Aviation_Only_-_Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Cartographic Services
- Solicitation number
- PKS-RFP-27-0470
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This is a Sensitive Security Information Acknowledgement Form for the City of Phoenix Aviation Department related to a Cartographic Services contract opportunity. The form is designed to control access to documents containing sensitive security information governed by 49 C.F.R. Parts 15 and 1520. Authorized representatives from bidding companies must sign the acknowledgement to confirm they understand the restricted nature of the documents, recognize their obligation to limit disclosure to personnel with a legitimate "need to know," and acknowledge that unauthorized release may result in civil penalties. Signatories agree to destroy the specified documents upon the earlier of their company's completion of the review and use period or the current contract end date, in full compliance with federal regulations.
The Cartographic Services contract is a two-year agreement with an effective date upon final signature and recording by the City Clerk, with a commencement date of February 1, 2027 or the date Phoenix City Council approves. The City has the option to extend the contract for one additional three-year term at its sole discretion. Sealed offers are being solicited through the City's Procurement Portal, with technical support available via the portal's support feature or through procurement-support@opengov.com. The contract will terminate upon expiration of the initial term and any exercised extensions, or earlier upon termination per the agreement's provisions.
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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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