Gratuitous Services Agreement

DEPARTMENT OF HOMELAND SECURITY

Cybersecurity and Infrastructure Security Agency

OMB Control Number: 1670-0031
Expiration Date: 03/31/2020

GRATUITOUS SERVICES AGREEMENT
Paperwork Reduction Act: The public reporting burden to complete this information collection is estimated at 6 minutes per response, including the
time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and the completing and reviewing the
collected information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a
currently valid OMB control number and expiration date. Send comments regarding this burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden to DHS/CISA/ISD /OBP, 245 Murray Lane SW., Mail Stop 0612, Washington, DC 20528–
0612 or [email protected]. ATTN: 1670-0031.
Privacy Act Notice:
Authority: 5 U.S.C. § 301 and 44 U.S.C. § 3101 authorize the collection of this information.
Purpose: The DHS Cybersecurity and Infrastructure Security Agency (CISA) will use this information to assess and update Office for Bombing
Prevention (OBP) training opportunities and provide individuals with updated materials and awareness product information following conferences and
other OBP related outreach events.
Routine Use: The information collected will be used by and disclosed to DHS personnel and contractors, to assist in activities related to participation in
DHS/CISA OBP training events.
Disclosure: Furnishing this information is voluntary; however, failure to provide any of the information requested may prevent the DHS/CISA from
contacting you regarding training opportunities and other OBP related outreach events.

1.

This gratuitous services agreement is between the United States Department of Homeland Security, Cybersecurity and
Infrastructure Security Agency, Infrastructure Security Division (“Recipient”) and
(“Provider”).

2.

The duration of this gratuitous services agreement is from
to
. The duration of this
agreement cannot be extended except by expressed, written, mutual consent of both parties. However, both parties can mutually
consent to early termination of this agreement, verbally or in writing. Additionally, this agreement can be unilaterally terminated by
either party, with or without cause, with or without prior notification to the other party, in writing or verbally. Both parties are
prohibited from claiming or seeking damages from the other party or from the Unites States because of any mutual or unilateral
early termination of this agreement.

3.

The terms of this agreement cannot be modified except by the expressed, written consent of both parties.

4.

Provider offers to provide the following gratuitous services to Recipient:

5.

Recipient agrees to accept Provider’s gratuitous services identified in Paragraph 4 above to the extent permitted by law.

6.

Provider agrees to provide the gratuitous services described in Paragraph 4 above with the full understanding that Recipient and
the United States cannot and will not compensate, provide any financial benefit to, or reimburse Provider in any manner for
providing those services.

7.

Provider agrees and declares that it has no expectation of receiving any compensation, financial benefit, or reimbursement of any
kind from Recipient or the United States for providing gratuitous services under this agreement.

8.

Provider agrees to make no claim for compensation, financial benefit, or reimbursement of any kind against Recipient or the United
States for gratuitous services provided under this agreement.

9.

Provider understands and agrees that it would be unlawful for Recipient to accept Provider’s services if Provider had any
expectation of any compensation, financial benefit, or reimbursement from Recipient or the United States.

10. Both parties declare that this document constitutes the sole and complete gratuitous services agreement between them.

Recipient:

Date:

Provider:

Date:

CISA Form XXX (12/19)

Page 1 of 1