Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Traffic Signal Cabinet Art Wrap
- Solicitation number
- RFQu-26-0114
- 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 conjunction with the Traffic Signal Cabinet Art Wrap contract opportunity. The form establishes the framework for managing sensitive security information controlled under 49 C.F.R. Parts 15 and 1520 in relation to project documentation. Authorized representatives of participating companies must acknowledge receipt of designated documents, understand the restrictions on disclosure to only those with requisite "need to know," and commit to destroying the materials by the contract end date or upon completion of their review and use, whichever occurs first. The form requires the signature, printed name, title, phone number, and address of the authorized company representative executing the acknowledgement.
The acknowledgement form serves as a compliance mechanism requiring all offerors and participants in the Traffic Signal Cabinet Art Wrap solicitation (RFQu-26-0114) to certify their understanding of federal security information protocols prior to accessing sensitive project materials. Unauthorized disclosure of the controlled information may result in civil penalties or other enforcement actions as outlined in federal regulations. The form is designed as a standard exhibit to be completed and executed by each entity handling sensitive documentation related to the three-year contract with potential two one-year extensions commencing January 1, 2026, ensuring that all parties acknowledge their legal obligations to maintain the confidentiality and proper handling of security-sensitive information throughout the contract term and beyond.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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
File details come from the government source that posted it. Updated .