Aviation_Only_-_Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Onsite Testing and Repair of Large Water Meters
- Solicitation number
- RFP GGS-26-0176
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This is a Sensitive Security Information Acknowledgement Form from the City of Phoenix Aviation Department, required for a contract project involving onsite testing and repair of large water meters. The form establishes compliance requirements for individuals and companies receiving access to documents containing sensitive security information controlled under 49 C.F.R. Parts 15 and 1520. Authorized representatives must acknowledge their understanding that unauthorized release of this information may result in civil penalties or other legal action, and they agree to destroy all specified documents upon the earlier of either completion of their need to review and use the materials or the contract end date. The City of Phoenix is soliciting sealed offers for this five-year contract, with the effective date commencing on or about May 1, 2026, contingent upon City Council award and execution by the City Clerk's department in accordance with Phoenix City Code provisions.
The acknowledgement form serves as a prerequisite documentation requirement for bidders and contractors seeking to access sensitive aviation-related project materials. All personnel handling these documents must be authorized on a "need to know" basis as defined in applicable federal regulations, and disclosure is restricted to prevent security vulnerabilities. For offerors requiring technical support or assistance with the City's Procurement Portal, contact information and support resources are available through the portal interface or via procurement-support@opengov.com. The contract will terminate upon reaching the end of the specified term, including any exercised extensions, or upon earlier termination in accordance with contract provisions.
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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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