Aviation_Only_-_Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Wheelchair Lift
- Solicitation number
- RFQ-PCC-26-0103
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
The document is a Sensitive Security Information Acknowledgement Form from the City of Phoenix Aviation Department, designed to protect confidential documents related to government projects. This form requires authorized representatives to recognize the sensitive nature of certain documents controlled under 49 C.F.R. Parts 15 and 1520, and commits signatories to destroy the documents upon completion of their review or by the contract end date.
The associated contract opportunity involves procuring a single vertical portable wheelchair lift for the Phoenix Convention Center through a Request for Quotation (RFQ-PCC-26-0103). The lift must provide accessibility for individuals with mobility challenges, with specific technical requirements including 36-inch doorway compatibility, lifting capacity between 12-54 inches, 750-pound weight capacity, and 120VAC power. The procurement includes Disadvantaged Business Enterprise (DBE) and small business participation provisions, with vendors required to demonstrate good faith efforts in DBE engagement. The contract is set to commence on January 1, 2026, with key dates including an October 8, 2025 deadline for questions and October 21, 2025 proposal submission deadline. The successful vendor must provide a 1-year manufacturing warranty and 5-year parts warranty, with the City reserving the right to purchase additional quantities up to 100 percent of the specified amount.
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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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