Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Electric Meter Testing, Calibration, and Repairs
- Solicitation number
- IFB-26-0013
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
The document is a Sensitive Security Information Acknowledgement Form from the City of Phoenix Aviation Department, designed to protect confidential documents related to a specific project. This form requires authorized representatives to acknowledge the sensitive nature of certain documents controlled under 49 C.F.R. Parts 15 and 1520, and commits the signatory to destroy these documents upon completion of their review or by the contract end date. The form mandates that documents can only be disclosed to individuals with a requisite "need to know" and warns of potential civil penalties for unauthorized release.
The related contract opportunity involves the City of Phoenix Water Services Department's Invitation for Bid (IFB-26-0013) for Electric Meter Testing, Calibration, and Repairs, a comprehensive five-year contract expected to start September 1, 2025. The solicitation covers 182 line items for testing, calibration, and repair services for electrical meters from various manufacturers. Bidder requirements include five years of business experience, employee certifications, ISO 9001:2015 certification, and ISO 17025 accreditation. Key procurement dates include a pre-offer conference on June 30, 2025, questions deadline on July 7, 2025, and bid response deadline of July 11, 2025 at 2:00 pm. The contract will be awarded to the most responsive and responsible bidder, with unit pricing proposed for line items ranging from 1 to 123 units, and contractors must maintain a local business facility in the Greater Phoenix area.
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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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