Aviation_Only_-_Sensitive_Security_Information_Acknowledgement_Form.docx

DOCX document 20 KB Posted

Attached to
Financial Reporting Software
Solicitation number
RFP 26-0035
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, designed to be used in conjunction with aviation-related contract solicitations. The form serves as a template for ensuring that recipients of sensitive security information comply with federal regulations governing the protection and handling of such materials. The document requires authorized representatives from interested companies to acknowledge receipt of documents containing Sensitive Security Information controlled under 49 C.F.R. Parts 15 and 1520, and to commit to destroying those documents upon the earlier of completion of their review or a specified contract end date. A non-mandatory pre-offer conference is scheduled, and written inquiries and sealed offers must be submitted by the specified deadlines, with the contract commencing on or about January 1, 2027, for an initial five-year term with one optional one-year extension available at the City's discretion.

The form requires signatories to acknowledge that unauthorized release of Sensitive Security Information may result in civil penalties or other legal action, and that disclosure is restricted to persons with a documented "need to know" as defined in applicable federal regulations. For U.S. government agencies, public disclosure is governed by 5 U.S.C. 552 and the referenced C.F.R. provisions. The acknowledgement must be completed by authorized company representatives providing their name, title, signature, phone number, and business address. This document is a mandatory component of the financial reporting software solicitation and must be executed prior to receipt of any sensitive aviation-related information, ensuring compliance with federal security protocols and protecting the City's critical infrastructure information from unauthorized disclosure.

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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

______
TITLEPHONE NUMBER

ADDRESS CITY, STATE AND ZIP CODE

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