Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Parks and Recreation Event-Related Services
- Solicitation number
- PKS-RFQu-26-0119
- 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 connection with a Parks and Recreation Event-Related Services contract opportunity. The form is designed to control access to documents containing Sensitive Security Information as governed by 49 C.F.R. Parts 15 and 1520. The contract has a five-year term commencing on or about February 1, 2026, and will be awarded by City Council, with effectiveness upon signature and recording by the City Clerk's department as required by Phoenix City Code. The solicitation is administered through the City's Procurement Portal, with technical support available through the portal's support bubble or at procurement-support@opengov.com.
The acknowledgement form requires authorized representatives of responding companies to certify their understanding of restricted disclosure requirements and to commit to destroying all controlled documents upon the earlier of either completion of their need to review and use the documents or the contract end date. Signatories must provide their name, title, phone number, and complete address. The form emphasizes that unauthorized release of Sensitive Security Information may result in civil penalties or other legal action, and that disclosure to U.S. government agencies is governed by 5 U.S.C. 552 and the referenced CFR parts. This acknowledgement represents a mandatory compliance requirement for all offerors seeking to access project-related documents containing security-sensitive 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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