IBWC Form 358A Nondisclosure Agreement Release SBU.pdf
PDF 87 KB Posted
- Attached to
- Retamal Dam Buoy System
- Solicitation number
- 191BWC26R0006
About this file
This is a certification and release form issued by the International Boundary & Water Commission (IBWC) for use upon contract completion or RFP/solicitation conclusion.
The form serves two primary functions. First, it documents the release of a prime contractor from their Nondisclosure Agreement (IBWC Form 359) related to a specific contract. Only the USIBWC may release the prime contractor from this obligation, while prime contractors are responsible for releasing their subcontractors and suppliers/vendors from any flow-down nondisclosure agreements. Second, the form certifies the destruction of all Sensitive But Unclassified (SBU) data by the contractor and all subcontractors and suppliers/vendors to whom such data was issued, ensuring destruction occurs in a manner that precludes recognition or reconstruction. The form includes checkboxes to note exceptions where written permission has been granted to retain SBU data per IBWC Form 358 15.a, or where USIBWC has been provided SBU data for storage per IBWC Form 358 15.b. The form requires signature and date from an authorized representative of the releasing organization, along with contact information for the person completing the certification. The form must be converted to PDF prior to submission to USIBWC.
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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 .