Aviation_Only_-_Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Print and Mail Election Materials
- Solicitation number
- RFP GGS-26-0079
- 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 a legal document designed to protect sensitive information controlled under federal regulations 49 C.F.R. Parts 15 and 1520. It requires authorized representatives of companies to acknowledge the confidential nature of specific documents related to an unspecified project, and commit to destroying these documents upon completion of their review or by the contract's end date.
The accompanying contract opportunity describes a solicitation for print and mail election materials for the City of Phoenix. The city seeks a single contractor (with subcontractors permitted) to provide comprehensive services including labor, materials, proofs, administration, and transportation for printing, addressing, and mailing election materials to Phoenix residents. The solicitation is specific to Arizona and focuses on an as-needed basis service model for election-related communication materials.
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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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