Aviation_Only_-_Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Papago Archery Range Operator
- Solicitation number
- PKS RFP26-0279
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This is a Sensitive Security Information Acknowledgement Form related to the City of Phoenix's procurement for a Papago Archery Range Operator. The form serves as a compliance document for aviation-related sensitive security information and is associated with a three-year initial term contract commencing on or about October 1, 2026, with two one-year renewal options and one additional five-year option, for a potential total contract period of 10 years. The contract is contingent upon City Council award and signature and recording by the City Clerk's department as required by Phoenix City Code. The solicitation is available through the City's Procurement Portal, with technical support available through the portal's support system or via procurement-support@opengov.com. Interested offerors should contact the designated procurement officer for non-technical inquiries regarding this solicitation.
The acknowledgement form specifically addresses the handling of sensitive security information and establishes compliance requirements for vendors or operators who may access such information during contract performance. This document is particularly relevant given the aviation-related security protocols that may apply to archery range operations or facilities potentially located near aviation facilities. The form functions as a prerequisite documentation requirement ensuring that all parties understand and agree to safeguard any sensitive security information in accordance with applicable federal and state regulations. No specific pricing terms, set-asides, incumbent information, or funding amounts are contained 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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