J_4_Nondisclosure_Agreement-Sample.pdf

DTFH61-14-R-00005

Attachment J-4

FHWA Office of Acquisition Management Non-Disclosure Agreement

NON-DISCLOSURE AGREEMENT

I, the undersigned, certify that I will not discuss or reveal any information concerning the following to anyone who is not a Federal Highway Administration ( FHWA) employee with a need to know, or an approved FHWA contractor employee* involved in the following:

Any technical and / or program information concerning current and future work, work statements, plans, reports; any procurement sensitive information, including contractor proposals, and proprietary information of other Contractors under any FHWA contracts and agreements; information on Government programs and initiatives, including all confidential and proprietary data and information of the Federal Government, and specifically, any work related to this contract, DTFH61- 14-D-_____, and more specifically, as related to work being performed under this contract for the Turner Fairbank Highway Research Center (TFHRC) and / or its customers.

I certify that such information and data will not be shared, copied, discussed, or shown to anyone who is not a FHWA employee or an approved FHWA contractor employee* and will be used exclusively and internally for the FHWA TFHRC Programs.

I certify that no one other than a FHWA employee with a need to know will receive access to the information and data described above unless they have signed this Non- Disclosure Agreement and submitted the signed agreement to the FHWA Contracting Officer with cognizance over FHWA Contract number DTFH61-14-D-_____.

In addition, I fully realize that any breach by me of my obligation to safeguard and not to disclose to unauthorized persons any information made available to me concerning the above items may result in appropriate disciplinary action, provided for by law or regulation, being taken against me by duly constituted authority.

Any questions regarding this document shall be immediately addressed to the FHWA Contracting Officer.

Print Name: _____________________________________________

Print Firm Name: _________________________________________

Working Under FHWA Contract No. DTFH61-14-D-_____- “Advanced Crash Analysis and Federal Outdoor Impact Laboratory (FOIL) Technical Support Services.”

Signature: _______________________________________________

Date: ________________________________________________

* Denotes contractor employee(s) previously approved to participate on related FHWA Office of Corporate Research, Technology, and Innovation Management (HRTM) work, programs and initiatives by the FHWA Contracting Officer.

NON-DISCLOSURE AGREEMENT