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 from the City of Phoenix Aviation Department for use in contract solicitations involving aviation-related projects. The form serves as a template requiring authorized company representatives to acknowledge receipt and understand restrictions on documents containing Sensitive Security Information controlled under 49 C.F.R. Parts 15 and 1520. Signatories agree to limit disclosure to persons with a "need to know" and commit to destroying the specified documents upon the earlier of project completion or the contract end date. The form requires completion of company name, authorized representative's printed name and signature, title, phone number, and address fields, with corresponding spaces to identify the specific document titles and project name involved.
The acknowledgement form directly relates to the City of Phoenix's five-year firm fixed-price Restoration Services contract commencing December 1, 2026, with sealed offers due May 8, 2026 at 2:00 p.m. via the OpenGov Procurement Portal. While the primary solicitation addresses general restoration services including carpentry, masonry, plumbing, electrical, roofing, and water damage restoration, this specific form applies only to contractors working on aviation-related projects within the scope of work. Contractors must acknowledge understanding that unauthorized release of sensitive security information may result in civil penalties or other legal action, ensuring compliance with federal aviation security protocols and establishing contractor accountability for proper document handling and destruction procedures.
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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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