Aviation_Only_-_Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Central Park Community Center Operations
- Solicitation number
- PKS-RFP-27-0430
- 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 aviation security documentation. The form establishes protocols for handling classified materials governed by 49 C.F.R. Parts 15 and 1520, which regulate the disclosure and protection of sensitive security information in aviation operations. The document requires authorized representatives of responding companies to acknowledge their understanding of security requirements and commit to proper handling of specified documents. Signatories must agree to destroy all sensitive materials upon the earlier of either completion of their review and use of the documents or by the contract end date specified in the procurement opportunity. The form requires completion of company name, authorized representative identification, signature, title, contact information, and full address.
The acknowledgement form contains no pricing, set-aside provisions, incumbent information, or funding details, as it serves solely as a compliance and security protocol document. Organizations responding to City of Phoenix Aviation Department solicitations must execute this form to demonstrate understanding of federal security regulations and commitment to safeguarding sensitive aviation security information. Failure to comply with the security requirements outlined in this acknowledgement may result in civil penalties or other enforcement actions under federal law.
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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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