Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Traffic Signal Controller Cabinets
- Solicitation number
- IFB-26-0038
- 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. The form requires authorized representatives to recognize the sensitive nature of the documents under 49 C.F.R. Parts 15 and 1520, and commit to destroying the documents upon completion of their review or by the contract end date. The form must be signed by a company representative, including their printed name, signature, title, contact information, and company address.
In conjunction with this acknowledgement form, the City of Phoenix is conducting a procurement for Traffic Signal Controller Cabinets through Invitation for Bid IFB-26-0038. The five-year contract, set to commence around March 1, 2025, seeks to acquire approximately 100 cabinets annually, specifically NEMA TS2 Type 1 Traffic Control Cabinets and Advanced Transportation Controller (ATC) Cabinets. Key procurement dates include a pre-offer conference on October 17, 2025, with written inquiries due by October 24, 2025, and proposal submissions due November 7, 2025, at 2:00 pm. The evaluation will focus on technical compliance, pricing, warranty coverage, and detailed specifications. While specific set-aside designations are not explicitly stated, the procurement process typically encourages diverse vendor participation, with pricing to remain firm for the first two years and potential annual adjustments thereafter.
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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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