Biosecurity Assessment Questionnaire

Biosecurity Assessment Questionnaire

Client Name:   Assessment Provider:   Assessment Date:

RECITALS

WHEREAS, the Client operates facilities, processes, or activities that involve biological agents, materials, or organisms that may present a biosecurity risk; and

WHEREAS, the Provider possesses expertise in evaluating biosecurity practices, identifying vulnerabilities, and recommending corrective measures to reduce the likelihood of intentional or unintentional release or misuse; and

WHEREAS, the parties desire to document the scope, procedures, findings, and recommendations of a biosecurity assessment in accordance with the terms set forth below.

SCOPE OF WORK

The Provider will perform a biosecurity assessment at the Client facility described below. The assessment will include a site inspection, interviews with key personnel, review of documentation, and preparation of a written report with prioritized recommendations.

FACILITY INFORMATION

CURRENT BIOSECURITY MEASURES

Indicate whether the following measures are implemented at the facility.

Perimeter fencing
Controlled entry with badging
Vehicle checkpoints and screening

Secure storage for biological agents
Segregated workflow areas
Environmental controls and monitoring

Access authorization policies
Personnel background screening
Documented incident response plan

RISK ASSESSMENT

Describe the primary biosecurity risks identified during the assessment and the likelihood and consequence ratings:

INCIDENT HISTORY

Provide information on any security breaches, losses, unauthorized access, or near misses involving biological materials in the past five years.

TRAINING AND PERSONNEL

Describe current training programs, frequency, and recordkeeping for personnel with access to biological materials.

MATERIAL HANDLING, STORAGE, AND TRANSPORT

Describe controls for inventory, labeling, chain-of-custody, storage, and transport of regulated or sensitive biological materials.

WASTE MANAGEMENT

Describe procedures for segregation, decontamination, and disposal of biological waste.

VISITOR AND CONTRACTOR CONTROLS

Describe visitor screening, escort requirements, contractor controls, and recordkeeping.

RECOMMENDATIONS AND ACTION PLAN

PAYMENT TERMS

The Client shall pay the Provider the fees for the assessment, as described below. Fees are due in accordance with the agreed schedule. Late payments shall accrue interest as set forth below.

TERM AND TERMINATION

This Agreement commences on the Start Date and continues until completion of the services or termination by either party in accordance with this section.

Either party may terminate this Agreement for material breach if the breaching party fails to cure within the notice period above. Termination does not relieve the Client of payment obligations for work performed prior to termination.

CONFIDENTIALITY

Each party agrees that all non-public information, findings, reports, technical data, and recommendations disclosed pursuant to this Agreement are Confidential Information. The receiving party shall use Confidential Information solely for performance under this Agreement and shall protect it with at least the same degree of care it uses to protect its own confidential information, but no less than reasonable care.

Notwithstanding the foregoing, the Provider may disclose information to the extent required by law, regulation, or bona fide governmental request, provided the Provider gives the Client prompt written notice where permitted and cooperates to limit the scope of disclosure.

GOVERNING LAW

This Agreement and any dispute arising out of or relating to it shall be governed by and construed in accordance with the laws of the state indicated below, without regard to conflict of law principles.

ENTIRE AGREEMENT

This document, together with any attachments or schedules expressly incorporated herein, constitutes the entire agreement between the parties with respect to the subject matter and supersedes all prior and contemporaneous agreements, understandings, and representations, whether oral or written. Any amendment must be in writing and signed by authorized representatives of both parties.

CERTIFICATION AND ATTESTATION

The undersigned certify that the information provided in this questionnaire is true and complete to the best of their knowledge, and that any known material inaccuracies will be reported promptly to the Provider.

By checking this box, I attest to the accuracy and completeness of the information provided above.

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