Aviation_Only_-_Sensitive_Security_Information_Acknowledgement_Form.docx

DOCX document 20 KB Posted

Attached to
Operations Control Center & Data Collection Services State and local contract opportunity
Solicitation number
PTD26-003
Issued by
Maricopa County, Phoenix City, Arizona

About this file

This is a Sensitive Security Information Acknowledgement Form issued by the City of Phoenix Aviation Department for use in connection with the Operations Control Center & Data Collection Services contract opportunity. The form serves as a binding acknowledgment that recipients understand and agree to comply with federal security regulations governing the protection of sensitive aviation security information. Signatories must confirm they have reviewed documents containing Sensitive Security Information controlled under 49 C.F.R. Parts 15 and 1520 and acknowledge that unauthorized disclosure may result in civil penalties or other legal action. The contract opportunity itself involves a five-year agreement commencing on or about July 1, 2027, with one two-year optional extension exercisable at the City's sole discretion. Sealed offers are being solicited through the City of Phoenix Procurement Portal.

All parties with access to the restricted documents must agree to destroy materials upon the earlier of either completion of their need to review and utilize the documents or by the contract end date specified in the final agreement. The acknowledgment form requires signature by an authorized company representative and must include the signatory's printed name, title, phone number, and complete address. This form is a mandatory exhibit to the solicitation and represents a prerequisite condition for participation in the bidding process, ensuring that all contractors understand and accept the legal obligations associated with handling sensitive aviation security information in compliance with federal regulations.

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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

______
TITLEPHONE NUMBER

ADDRESS CITY, STATE AND ZIP CODE

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