Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Lutron Lighting Systems
- Solicitation number
- IFB PCC-26-0101
- 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. The form is associated with a Lutron lighting systems contract for a five-year term commencing on or about March 1, 2026, and will be awarded by City Council. The solicitation is available through the City's Procurement Portal, with technical support provided via email or support bubble. The contract will terminate upon reaching the end of its term or through specified termination provisions.
The acknowledgement form requires authorized company representatives to recognize the sensitive nature of the documents, which contain Sensitive Security Information controlled under federal regulations. Recipients must protect the information, disclose it only to those with a "need to know," and destroy the documents upon contract completion or by the specified contract end date. While specific pricing details are not included in this document, the form emphasizes strict compliance with federal security regulations and mandates proper handling and disposal of sensitive contract-related materials.
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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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