Attach2_ITnondisclosure.pdf

Information Technology Systems Security Prospective Offeror Non-Disclosure Agreement

Request For Proposal (RFP) No:

(fill in RFP Number)

Project Title:

(Fill in Title from RFP)

(Organization’s name), intends to respond to the Government’s Solicitation/Project title indicated above. The Government has determined that the solicitation requires prospective offerors to have access to sensitive information in order to prepare an offer.

I, (Offeror Official name and title), of (Organization’s name), on this day of , 20 , on behalf of my organization hereby request access to the sensitive information described in Section L.III. of the RFP sited above.

I, the undersigned, understand that the Government has determined that any individual having access to the sensitive information described in the RFP must possess a valid and current Suitability Determination at the Level identified in Section L.III. of the RFP sited above.

I, the undersigned, do hereby affirm the following:

• I have a valid and current Suitability Determination sufficient to access the sensitive information (copy of suitability determination attached.

• I will be the corporate official soley responsible for appropriately safeguarding the sensitive information while in the possession of (Organizations’s name);

• The sensitive information will be used solely for the purpose of preparing an offer;

• I will not release, publish, or disclose the sensitive information to unauthorized personnel; and

• I will protect the sensitive information in accordance with provisions of the following laws and any other pertinent laws and regulations governing the confidentiality of sensitive information;

• 18 U.S.C. 641 (Criminal Code: Public Money, Property of Records)

• 18 U.S.C. 1905 (Criminal Code: Disclosure of Confidential Information)

• Public Law 96-511 (Paperwork Reduction Act)

Signature of Prospective Offeror Official:

Name of Prospective Offeror Official:

Name of Prospective Offeror:

Date:

Signature of Witness:

Name of Witness:

Date:

Copies Retained by: Contractor Official & Contracting Officer

Attachment 2 RFP Number: NIHES2009078