Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Welding and Sheet Metal Fabrication Services
- Solicitation number
- IFB 26-FMD-034
- 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 connection with the Welding and Sheet Metal Fabrication Services contract opportunity. The form establishes protocols 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 Welding and Sheet Metal Fabrication Services on a three-year term with two one-year renewal options, with an anticipated commencement date of April 1, 2026. The contract will become effective upon award by City Council, subject to signature and recording by the City Clerk's department as required by Phoenix City Code. Interested offerors may access the solicitation through the City's Procurement Portal, with technical support available through the portal's support feature or via email to procurement-support@opengov.com.
The acknowledgement form requires authorized representatives from bidding companies to certify receipt and understanding of security information restrictions, confirming their obligation to limit disclosure to personnel with a demonstrated "need to know" and to destroy documents upon completion of their review or by the contract end date, whichever occurs first. Unauthorized release of Sensitive Security Information may result in civil penalties or other action. For U.S. government agencies, public disclosure is governed by 5 U.S.C. 552 and applicable Code of Federal Regulations provisions. All companies submitting offers must complete and sign this acknowledgement form as a condition of participation in the solicitation process.
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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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