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Kena Norris,
Executive Director

312.227.7406
knorris@ccpapp.org

Priya Stemler,
Director of Operations

312.227.7437
pstemler@ccpapp.org

Paresh Patel,
National Sales Manager

312.227.7436
papatel@ccpapp.org

Melissa Romey,
Member Relations Specialist
312.227.7508
 
General Inquiries:
312.227.7444
info@ccpapp.org
 

Acknowledgement of Confidentiality and Non-Disclosure Obligations

* - denotes required fields

The parties expressly agree to enter into this Acknowledgement of Confidentiality and Non-disclosure Obligations in electronic format, to be bound by the terms thereof as expressed electronically, and to the use of an electronic signature process as the parties’ intent to be bound by such terms. You may be provided a paper copy of the Acknowledgement of Confidentiality and Non-disclosure Obligations upon written request by contacting CCPA Purchasing Partners.

The undersigned, a prospective business associate ("Prospect") of CCPA Purchasing Partners, L.P. ("CCPA PP"), is reviewing potential business opportunities and/or is considering entering into a marketing agreement with CCPA PP and accordingly has or may have access to vendor pricing and other proprietary information.

For the benefit of CCPA PP in the administration of the above-referenced arrangements, the undersigned hereby affirms that Prospect will not disclose to any third party any of the following information:

(i) Proprietary business information, not available to the general public, which is obtained by the Prospect; or

(ii) The specific vendor pricing provided for under the agreement between CCPA PP and Prospect The Prospect agrees to indemnify, defend, and hold harmless CCPA PP and its employees, officers and directors from and against any claim (including the costs of the investigation and defense thereof and any damages assessed) arising from or out of any breach by the Prospect of this agreement.

Business Name:
* First Name:
* Last Name:
Title:
* Email Address or Fax Number of where
you would like this pricing sent:
* Phone Number
(Format: 123-456-7890):
Sample Pricing Requested:












Alliance Tech Medical and McKesson provide sample pricing that is tailored to various physician specialties. If your practice is interested in either/both vendors, please indicate the specialty(ies) of the physician(s) in your office:

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