J-16_NonDisclosureStatement.doc

Non-Disclosure Statement

RFP-CMS-2007-0013

NON-DISCLOSURE STATEMENT

References: 48 CFR (Federal Acquisition Regulation) Sections 3.104, 5.401, and relevant corresponding sections of the Health and Human Services Acquisition Regulation.

Non-disclosure of proprietary data

Certain information of a proprietary nature will be provided to you by the government and/or its contractors. It is understood that the information is required for proposal preparation in response to a CMS solicitation for Medicare Administrative Contractor (MAC) services. Accordingly, employees including Subcontractor employees agree to use and examine this information exclusively as part of the proposal preparation process and to take the necessary steps to prevent disclosure of such information to any party outside the government, as long as it remains proprietary. It is also agreed that the information will be destroyed or returned to CMS upon submission of the proposal requiring the information.

The contractor and any subcontractors agree to indoctrinate their affiliates who will have access to this information as to the proprietary nature of the information and the relationship under which they have possession of the information. Affiliates will also be informed that they may not engage in any other actions, venture or employment where this information will be used for the profit of any party other than the party furnishing this information. The contractor and subcontractors will restrict access to proprietary information to the minimum number of employees necessary for the preparation of a proposal in response to a CMS solicitation for MAC services.

Affirmation

I, the undersigned, recognize that information provided by the government and/or its contractors may be proprietary and confidential. Further, I do understand the requirements of the nondisclosure statement and agree to refrain from discussing or disclosing any sensitive data or information obtained or generated in the process of preparing a proposal in response to a CMS solicitation for MAC services. I further understand that if I have any questions concerning this matter, I should consult the CMS Contracting Officer assigned to Solicitation CMS-RFP-200X-XXXX.

Signature

Date

Print Name and Title

Witness

Date Attachment J-16