Form 10 - Application For Access To Information Under Protective Order By Expert Consultant Or Witness - United States Court Of Federal Claims Page 2

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is an interested party in this proceeding or whose protected information will be reviewed; if
none, I have so stated;
e.
a list identifying by name of forum, case number, date, and circumstances all instances in
which I have been granted admission or been denied admission to a protective order, had a
protective order admission revoked, or have been found to have violated a protective order
issued by an administrative or judicial tribunal; if none, I have so stated; and
f.
a list of the professional associations to which I belong, including my identification
numbers.
6. I have read a copy of the Protective Order issued by the court in this proceeding. I will comply in
all respects with all terms and conditions of that order in handling any protected information produced in
connection with the proceeding. I will not disclose any protected information to any individual who has not
been admitted under the Protective Order by the court.
7. For a period of two years after the date this application is granted, I will not engage or assist in the
preparation of a proposal to be submitted to any agency of the United States government for
____________________ when I know or have reason to know that any party to this proceeding, or any
successor entity, will be a competitor, subcontractor, or teaming member.
8. For a period of two years after the date this application is granted, I will not engage or assist in the
preparation of a proposal or submission to_____________ nor will I have any personal involvement in any
such activity.
9. I acknowledge that a violation of the terms of the Protective Order may result in the imposition of
such sanctions as may be deemed appropriate by the court and in possible civil and criminal liability.
* * *
By my signature, I certify that, to the best of my knowledge, the representations set forth above
(including attached statements) are true and correct.
___________________________
___________________________
Signature
Date Executed
___________________________
Typed Name and Title
___________________________
Telephone & Facsimile Numbers
___________________________
E-mail Address
___________________________
___________________________
Signature of Attorney of Record
Date Executed
___________________________
Typed Name and Title
___________________________
Telephone & Facsimile Numbers
___________________________
E-mail Address

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