Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Youth Crime Prevention Program
- Solicitation number
- HSD-RFP-26-0074
- 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. This form is related to a Youth Crime Prevention Program solicitation, which seeks a three-year contract commencing on or about January 1, 2026, to implement crime prevention services in specific Phoenix neighborhoods including Maryvale, South Phoenix, Alhambra, and Central City. The solicitation is available through the City's Procurement Portal, with technical support provided via OpenGov e-Procurement Portal. The contract will terminate upon reaching the end of its term or through specific agreement provisions.
The acknowledgement form emphasizes strict handling of sensitive security information, governed by federal regulations (49 C.F.R. Parts 15 and 1520), requiring signatories to confirm they understand the confidentiality requirements and agree to destroy documents in compliance with specified guidelines. While specific budget details are not provided in this document, the form is designed to ensure proper management and protection of sensitive project-related information by authorized representatives who have a demonstrable "need to know" about the youth crime prevention program.
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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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