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 issued by the City of Phoenix Aviation Department, a template document designed to protect classified aviation security information in accordance with federal regulations 49 C.F.R. Parts 15 and 1520. The form requires authorized representatives of companies receiving sensitive security documentation to acknowledge their understanding of disclosure restrictions and commit to information protection protocols. The document serves as a template wherein specific details—including document titles, project names, and contract end dates—must be completed by the City prior to distribution. Signatories agree to destroy all received documents upon the earlier of either their company's completion of its need to review and use the materials or the specified contract termination date.
The acknowledgement form represents a standard security compliance mechanism and does not itself contain substantive information regarding contract scope, deliverables, pricing, or performance requirements. Rather, it functions as a prerequisite administrative document that contractors must execute before accessing sensitive aviation-related materials. The form applies to all contractors and subcontractors requiring access to aviation security information and establishes legal accountability under federal civil penalties for unauthorized disclosure, making it a mandatory component of the City's procurement process for aviation-related contracts. No specific incumbent contractor, budget allocation, or contract values are referenced within this acknowledgement form itself.
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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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