Aviation_Only_-_Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Full-Service Laundry and Rental Program
- Solicitation number
- RFP GGS-26-0384
- 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 conjunction with aviation-related contract documents containing controlled security information. The form serves as a compliance document under 49 C.F.R. Parts 15 and 1520, requiring authorized representatives of bidding companies to acknowledge their understanding that disclosed documents contain sensitive security information with restricted access and distribution limitations. Signatories agree to destroy all provided documents upon the earlier of either their company's completion of review and use or the specified contract end date, with unauthorized release subject to civil penalties and other legal action.
The document functions as a protective mechanism for federal aviation security information governed by Transportation Security Administration regulations and U.S. Freedom of Information Act provisions. This form is a template with blank fields to be completed with specific document titles, project names, and contract end dates relevant to individual solicitations. All authorized company representatives accessing aviation-related contract materials must execute this acknowledgement, thereby confirming their "need to know" status and legal obligation to handle sensitive security information in compliance with federal regulations. The form establishes contractual accountability for information security throughout the contract lifecycle and post-award periods.
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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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