Aviation_Only_-_Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Flight Helmets, Accessories and Repair Services
- Solicitation number
- RFQ-26-0319
- 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, required for vendors and authorized representatives accessing security-controlled documentation related to the Flight Helmets, Accessories and Repair Services contract. The form mandates that all personnel with access to sensitive security information comply with disclosure restrictions under 49 C.F.R. Parts 15 and 1520, which govern aviation security protocols. Signatories must acknowledge the confidential nature of the documents, confirm their understanding of unauthorized disclosure penalties, and commit to destroying all materials upon completion of their need-to-know period or no later than the contract end date. The form requires completion of standard identification fields including company name, authorized representative name and signature, title, phone number, and mailing address.
This acknowledgement form applies to the City of Phoenix's five-year contract for flight helmets, accessories, and repair services, commencing December 1, 2026, with two optional two-year extensions at the City's discretion. All bidders must execute this form as a condition of accessing contract documentation through the City's Procurement Portal. Failure to comply with the security information requirements may result in civil penalties or other legal action, in addition to potential contract disqualification. The form serves as a mandatory compliance instrument ensuring that all parties involved in the procurement process maintain strict confidentiality regarding aviation security matters throughout the contract term and beyond.
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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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