Aviation_Only_-_Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- 35-65-95 Gallon Containers
- Solicitation number
- RFP 27-SW-001
- 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, which establishes protocols for handling classified aviation security documents in compliance with federal transportation security regulations. The form serves as a template for bidders and contractors participating in aviation-related projects to acknowledge receipt and understanding of sensitive materials governed by 49 C.F.R. Parts 15 and 1520. Signatories must confirm they understand that unauthorized disclosure of the controlled documents may result in civil penalties or other legal action, and they commit to destroying all received materials upon the earlier of project completion or a specified contract end date. The document requires completion by an authorized company representative with printed name, signature, title, phone number, and full business address.
This acknowledgement form is ancillary to the City of Phoenix's 35-65-95 Gallon Containers procurement, which seeks vendors to supply residential curbside collection containers through an RFP process. However, the sensitive security information form appears to be included in error or for reference purposes, as the container procurement itself does not involve aviation or sensitive security materials. The primary container solicitation covers refuse, recycling, and green organics containers with specific performance requirements and includes substantial DBE and small business participation mandates, a pre-offer conference scheduled for January 21, 2026, proposal submission deadline of February 11, 2026, and a contract term commencing July 1, 2026, for three years with two optional one-year extensions.
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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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