Aviation_Only_-_Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Solicitation number
- RFP 27-SWDD-006
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This document is a Sensitive Security Information Acknowledgement Form issued by the City of Phoenix Aviation Department. The form is designed to protect confidential documents related to an unspecified project, requiring signatories to adhere to strict federal regulations under 49 C.F.R. Parts 15 and 1520 regarding the handling and destruction of sensitive information. Authorized representatives must commit to destroying specified documents upon completion of their review or by the contract's end date, with acknowledgment that unauthorized release could result in civil penalties.
The related state and local contract opportunity involves the City of Phoenix's landfill gas collection control system operations, maintenance, and monitoring. The city is committed to managing landfill gas in compliance with federal, state, and local regulations, with a proactive approach to controlling offsite odors and subsurface gas migration. The program aims to operate the Gas Collection Control System (GCCS) preventatively, addressing potential issues before they require immediate intervention or remediation. The contract demonstrates the city's commitment to environmental stewardship and community responsibility in Arizona.
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Text version
EXHIBIT __
City of Phoenix Aviation Department Sensitive Security Information Acknowledgement Form
The documents entitled [fill in document title(s)] (“Documents”) to be used as part of the [fill in project name] contain Sensitive Security Information that is controlled under 49 C.F.R. Parts 15 and 1520. These documents may only be disclosed to persons who have the requisite “need to know”, as defined in 49 C.F.R. Parts 15 and 1520. Unauthorized release of this information may result in civil penalty or other action. For U.S. government agencies, public disclosure is governed by 5 U.S.C. 552 and 49 C.F.R. Parts 15 and 1520.
I acknowledge, on my behalf and that of my company, the above statement and agree to destroy the [fill in document title(s)], in compliance with 49 C.F.R. Parts 15 and 1520, upon the earlier of our company’s completion of our need to review and/or use the Documents or no later than [fill in current contract end date].
NAME OF COMPANY
AUTHORIZED REPRESENTATIVE PRINTED NAME
AUTHORIZED REPRESENTATIVE’S SIGNATURE
| ______ | ||
| TITLE | PHONE NUMBER |
ADDRESS CITY, STATE AND ZIP CODE
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