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 issued by the City of Phoenix Aviation Department, specifically designed for protecting confidential documents related to aviation projects. This form requires authorized representatives to acknowledge the sensitive nature of specific documents controlled under 49 C.F.R. Parts 15 and 1520, with mandatory destruction protocols upon project completion or contract end date. Signatories must commit to maintaining strict confidentiality and only disclosing information to individuals with a requisite "need to know" status.
The associated state and local contract opportunity involves the City of Phoenix procuring a vertical portable wheelchair lift for the Phoenix Convention Center through a Request for Quotation (RFQ-PCC-26-0103). The procurement includes critical technical specifications requiring a lift that can pass through a 36-inch doorway, lift between 12-54 inches, support a minimum 750-pound capacity, and feature 120VAC power and safety mechanisms. Key procurement requirements include Disadvantaged Business Enterprise (DBE) participation, monthly reporting, and a mandatory Small Business Participation Plan. The contract is set to commence on January 1, 2026, with a one-year manufacturing warranty and five-year parts warranty, subject to City Council approval and recording by the City Clerk's department.
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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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