Aviation_Only_-_Sensitive_Security_Information_Acknowledgement_Form.docx

DOCX document 20 KB Posted

Attached to
Streetlight Maintenance Services
Solicitation number
RFP GGS-26-0220
Issued by
Maricopa County, Phoenix City, Arizona

About this file

This is a Sensitive Security Information Acknowledgement Form related to a Streetlight Maintenance Services solicitation issued by the City of Phoenix, Arizona. The form serves as a security compliance document for the streetlight maintenance contract opportunity, which has a five-year initial term commencing December 1, 2026, or upon the Effective Date, whichever is later. The contract includes two optional one-year extensions exercisable at the City's sole discretion. Sealed offers for this maintenance services contract are being accepted through the City's Procurement Portal, with technical support available through the portal's support feature or via procurement-support@opengov.com. The Agreement will terminate upon the earliest of: completion of the initial term plus any exercised extensions, or termination pursuant to agreement provisions.

The Sensitive Security Information Acknowledgement Form is a prerequisite document that bidders and offerors must complete to acknowledge their understanding of and agreement to comply with security protocols and confidentiality requirements related to sensitive or restricted information associated with the streetlight maintenance services contract. This document ensures that all participants in the procurement process are aware of their obligations regarding the protection of sensitive security information and establishes compliance with applicable security standards before submitting offers or accessing restricted project materials.

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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

______
TITLEPHONE NUMBER

ADDRESS CITY, STATE AND ZIP CODE

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