees of the Executive Branch; 18 USC 201-209, 216, Conflict of Interest Laws;

41 USC 423 Procurement Integrity Act; and 18 USC 1905, Disclosure of Confidential Information.

I understand that failure to comply with the above will result in termination of my participation in the source selection activities for this procurement and may result in disciplinary action and/or referral for civil or criminal action. I will promptly inform the FAA’s NAVTAC II Contracting Officer in writing of any changes that may affect the agreement or potential violations of the same.

ACKNOWLEDGEMENT (Contractors please provide a copy of this form to your manager.)

Print name:

Title:

Signature/Date:

Email/Phone: