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
The document is a Sensitive Security Information Acknowledgement Form from the City of Phoenix Aviation Department, designed to control the disclosure of sensitive documents related to aviation projects. The form requires authorized representatives to recognize the confidential nature of certain documents governed by 49 C.F.R. Parts 15 and 1520, and commit to destroying these documents upon completion of their review or by the contract's end date. Signatories must provide company details, including name, authorized representative, signature, title, contact information, and address.
Complementing the acknowledgement form is a related solicitation (RFP GGS-26-0079) for print and mail election materials services, targeting a contract period from April 1, 2026, to March 31, 2031, with potential four one-year extensions. The City of Phoenix seeks a contractor capable of printing and mailing between 1 and 750,000 election pamphlets across eight city council districts. Key requirements include a minimum seven-year business history, comprehensive insurance, background screening capabilities, and strict voter information confidentiality. The procurement emphasizes Disadvantaged Business Enterprise (DBE) and small business participation, mandating an initial DBE/Small Business Participation Plan within 30 days of contract award and monthly documentation of DBE engagement through phoenix.diversitycompliance.com.
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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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