Aviation_Only_-_Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Solicitation number
- RFP 26-0158
- 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 individuals and companies accessing security-controlled documents related to airport operations. The form mandates that recipients acknowledge their understanding of restrictions governing the disclosure of sensitive security information regulated under 49 C.F.R. Parts 15 and 1520. Signatories agree to restrict access to individuals with a documented "need to know" and commit to destroying all controlled documents upon the earlier of project completion or the contract end date specified in the agreement. The form requires the authorized representative of the company to provide their printed name, signature, title, phone number, and complete address, thereby creating a binding acknowledgement of compliance with federal security protocols governing airport-related sensitive information.
This acknowledgement form serves as a mandatory compliance document for the City of Phoenix's lease procurement of a high-volume digital color production press with an effective date of June 15, 2026. The inclusion of this aviation security form in a digital press lease solicitation indicates that the equipment or related documentation involves airport infrastructure or operations subject to federal security requirements. Vendors submitting bids for this five-year lease must execute and return this acknowledgement form as part of their sealed offer submission, demonstrating their organization's commitment to protecting sensitive security information and complying with federal aviation security regulations. Unauthorized disclosure of controlled information carries civil penalties and potential legal action under federal law.
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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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