OSHS Agent Agreeme OSHS Agent Agreement

Bureau of Labor Statistics Occupational Safety and Health Statistics Cooperative Agreement Application Package

OSHS BLS Agent Agreement

OSHS Cooperative Agreement

OMB: 1220-0149

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BLS AGENT AGREEMENT
FOR OSHS FEDERAL-STATE PROGRAM
1. I,___________________________, an authorized official of the Bureau of Labor Statistics (BLS), U.S. Department of Labor,
hereby designate ________________________________ as a temporary agent of the BLS, within the meaning of the Confidential
Information Protection and Statistical Efficiency Act (CIPSEA), to serve in accordance with this Agent agreement, the Cooperative
Agreement and any other agreements entered into between the BLS and ________________________________, and in
accordance with applicable Federal law.
2. I, ___________________________, hereby accept the designation as agent in paragraph 1. I certify that I have read all
applicable agreements between the BLS and the state agency and promise that I will comply with all provisions of this Agent
Agreement, the Cooperative Agreement or any other agreements between the BLS and the state agency, and applicable law. I
will assure that my actions or inactions do not cause the state agency to violate its responsibilities under those agreements. I
specifically swear (or affirm) to comply with all provisions of law that affect information acquired by the BLS, including, but not
limited to, the Trade Secrets Act, the Privacy Act, and the CIPSEA, and I understand that my failure to comply with these
provisions may subject me to criminal sanctions. I also agree to comply with all other BLS information policies communicated by
BLS through formal memoranda to the state agency and annual confidentiality training.
3. We, the parties to this agreement understand that the BLS is granting the Agent access to confidential information only for the
purpose of carrying out the Agent's responsibilities under written agreements between the BLS and the state agency. The Agent
will not seek or obtain such confidential information for any other purpose. Confidential information includes confidential
personally identifiable information and respondent identifiable information protected from unauthorized use or disclosure under
CIPSEA, including the disclosure avoidance parameters applied to published data. Confidential information also includes prerelease information such as official estimates and other official statistical products prior to the official BLS release of the
corresponding national data.
4. We, the parties, understand and agree that the activities performed by and any outputs produced by the Agent under this
agreement are subject to review upon request by the assigned BLS Regional Commissioner or any other BLS official that the BLS
designates for verification that the activities are statistical in nature and that outputs do not contain respondent or personally
identifiable information.
5. We, the parties, understand and agree that the Agent will not be an employee of the United States for any purpose and will
not receive compensation or payment of any kind from the BLS or the Government in connection with the Agent's activities
under this agreement or any other agreements between the BLS and the state agency. Neither this agreement nor any
agreement between the BLS and the state agency provide any right of access to BLS information. The parties also understand
and agree that the BLS may decline to give the Agent access to information and/or to terminate this agreement at any time,
without notice. The parties agree that neither this agreement, nor any termination thereof will result in any legal liability by the
BLS or the Government; however, termination will not affect the Agent's continuing obligation to safeguard all confidential data,
and it will not affect any license granted to the Government pursuant to section 6.
6. We, the parties, understand and agree that for the purposes of the copyright laws any product developed under this
agreement is in the public domain and is therefore not subject to copyright protection. However, it is also understood that
confidential information remains fully protected from improper disclosure and use as provided by law and this agreement.
7. I, __________________________, understand that the state agency or I will notify the BLS if I should no longer be affiliated
with the state agency or of any change of status with the state agency.
8. I, ___________________________, fully understand my responsibilities to protect confidential information. I will comply with
all security requirements and will avoid all improper use or disclosure of confidential information. I understand that under
CIPSEA, the penalty for a knowing and willful disclosure of confidential information is a class E felony with a fine of not more than
$250,000 or imprisonment for not more than 5 years, or both.

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File Typeapplication/pdf
AuthorWolff, Christine - BLS
File Modified2020-04-01
File Created2018-06-13

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