Attachment 3 - Non Disclosure Agreement.docx

N0001426R3002, Attachment 3, NDA

CERTIFICATION STATEMENT ON PERSONAL CONFLICTS OF INTEREST,

NON-PERSONAL SERVICES AND NONDISCLOSURE AGREEMENT

CONTRACTOR EMPLOYEES

Acquisition Function: Identify the Acquisition Function involved (e.g., acquisition planning, development of statement of work or requirements, assistance with evaluation of proposals or source selection and other functions listed in FAR 3.1101 ).

Role of Contractor Employee: Describe the role of the contractor employee in the Acquisition Function identified above (e.g., evaluation team member or advisor, technical expert, or consultant. If this Certification Statement and Non-Disclosure Agreement are being executed for support of a specific contract, grant, solicitation or other particular matter, identify the particular matter, to include the applicable identifying number.

Support Services Contract Number (under which the contractor employee’s services are provided):

[Note to Contracting Officer: check the support contract identified above to ensure that FAR clause 52.203-16, Preventing Personal Conflicts of Interest, is included in the contract or task order.] ______ 52.203-16

Carefully read the following information

FAR Subpart 3.11 Preventing Personal Conflicts of Interest for Contractor Employees Performing Acquisition Functions

In accordance with these provisions, contractor employees performing certain acquisition-related functions for the Government (a) must disclose and avoid/prevent personal conflicts of interest and the appearance thereof, and (b) may not use or disclose for personal gain any non-public information to which they have access by reason of performance on a Government contract.

A Personal Conflict of Interest is a situation in which a covered contractor employee has a financial interest, personal activity or relationship that could impair his or her ability to act impartially and in the best interest of the Government when performing under a contract. For example, the contractor employee, or a person whose financial interests are imputed to him/her, may have a financial interest -- through investments, prospective employment or business, or gifts – in the prime or in a subcontractor involved in an acquisition in which the contractor employee is providing an Acquisition Function. Sources of Personal Conflicts of Interest include:

· Financial interests of the contractor employee, close family members or other members of his or her household;

· Other employment or financial relationships (including seeking or negotiation for prospective employment or business; and

· Gifts (including travel).

FAR Subpart 37.104 Personal Services Contracts

This provision stipulates that a personal services contract is characterized by the employer-employee relationship it creates between the Government and the contractor’s personnel. The awarded contract identified above is for support services to assist ONR in accomplishment of the mission and is not a personal services contract.

The full text of this clause can be found at: http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/37.htm#P52_7302

Read, complete and sign below

I hereby certify to the following matters:

I. Personal Conflicts of Interest

1. Except as identified in paragraph 2 below, I do not have a Personal Conflict of Interest, as defined above and in FAR 3.1101, that would arise from my participation in the Acquisition Function identified in this Non-Disclosure Agreement (NDA). I also acknowledge that I am prohibited from using for personal gain any non-public information to which I have access by reason of performance on the Support Services Contract identified above or through my participation in the Acquisition Function identified herein.

2. Disclosure of Financial Interests or Affiliations. I hereby notify the Contracting Officer that I have the following Personal Conflict(s) of Interest: (Use additional pages if required; strike through if no personal conflicts exist.)

II. Non-Disclosure of Information

· I have executed an NDA with my employer.

· In accordance with this NDA and the NDA I executed with my employer, I will protect from unauthorized release or disclosure any non-public information to which I have access as part of my work in support of the Acquisition Function identified above. I will use the non-public information made available to me only for the purpose of performing my work related to the particular matter identified above. When my work associated with this particular matter is completed, I will return all non-public information to the Contracting Officer and/or destroy any written material or electronic files containing non-public information at the direction of the Contracting Officer.

· I understand that the unauthorized release of information may result in civil liability or criminalprosecution.

· I understand that the terms of this NDA will continue to apply to me even after I am no longer performing work in support of the Acquisition Function identified above.

III. Non-Personal Services Contract

I have read FAR Subpart 37.104 and understand the purpose and intent of the support services contract identified above and acknowledge that it is not for personal services.