ATT G- Document Security Agreement for Sensitive Security Information Fillable.pdf

WARNING: Documents being distributed contain Sensitive Security Information controlled under 49 CFR parts 15 and 1520. No part of this record may be disclosed to persons without a "need to know", except with the written permission of the Administrator of the Transportation Security Administration, or the Secretary of Transportation.

Unauthorized release may result in civil penalty or other action. For US Government agencies, 5USC 552, and 49 CFR parts 15 and 1520 govern public disclosure

WAYNE COUNTY AIRPORT AUTHORITY

REQUEST FOR BIDS #

DOCUMENT SECURITY AGREEMENT FOR SENSITIVE

SECURITY INFORMATION

Construction Documents available for this Request for Bids/Proposals/Qualifications are considered Sensitive Security Information ("SSI") and are intended for use by authorized users only. In support of this requirement, the Wayne County Airport Authority ("Airport Authority") requires Bidders/Proposers/Respondents (you) to exercise prudent caution when handling SSI.

Limiting dissemination to authorized users. Dissemination of information shall only be made upon determination that the recipient is authorized to receive it. The criterion to determine authorization is need toknow. Those with a needtoknow are those who are specially granted access for business on behalf of, or with, the Airport Authority. This includes all persons or companies necessary to do work at the request of the Airport Authority. Dissemination of SSI documents shall be made, only upon receipt, by the Airport Authority of the duly signed Document Security Agreement ("DSA") from each business requesting a set of Construction Documents.

Bidders/Proposers/Respondents may provide copies of the SSI documents to subcontractors/sub consultants, as necessary, to submit a Bid/Proposal/Response. Bidders/Proposers/Respondents will require each subcontractor/subconsultant to fill out and sign a Document Security Agreement and provide a copy of the DSA to the Airport Authority. NOTE: It is the responsibility of the person or firm disseminating the SSI documents to assure that the recipient is an authorized user.

Retaining and destroying documents: The efforts required above shall continue throughout the entire term of the contract and for whatever specific time thereafter as may be necessary. Necessary record copies for legal purposes must be safeguarded against unauthorized use. Documents no longer needed shall be destroyed (after contract award or completion of the work). Destruction shall be done by burning or shredding hardcopy, and/or physically destroying CD's, deleting, and removing files from the electronic recycling bins, and removing material from computer hard drives using a permanent erase utility or similar software.

The recipient acknowledges the requirement to use reasonable care to safeguard the documents and, if not awarded the contract, will make every reasonable and prudent effort to destroy or render useless all SSI documents received during the solicitation.

I AGREE THAT I AM DULY AUTHORIZED TO EXECUTE THIS AGREEMENT ON BEHALF OF THE

BELOW-NAMED ENTITY AND AGREE TO ABIDE BY THIS AGREEMENT AND WILL ONLY

DISSEMINATE 551 DOCUMENTS TO OTHER AUTHORIZED USERS UNDER THE CONDITIONS SET

FORTH ABOVE.

Name of Business:

Printed Name: Signature:

Title _Date:

Phone Number:. Email Address:.

Construction Document Set#:

Project Name:

Airport Authority Solicitation Number: DSA SSI 021510