Section J Attachment D - Non-Disclosure Agreement July 30.docx

Section J Attachment D

HRSA CONTRACTOR NON-DISCLOSURE AGREEMENT

This NDA is to be completed by a contractor upon award of contract.

Information Technology Systems Security Contractor Non-Disclosure Agreement

The following statement is to be completed by all contractor employees who may be involved in the performance of contract work.

Access to privileged information from HRSA information technology systems is required in the performance of my official duties under Contract # between the Health Resources and Services Administration (HRSA) and my employer (.).

I, _________________________________, ON THIS _____DAY __________ OF ____, hereby agree that I shall not release, publish, or disclose such information to unauthorized personnel, and I shall protect such information in accordance with the provision of 18 U.S.C. 641, 18 U.S.C. 1905, 18 U.S.C. 2071, Public Law 96-511, and other pertinent laws and regulations governing the confidentiality of privileged information.

I understand the provision of 18 U.S. C. 641, 18 U. S. C. 1905, 18 U. S. C. 2071 and Public law 96-511, and that I am subject to criminal penalties prescribed by law for any violations thereof.

Signed: ___________________

Date: ___________________

Witnessed by: ___________________

Date: ___________________

Cc:

Contracting Specialist

COR