IBWC_Form_358A_Nondisclosure_Agreement_Release_SBU.pdf
PDF 87 KB Posted
- Attached to
- Replacement of Hydraulic System for Penstock #5
- Solicitation number
- 191BWC25B0003
About this file
This is an International Boundary & Water Commission (IBWC) Nondisclosure Agreement Release form (IBWC Form 358A) for the certification and destruction of Sensitive But Unclassified (SBU) information. The form serves two primary functions: 1) releasing a company from its previous Nondisclosure Agreement (IBWC Form 359) related to a specific contract, and 2) certifying that the company and its subcontractors have destroyed all SBU data in a manner that prevents recognition or reconstruction, unless specific written permission was granted to retain the data. The form requires signatures from the releasing representative and the person completing the form, with spaces to document project details, contract number, and company information.
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Text version
IBWC Form 358A(COND) Updated 9/29/2022 Page 1 of 1 www.ibwc.gov
INTERNATIONAL BOUNDARY & WATER COMMISSION
NONDISCLOSURE AGREEMENT RELEASE
Certification of Destruction of Sensitive But Unclassified (SBU) Information
Project: Contract Number:
Prime Contractor:
NOTE: All references to "Contract" also apply to the associated RFP/Solicitation or Task Order, as appropriate.
Agreements signed during the RFP/Solicitation period do not need to be re-signed once Contract is awarded.
Release of Nondisclosure Agreement The company noted below is released from their Nondisclosure Agreement (IBWC Form 359) in relation to this Contract.
Signature of Releasing Representative Date Signed
Printed Name of Releasing Representative Representative's Title
Only the USIBWC may release the Prime Contractor from their Nondisclosure Agreement.
The Prime Contractor shall release their subcontractors and suppliers/vendors from flow-down Nondisclosure Agreements.
Certification of Destruction of SBU Data
1. Prior to signing this form, note if either of the following apply to this Contract.
Written permission has been granted allowing retention of SBU data per IBWC Form 358 15.a.
USIBWC has been provided SBU data to store per IBWC Form 358 15.b.
2. With my signature below, I certify that my company and all subcontractors and suppliers/vendors to whom the data was issued have destroyed all SBU data in a manner to preclude recognition or reconstruction unless written permission was granted to keep a copy of the SBU data.
Signature Date Signed
Information of Person Completing Form
Printed Name:
Title:
Company Name:
Company Address:
Phone Number: Email:
The person completing this form is completing it as a representative of the company stated whether that company is an individual, partnership, joint venture, LLC, or corporation.
| Project: |
| Contract Number: |
| Prime Contractor: |
| Printed Name 1: |
| Printed Name 2: |
| Company Name: |
| Company Address: |
| Phone Number: |
| Email: |
| Button: |
| Data: Off |
| Permission: Off |
| Signature: |
| Click here to add signature image to form: Click below to add signature image to form |
| Check: No |
| Date: |
| Button2: |
| Print: |
| Note: Form must be "printed" to pdf prior to submittal to USIBWC. |
| buttonClear: |
| Printed Name of Accepting Representative: |
| Representatives Title: |
| Signature2: |
| Click2 here to add signature image to form: Click below to add signature image to form |
| Date2: |
| Note2: Use signature image |
| Check2: No |
| Note1: Use digital signature |
| Button3: |
File details come from the government source that posted it. Updated .