MEDLINE established its due diligence program to support its ongoing commitment to meet all its legal and compliance obligations. This program is designed to ensure that MEDLINE is in compliance with the anti-bribery/anti-corruption laws enacted in each country where MEDLINE conducts business, the United States Foreign Corrupt Practices Act, legislation enacted in accordance with the OECD United Nations Convention Against Corruption, and in the United States, the United States Anti-kickback Statute, Stark Laws and Federal False Claims Law.
MEDLINE will decide whether to enter into or continue any contractual relationship with you or your Company based in part on the responses to this Questionnaire. If MEDLINE determines that you have provided any false, incomplete or misleading statements, MEDLINE may immediately terminate any contractual relationships with you or your Company or modify such contracts to prohibit any dealing with government customers and take any other action allowed by contract or applicable law. The information you provide in this questionnaire will be used by MEDLINE to help achieve compliance with laws of the United States and other jurisdictions. The questions have been tailored to seek only information that is relevant to MEDLINE's compliance efforts. MEDLINE may obtain further information about you, your company, and/or the individuals you have provided information on in the this form from the references and other parties identified in your response, as well as from third party sources, and will use such information for the purposes described above. The information collected through this due diligence program, and from your references and other parties, will not be used, transmitted, or processed for any other purposes.
It is necessary for you to answer each question completely. Please be specific and thorough in your responses. If the information does not fit in the spaces provided in this questionnaire, please use the "Additional Information" tab.
Data Protection Information and Representation
By submitting this questionnaire, your Company represents and warrants that it has or will secure whatever legal authority or consent may be necessary for the transfer to MEDLINE in the United States and elsewhere, processing and use of all personal/business information, including any special or sensitive categories of personal information (as may be defined by applicable data protection law), provided in this questionnaire. In order to verify the information provided by your Company and to conduct background/due diligence investigations on your Company, we may transfer the data your Company provides to our subsidiaries, agents and representatives and to third parties throughout the world, including to countries which may not be deemed to provide adequate protection for personal information by your country. Regardless of the particular laws of the jurisdiction in which the information may be at any particular moment, wherever we or our subsidiaries, agents or representatives collect, use, access, transfer or store the information, it will be treated privately and securely in compliance with relevant data protection laws. In the case of personal data, you must obtain the consent in written form signed by the personal data subject, to the processing of his/her personal data, including name, address, residence, relationships with government officials, reputation, education, published business and professional media information relating to corruption or criminal activities, and similar personal data from publicly available and legally permissible sources reflecting on the data subject’s reputation. You must provide the consent forms to us via PDF in the form prescribed by local data protection/privacy laws and signed by the personal data subject. Individuals may have certain rights related to their personal data, depending on applicable data protection laws, including access, rectification, deletion, and objection, subject to certain limitations, and should be directed your Company to contact MEDLINE's Global Privacy Office at medlineprivacyoffice@medline.com to inquire about or exercise such rights. Additional information regarding our Privacy Policy is located online at: https://www.medline.com/pages/privacy/.
If you agree with the above processing of your or your Company’s business and personal information, please complete and submit the following questionnaire, providing only objective and verifiable information. Completion of the due diligence questionnaire is voluntary; however, failure to complete and submit it may preclude MEDLINE from doing business with your Company. If you have any questions or concerns about the above, please consult with your MEDLINE business contact.
