Aviation_Only_-_Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Restoration Services
- Solicitation number
- RFP GGS-26-0202
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This is a Sensitive Security Information Acknowledgement Form issued by the City of Phoenix Aviation Department for use in conjunction with aviation-related contract activities. The form serves as a compliance document requiring authorized representatives of bidding companies to acknowledge receipt and understanding of sensitive security information controlled under 49 C.F.R. Parts 15 and 1520. Signatories agree to restrict disclosure of the specified documents to personnel with established need-to-know and commit to destroying the materials upon the earlier of project completion or the contract end date. The form requires standard identifying information including company name, authorized representative signature, title, phone number, and complete address.
This acknowledgement form is associated with a City of Phoenix Restoration Services contract opportunity with an effective date upon final signature and recording by the City Clerk's department. The agreement commences December 1, 2026, or the contract term start date approved by Phoenix City Council, whichever is later, and runs for a five-year term with no extension options. The solicitation is administered through the City's Procurement Portal, with technical support available via the portal's support feature or through procurement-support@opengov.com. Contract termination occurs upon the earliest of the following: expiration of the five-year term, exercise of any extension provisions, or termination pursuant to agreement 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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