Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Vehicle Maintenance of Repair
- Solicitation number
- 26-FSD-013
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This is a Sensitive Security Information Acknowledgement Form from the City of Phoenix Aviation Department related to a Vehicle Maintenance and Repair contract solicitation. The City of Phoenix is seeking sealed offers for vehicle maintenance and repair services under a three-year term with two optional renewal years, with the contract commencing on or about July 1, 2026. The solicitation is administered through the City's Procurement Portal, and interested offerors should direct technical questions to the portal support or contact the listed procurement officer for solicitation-related inquiries.
The form requires authorized company representatives to acknowledge receipt of sensitive security information controlled under 49 C.F.R. Parts 15 and 1520, which pertains to Transportation Security Administration (TSA) regulations for airport security. Signatories agree to restrict disclosure to personnel with a legitimate "need to know" and commit to destroying the designated documents upon completion of their review or by the contract end date, whichever is earlier. Unauthorized release of this information may result in civil penalties or other enforcement action. The form includes signature blocks for the authorized representative's name, title, phone number, and company address, emphasizing the confidential nature of materials related to airport security procedures and protocols.
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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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