SAMPLE CONTRACT

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP79-00434A000300070027-2
• Release Decision: RIFPUB
• Original Classification: S
• Document Page Count: 2
• Document Creation Date: December 9, 2016
• Document Release Date: September 26, 2000
• Sequence Number: 27
• Content Type: CONT

Approved For Releas2001/03/03: S79-004344e00300070027-2
SAlTLE CONTRACT
Date:
Dr.
(Address
1. The United States Government, as represented by the Central intelli-
gence Agency, hereby contracts with you for the furnishing of certain per-
sonal services on a consultatory basis. The fee to be paid by CIA shall be
as determined by the Central Intelligence Agency Surgeon based on the gen-
eral practice in the profession and, where appropriate, on Veterans' Admin-
istration and Public Health standards for similar -work.
2. The services to be furnished by you hereunder may involve examina-
tion, diagnosis, consultation and recommendations to CIA. No curative serv-
ices, treatment, surgical operations or other professional services of a non-
consultatory nature shall be requested of you or reimbursed by CIA hereunder.
3. Statements or vouchers rendered by you hereunder shall be itemized
in an appropriate manner. They shall set forth, e.g., physical examination,
number of visits by an individual, purposes of those visits, period of time
of visits, interpretation of N-rays, etc.
1~. ? You -gill be required to keep forever secret this contract and all
information which you may obtain by reason thereof (unless released in writ-
ing by CIA from such obligations), with full knowledge that violation of such
secrecy may subject you to criminal'prosecution under the 'espionage Laws,
dated 25 June 1948 (18 U.S.C. 793 and 794) and other applicable lades and reg-
ulations. You will be required to subscribe to an oath of secrecy prior to
the activation of this contract.
Approved For Release 2001/03/03 : CIA-RDP79-00434A000300070027-2
SECIff
 Approved For Releew 2001/03/03: CISon-004374000300070027-2
5. The effective date of this contract is . This contract
may be terminated by either party at any time. Termination of this contract
will not release you from the provisions of Paragraph 4 above or the secrecy
oath which you will be required to take.
6. The CIA requirements for payments hereunder will be the subject of
discussion in order that
a. appropriate methods may be devised to forward billins to CIA,
b. payments by CIA to you will be accomplished in such manner as
will comply vaith security standards.
Contracting Of'fic'er ~~~
Approved For Release 2001/03/03 : CIA-RDP79-00434A000300070027-2
SECRET