RFP 6171 ATTACHMENT B DISCLOSURE EXEMPTION AFFIDAVIT.pdf
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- Attached to
- RFP 6171 MMIS Controls Audit
- Solicitation number
- S-44300-00018176
- Issued by
- Oregon
About this file
This document is a Disclosure Exemption Affidavit (Attachment B) for RFP 6171, a Medicaid Management Information System (MMIS) Controls Audit procurement issued by the State of Oregon's Department of Administrative Services (DAS). The affidavit is a sworn statement submitted by a designated employee of the proposing contractor, confirming that the employee has authority to represent the proposer and is familiar with both the RFP requirements and the proposal submission. The affidavit requires the affiant to acknowledge familiarity with Oregon's Public Records Law (ORS 192.311-192.478) and the Uniform Trade Secrets Act as adopted in Oregon (ORS 646.461-646.475), establishing the legal framework under which certain proposal information may be withheld from public disclosure.
The affidavit identifies specific information contained within the proposal that the proposer claims is exempt from public disclosure, which is detailed in Exhibit A and incorporated by reference. The proposer must demonstrate that the exempt information qualifies as trade secrets under either Oregon's Public Records Law or the Uniform Trade Secrets Act by meeting specific criteria: either that the information is a formula, plan, pattern, process, or compilation known only within the proposer's organization with commercial value that provides competitive advantage; or that the information derives independent economic value from not being publicly known and is subject to reasonable efforts by the proposer to maintain its secrecy. The affidavit acknowledges that actual disclosure determinations may ultimately depend on official or judicial determinations made in accordance with Oregon Public Records Law, and requires notarization by a qualified notary public.
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Text version
RFP 6171 [S-44300-00018176] MMIS CONTROLS AUDIT
DAS Procurement Services, Version 4.0 – March 25, 2018 Page 1 of 3
ATTACHMENT B — DISCLOSURE EXEMPTION AFFIDAVIT
____________________ (Affiant), being first duly sworn under oath, and representing [insert Proposer Name] (hereafter “Proposer”), hereby deposes and swears or affirms under penalty of perjury that:
1. I am an employee of the Proposer, I have knowledge of the Request for Proposals referenced herein, and I have full authority from the Proposer to submit this affidavit and accept the responsibilities stated herein.
2. I am aware that the Proposer has submitted a Proposal, dated on or about [insert date] (the “Proposal”), to the State of Oregon (State) in response to Request for Proposals RFP #6171, for MMIS Controls Audit, and I am familiar with the contents of the RFP and Proposal.
3. I have read and am familiar with the provisions of Oregon’s Public Records Law, Oregon Revised Statutes (“ORS”) 192.311 through 192.478, and the Uniform Trade Secrets Act as adopted by the State of Oregon, which is set forth in ORS 646.461 through ORS 646.475. I understand that the Proposal is a public record held by a public body and is subject to disclosure under the Oregon Public Records Law unless specifically exempt from disclosure under that law.
4. I have reviewed the information contained in the Proposal. The Proposer believes the information listed in Exhibit A is exempt from public disclosure (collectively, the “Exempt Information”), which is incorporated herein by this reference. It is my opinion that the Exempt Information is exempt from disclosure under Oregon’s Public Records Law under the specifically designated sections as set forth in Exhibit A or constitutes “Trade Secrets” under either the Oregon Public Records Law or the Uniform Trade Secrets Act as adopted in Oregon because that information is either:
A. A formula, plan, pattern, process, tool, mechanism, compound, procedure, production data, or compilation of information that:
i. is not patented,
ii. is known only to certain individuals within the Proposer’s organization and that is used in a business the Proposer conducts,
iii. has actual or potential commercial value, and
iv. gives its user an opportunity to obtain a business advantage over competitors who do not know or use it.
or
B. Information, including a drawing, cost data, customer list, formula, pattern, compilation, program, device, method, technique or process that:
DAS Procurement Services, Version 4.0 – March 25, 2018 Page 2 of 3
i. Derives independent economic value, actual or potential, from not being generally known to the public or to other persons who can obtain economic value from its disclosure or use; and
ii. Is the subject of efforts by the Proposer that are reasonable under the circumstances to maintain its secrecy.
5. I understand that disclosure of the information referenced in Exhibit A may depend on official or judicial determinations made in accordance with the Public Records Law.
Affiant’s Signature
State of ___________)
) ss:
County of ________)
Signed and sworn to before me on ___________ (date) by ______________________ (Affiant’s name).
Notary Public for the State of _________________
My Commission Expires: _________
DAS Procurement Services, Version 4.0 – March 25, 2018 Page 3 of 3
EXHIBIT A TO ATTACHMENT B
Proposer identifies the following information as exempt from public disclosure under the following designated exemption(s):
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