Sensitive_Security_Information_Acknowledgement_Form.docx

DOCX document 20 KB Posted

Attached to
Traffic Control Officer Services Requirements Contract
Solicitation number
IFB-25-0739
Issued by
Maricopa County, Phoenix City, Arizona

About this file

This document is a Sensitive Security Information Acknowledgement Form issued by the City of Phoenix Aviation Department for use in connection with a Traffic Control Officer Services Requirements Contract. The form serves as a template requiring authorized representatives of bidding companies to acknowledge receipt of documents containing Sensitive Security Information governed by 49 C.F.R. Parts 15 and 1520. Signatories must confirm their understanding that the information is restricted to individuals with a demonstrated need-to-know and that unauthorized disclosure may result in civil penalties or other legal action. The City of Phoenix Street Transportation Department, Traffic Services Division is seeking traffic control officer services for a five-year term commencing on or about April 1, 2026, with the contract effective upon City Council award and signature by the City Clerk's department, as required by Phoenix City Code. The contract will terminate upon the earlier of the end of the contract term including any exercised extensions or upon termination pursuant to the agreement's provisions.

Bidders must sign the acknowledgement form, providing company name, authorized representative name and signature, title, phone number, and complete address. Signatories agree to destroy all marked documents in compliance with federal security regulations upon the earlier of their company's completion of need to review and use the documents or no later than the current contract end date. The solicitation is available through the City's OpenGov e-Procurement Portal, with technical support available through the platform's support function or via procurement-support@opengov.com. Interested offerors should contact the listed procurement officer for inquiries related to this solicitation.

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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

______
TITLEPHONE NUMBER

ADDRESS CITY, STATE AND ZIP CODE

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