Employee Non-Disclosure Statement

Non Disclosure and Ethics Statements.pdf

USDA Web Based Supply Chain Management System (WBSCM)

Employee Non-Disclosure Statement

OMB: 0581-0273

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NON-DISCLOSURE STATEMENT
1.

In the course of participating either directly, in an advisory or supplemental role in the
procurement process utilizing the WBSCM program, I may be given access to or entrusted with
sensitive Government information associated with the ongoing procurement of agricultural
commodities. Sensitive Government information is identified as Business Sensitive, Procurement
Sensitive, Proprietary (e.g., 41 USC section 423, the Procurement Integrity Act restrictive legend
per Federal Acquisition Regulation (FAR) 52.215-1) or Source Selection Information (as defined
in FAR 3.104-3). This sensitive information includes data derived from materials identified, by
marking or subject matter content, as Source Selection, Business Sensitive, Procurement Sensitive
and/or Proprietary Data (collectively referred to herein as "the data"). Data subject to this
certification is applicable regardless to the method the information is published or stored including,
but is not limited to electronic or paper, and/or any other format the data exist.

2.

I agree not to discuss with, disclose, release, reproduce or otherwise provide or make available the
data, or any portion thereof, to any other Government or non-government employee, person, or
organization unless that other employee, person, or organization has signed a non-disclosure
statement consistent with this statement. Furthermore, I agree to adhere to all safeguards
established for the data and to use the data solely for the purpose of performing my role in
procuring commodities.

3.

I agree that these obligations not to inappropriately use, discuss, disclose, release, reproduce or
otherwise provide or make available the data are binding upon me as required by applicable federal
laws and regulations including applicable U.S. Department of Agriculture (USDA) and/or Farm
Services Agency (FSA) policies and regulations (collectively referred to herein as "the
regulations").

4.

I understand that any inappropriate use, disclosure, release or reproduction of the data is
unauthorized and may result in substantial administrative, civil and criminal penalties, including
fines, imprisonment, and loss of employment, under the Procurement Integrity Act or other
applicable laws and regulations. I understand that nothing in this non-disclosure agreement
changes, alters or, otherwise, is intended to replace the requirements of any regulations. I freely
and willingly sign this document, fully understanding its contents.

5.

I understand that making a false, fictitious, or fraudulent certification may subject me to criminal
prosecution under Title 18, United States Code, Section 1001.

6.

I understand that information regarding ethics in the federal acquisition process is provided in the
U.S. Office of Government Ethics publication entitled “Ethics & Procurement Integrity” available
at
http://www.usoge.gov/pages/forms_pubs_otherdocs/fpo_files/booklets/bkprocuremen
tintegrity_07.pdf

CONFLICT OF INTEREST
I, certify that neither I nor my immediate family, to the best of my knowledge, possess any financial
interest whatsoever in any company, parent or subsidiary, which could in any way be involved acquisition
related activities related to the procurement of agricultural commodities for the U.S. Department of
Agriculture. Should any company, parent or subsidiary in which my immediate family or I have a
financial interest submits a proposal or otherwise becomes involved in this acquisition, I will immediately
reveal such interest to the responsible program official and Contracting Officer.

I understand that my obligations under this certification are of a continuing nature. If at any time during
the acquisition process, I am contacted by any offeror concerning employment or other business
opportunity, or I receive an offer of a gift from any offeror, or I encounter circumstances where my
participation might result in a real, apparent, or potential conflict of interest, I will immediately seek the
advice of an Ethics Counselor and report the circumstances to the Contracting Officer or management.


File Typeapplication/pdf
File TitleMicrosoft Word - Non Disclosure and Ethics Statements _2_.docx
AuthorRUlibarr
File Modified2011-03-23
File Created2011-03-23

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