Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Concrete Flatwork Services
- Solicitation number
- IFB 26-0078
- 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 in connection with the Concrete Flatwork Services solicitation (IFB 26-0078). The form establishes protocols for handling documents classified as Sensitive Security Information under 49 C.F.R. Parts 15 and 1520, which are restricted to individuals with established "need to know" authorization. The concrete flatwork services contract is a five-year agreement commencing June 1, 2026, covering comprehensive concrete installation and replacement services throughout the Phoenix Metro area, including sidewalks, ramps, walls, curbs, steps, and light pole bases. Concrete specifications range from 2,500 to 6,000 PSI and encompass new construction, replacement, and specialized installations for the Aviation Department. The pre-offer conference is scheduled for October 15, 2025, at 9:00 a.m., with written inquiries due by October 29, 2025, and bids due November 12, 2025, at 2:00 p.m. Estimated annual service quantities range from 2 to 10,000 units depending on the specific service category.
Contractors must provide detailed unit costs incorporating all associated expenses including licenses, traffic control, administration, materials, and equipment across multiple service categories. The solicitation emphasizes Disadvantaged Business Enterprise (DBE) and Small Business participation, requiring contractors to submit initial and annual DBE/Small Business Participation Plans with monthly documentation through the City's Certification and Compliance System. All recipients of Sensitive Security Information documents must acknowledge compliance with federal security regulations and agree to destroy documents upon contract completion or by the specified contract end date, with unauthorized disclosure subject to civil penalties under federal law.
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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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