Sensitive_Security_Information_Acknowledgement_Form.docx

DOCX document 20 KB Posted

Attached to
Sewer Rods
Solicitation number
IFB-26-0168
Issued by
Maricopa County, Phoenix City, Arizona

About this file

This is a Sensitive Security Information Acknowledgement Form for the City of Phoenix Aviation Department related to a sewer rods procurement contract. The form establishes procedures for handling documents containing Sensitive Security Information controlled under 49 C.F.R. Parts 15 and 1520. The City of Phoenix is soliciting sealed offers for sewer rods under a five-year contract commencing on or about March 1, 2026. The solicitation is available through the City's Procurement Portal, with technical support available through the portal's support feature or via email at procurement-support@opengov.com. 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.

The Acknowledgement Form requires authorized representatives of bidding companies to sign and acknowledge receipt of sensitive security documents, agreeing to maintain confidentiality and destroy the documents upon the earlier of the company's completion of its need to review or use the documents or no later than the current contract end date. Disclosure of sensitive security information is restricted to persons with requisite "need to know" as defined in applicable federal regulations, with unauthorized release potentially resulting 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 effective date of the contract will be upon award by City Council, conditioned upon signature and recording by the City Clerk's department as required by Phoenix City Code, whichever date is later.

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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

______
TITLEPHONE NUMBER

ADDRESS CITY, STATE AND ZIP CODE

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