SAMPLE CONTRACT

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP79-00434A000300070028-1
• Release Decision: RIFPUB
• Original Classification: S
• Document Page Count: 2
• Document Creation Date: December 9, 2016
• Document Release Date: September 26, 2000
• Sequence Number: 28
• Content Type: CONT

'Approved For Release-2001/03/03 : 79-00434A600300070028-1
Date:
Dr,
(Address
1. The United States Government, as represented by the Contracting Of-
ficer signing this contract, hereby contracts vrith you for the furnishing of
certain personal services on a consultatory basis. bnere such services con-
sist of complete physical evaluation by you of individuals designated by the
the United States Government, the fee for each such evaluation normally will
be a25.OO. :'here services other than evaluations will be required, the fee
to be paid by the United States Government shall be as determined by the
United States Government surgeon concerned based on the general practice in
the profession and, where appropriate, on Veterans' Administration 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 the United States Gov-
ernment.. No curative services, treatment, surgical operations or other pro-
fessional services of a nonconsultatory nature shall be requested of you or
reimbursed by the United States Government 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.X-rays, etc.
4. You will be required to keep forever secret this contract and all
information which you may obtain by reason thereof (unless released in writ-
ing by the Contracting Officer from such obligation), rrith full knowledge
Approved For Release 2001/03/03 : CIt 00434A000300070028-1
 'Approved For ReIe2001/03/03
that violation of such secrecy may subject you to criminal prosecution under
the Espionage Laws, dated 25 June 19148 (18 U.S.C. 793 and 79) and other ap-
plicable laws and regulations, You will be required to subscribe to an oath
of secrecy prior to the activation of this contract.
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 United States Government requirements for payments hereunder
will be the subject of discussion in order that
a.. appropriate methods may be devised to forward billings to the
United States Government, and
b. payments to you ;rill be accomplished in such manner as will con-
ply with security standards.
UNITED STATES OF AI:T#IRICA
Contracting Officer
Approved For Release 2001/03/03-(M-00434A000300070028-1
-0043' 600300070028-1