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 relation to aviation-related projects containing security-controlled documents. The form serves as a template requiring authorized representatives from bidding companies to acknowledge receipt of documents classified as Sensitive Security Information under 49 C.F.R. Parts 15 and 1520. Signatories must confirm understanding that such materials may only be disclosed to individuals with a documented need to know and commit to destruction of the documents upon the earlier of project completion or a specified contract end date. The form requires completion with the relevant document titles, project name, and contract end date, along with the authorized representative's printed name, signature, title, phone number, and company address.
This acknowledgement form is directly linked to the City of Phoenix's five-year firm fixed-price Restoration Services contract solicitation commencing December 1, 2026, with no extension options. The inclusion of this aviation-specific form indicates that certain restoration services may be performed at Phoenix's aviation facilities, necessitating compliance with federal security protocols. Contractors responding to this solicitation must complete and sign this acknowledgement if their proposed work involves aviation-related projects, demonstrating their understanding of security restrictions and commitment to proper handling of sensitive information as a condition of contract eligibility.
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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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