Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Various Metals Supply
- Solicitation number
- IFB-26-0075
- 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 a contract opportunity involving various metals supply. The form is designed to ensure that individuals and companies accessing security-sensitive documents understand their obligations under federal regulations. The metals supply contract is a five-year agreement commencing on or about July 1, 2026, with the effective date upon award by City Council, conditioned upon signature and recording by the City Clerk's department as required by Phoenix City Code. The solicitation is available through the City's Procurement Portal, and offerors may contact the designated procurement officer with questions or procurement-support@opengov.com for technical portal assistance. The contract will terminate upon the earliest occurrence of reaching the end of the term including any extensions exercised, or upon termination pursuant to the agreement's provisions.
Signatories to this acknowledgement form must confirm their understanding that the contract documents contain Sensitive Security Information controlled under 49 C.F.R. Parts 15 and 1520, which may only be disclosed to individuals with requisite "need to know." Authorized representatives must agree to destroy the documents upon the earlier of the company's completion of its need to review and use the materials or no later than the contract end date. Unauthorized release of this information may result in civil penalties or other legal 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. The form requires completion of the authorized representative's name, title, signature, phone number, and company address.
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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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