RFP Document 12 - CBP Non-Disclosure Agreement Form.pdf

DEPARTMENT OF HOMELAND SECURITY

U.S. CUSTOMS AND BORDER PROTECTION

FACILITIES MANAGEMENT AND ENGINEERING

FIELD OPERATIONS FACILITIES PROGRAM MANAGEMENT OFFICE

NON-DISCLOSURE AGREEMENT

I, , an individual official, employee, consultant, or subcontractor of or to U.S. Customs and Border Protection (the Authorized Entity), intending to be legally bound, hereby consent to the terms in this Agreement in consideration of my being granted conditional access to certain information, specified bel ow, that is owned by , produced by, or in the possession of the United States Government.

(Signer will acknowledge the category or categories of information that he or she may have access to, and the signer’s willing ness to comply with the standards for protection by placing his or her initials in front of the applicable category or categories.)

Protected Critical Infrastructure Information (PCII) I attest that I am familiar with, and I will comply with all requirements of the PCII program set out in the Critical Infrastructure Information Act of 2002 (CII Act) (Title II, Subtitle B, of the Homeland Securit y Act of 2002, Public Law 107-296, 196 Stat. 2135, 6 USC 101 et seq.), as amended, the implementing regulations thereto (6 CFR Part 29), as amended, and the applicable PCII Procedures Manual, a s amended, and with any such requirements that may be officiall y communicated to me by the PCII Program Manager or the PCII Program Manager’s designee.

Sensitive Security Information (SSI) I attest that I am familiar with, and I will co mply with the standards for access, dissem ination, handling, and safeguarding of SSI inform ation as cited in this Agreement and in accordance with 49 CFR Part 1520, “Protection of Sensitive Security Information,” “Policies and Procedures for Safeguarding and Control of S SI,” as amen ded, and any supplem entary guidance issued by an authorized official of the Department of Homeland Security.

Other Sensitive But Unclassified (SBU) As used in this Agreement, sensitiv e but unclassified information is an over-arching term that covers any information, not ot herwise indicated above, which t he loss of, misuse of, or unauthorized access to or modification of could adv ersely affect the national in terest or the conduct of Federal programs, or the privacy to which individuals are entitled under Section 552a of Title 5, as amended, but which has not been specifically authorized under criteria established by an Executive Order or an Act of Congress to be kept secret in the interest of national defense or fo reign policy. This includes information categorized by DHS or other government agencies as: For Offici al Use Only (FOUO); Official Use On ly (OUO);

Sensitive Homeland Secu rity Information (SHSI); Limited Official Use (L OU); Law Enforcement Sensitive (LES); Safeguarding Inform ation (SGI); Unclassified Controlled Nuclear Infor mation (UCNI);

and any othe r identifier used by other government agencies to categorize information as sensitive but unclassified.

I attest that I am familiar with, and I will co mply with the standards for access, dissem ination, handling, and safeguarding of the inform ation to which I a m granted access as cited in this Agre ement and in accordance with the guidance provided to me relative to the specific category of information.

I understand and agree to the following terms and conditions of my access to the information indicated above:

1. I hereby acknowledge that I have received a security indoctrination concerning the nature and protection of information to which I have been pr ovided conditional access, in cluding the procedures to be followed in ascertaining whether other persons to whom I contemplate disclosing this information have been approved for access to it, and that I understand these procedures.

2. By being granted conditional access to the inform ation indicated above, the United States Government has placed s pecial confidence and trust in m e and I am obligated to protect this inform ation from unauthorized disclosure, in accordance with the terms of this Agreement and the laws, regulations, and directives applicable to the specific categories of information to which I am granted access.

3. I attest that I understand m y responsibilities and th at I am familiar with and will compl y with the standards for protecting s uch information that I m ay have access to in accordance with the terms of this

FACILITIES MANAGEMENT AND ENGINEERING

Agreement and the laws, regulations, and/or directives applicable to the specific categories of information to which I am granted access. I understand that the United States Government may conduct inspections, at any time or place, for the purpose of ensuring compliance with the conditions f or access, dissemination, handling and safeguarding information under this Agreement.

4. I will not disclose or release any information provided to me pursuant to this Agreement without proper authority or authorization. Shoul d situations arise that warra nt the disclosure or release of suc h information I will do so only under approved circumstances and in accordance with the laws, regulations, or directives applicable to the specific categories of information. I will honor and comply with any and all dissemination restrictions cited or verbally relayed to me by the proper authority.

5. (a) For PCII –

(1) Upon the completion of my engagement as an employee, consultant, or subcontractor under the contract, or the completion of my work on the PC II Program, whichever occurs first, I will surrender promptly to the PCII Program Manager or his designee, or to the appropriate PCII officer, PCII of an y type whatsoever that is in my possession.

(2) If the Authorized Entity is a United States Govern ment contractor performing services in support of the PCII Progr am, I will not request, obt ain, maintain, or use PCII unless the PCII Program Manager or Program Manager’s desig nee has first made in writing, with respect to the c ontractor, the certification as provided for in Section 29.8(c) of the implementing regulations to the CII Act, as amended.

(b) For SSI and SBU - I hereby agree that material which I have in my possession an d containing information covered by this Agreement, will be handled and safegua rded in a manner that affords sufficient protection to prevent the unauthorized disclos ure of or inadvertent ac cess to such information, consistent with the laws, regulations, or directives applicable to the specific c ategories of information. I agree that I shall return all information to which I have had access or which is in m y possession 1) upon demand by an authorized individual; and/or 2) upon the conclusion of my duties, association, or support to DHS; and/or 3) upon the deter mination that my official duties do not require further acc ess to such information.

6. I hereby agree that I will not alter or rem ove markings, which indicate a categor y of information or require specific handling instructions, from any material I may come in contact with, in the case of SSI or SBU, unless such alteration or rem oval is consiste nt with the requirem ents set forth in the laws, regulations, or directives applicable to the specific category of information or, in the case of PCII, unless such alteration or removal is authorized by the PCII Program Manager or th e PCII Program Manager’s designee. I agree that if I use inform ation from a sensitive document or other medium, I will carry forward any markings or other required restrictions to derivative products, and will protect them in the same matter as the original.

7. I hereby agree that I sh all promptly report to the appropriate official, in a ccordance with the guidance issued for the applicable category of inform ation, any loss, theft, misuse, misplacement, unauthorized disclosure, or other security violation, I have knowledge of and whether or not I am personally involved. I also understand that my anonymity will be kept to the extent possible when reporting security violations.

8. If I violate the terms and conditions of this Agreement, such violation may result in the cancellation of my conditional access to the inform ation covered by this Agreement. This ma y serve as a basis for denying me conditional access to oth er types of i nformation, to include cl assified national security information.

9. (a) With respect to SSI and SBU, I hereby assign to the U nited States Government all roy alties, remunerations, and em oluments that have resulted, will result, or m ay result from any disclosure, publication, or revelation of the information not consistent with the terms of this Agreement.

(b) With respect to PCII I hereby assign to the entity owning the PCII and the United States Government, all royalties, remunerations, and emoluments that have resulted, will result, or may result from any disclosure, publication, or revelation of PCII not consistent with the terms of this Agreement.

FACILITIES MANAGEMENT AND ENGINEERING

10. This Agreement is made and intended for the be nefit of the United States Government and m ay be enforced by the United States Government or the Authorized Entity. By granting me conditional access to information in this context, the United States Gove rnment and, with respect to PCII, the Authorized Entity, may seek any remedy available to it to en force this Agree ment including, but not lim ited to, application for a court order prohibiting disclosure of inform ation in breach of this Agreement. I understand that if I violate the terms and conditions of this Agreement, I could be subjected to administrative, disciplinary, civil, or crim inal action, as appropriate, under the laws, reg ulations, or directives applicable to t he category of information involved and neither the United States Government nor the Authorized Entity have waived any statutory or common law evidentiary privileges or protections that they may assert in any administrative or court proceeding to protect any sensitive inform ation to which I have been given conditional access under the terms of this Agreement.

11. Unless and until I am released i n writing by an authorized representative of the Depart ment of Homeland Security (if p ermissible for the particu lar category of information), I understand that all conditions and obligations imposed upon me by this Agreement apply during the time that I am granted conditional access, and at all times thereafter.

12. Each provision of this Agreement is severable. If a court should find any provision of this Agreement to be unenforceable, all other provisions shall remain in full force and effect.

13. My execution of this Agreement shall not nulli fy or affect in an y manner any other s ecrecy or non-disclosure Agreement which I have executed or may execute with the United States Government or any of its departments or agencies.

14. These restrictions are consistent with and do not supersede, conflict with , or otherwise alter th e employee obligations, rights, or liabiliti es created by Executive Order No. 12958, as am ended; Section 7211 of Title 5, United States Code (governing disclosures to Congress); Section 1034 of Title 10, United States Code, as amended by the Military Whistleblower Protection Act (governing disclosure to Congress by members of the military); Section 2302( b)(8) of Title 5, United States Code, as amended by the Whistleblower Protection Act (governing disclosures of illegality, waste, fraud, abuse or public health or safety threats); the Intelligence Identities Protectio n Act of 1982 (50 USC 421 et seq.) (governing disclosures that could expose confidential Government agents); and the statutes which protect agains t disclosure that may compromise the national security, including Sections 641, 793, 794, 798, and 952 of Title 18, United States Code, and Section 4(b) of the Subversive Activities Act of 1950 (50 USC 783(b)).

The definitions, requirements, obligati ons, rights, sanctions, and liabilities created by said Executive Order and listed statutes are incorporated into this agreement and are controlling.

15. Signing this Agreement does not bar disclosures to Congress or to an authorized official of an executive agency or the Department of Justice that are essential to reporting a substantial violation of law.

16. I represent and warrant that I have the authority to enter into this Agreement.

17. I have read this Agreement carefully and my questions, if any, have been answered. I acknowledge that the briefing officer has made available to me any laws, regulations, or dir ectives referenced in this document so that I may read them at this time, if I so choose.

FACILITIES MANAGEMENT AND ENGINEERING

FIELD OPERATIONS FACILITIES PROGRAM MANAGEMENT OFFICE

NON-DISCLOSURE AGREEMENT

DEPARTMENT OF HOMELAND SECURITY

NON-DISCLOSURE AGREEMENT

Acknowledgement

REQUESTOR

Requestor Name: Email Address: Telephone Number:

Requestor Address:

I make this Agreement in good faith, without mental reservation or purpose of evasion.

Signature Date

KMS ADMINISTRATOR

Design Standard Program Manager: Email Address: Telephone Number:

Lawrence Comiskey LAWRENCE.A.COMISKEY@cbp.dhs.gov 202-325-7345

Design Standard Administrator Address:

U.S. Customs and Border Protection

FOF PMO

90 K Street NE Washington, DC 20002

This form is not subject to the requirements of P.L. 104-13, “Paperwork Reduction Act of 1995” 44 US