Sensitive_Security_Information_Acknowledgement_Form.docx

This is a Sensitive Security Information Acknowledgement Form issued by the City of Phoenix Aviation Department for use in connection with a Comprehensive Community Needs Assessment contract. The form serves as a template for contractors and authorized representatives to acknowledge receipt of documents containing Sensitive Security Information governed by 49 C.F.R. Parts 15 and 1520. The acknowledgement applies to a three-year contract term commencing on or about July 1, 2026, with the effective date established upon award by City Council, conditional upon signature and recording by the City Clerk's department. Signatories commit to limiting disclosure of the controlled documents to persons with requisite "need to know" as defined in federal regulations and agree to destroy the documents upon the earlier of contract completion or the contract end date.

The form requires authorized company representatives to execute the acknowledgement, providing their printed name, signature, title, phone number, and company address. Unauthorized release of Sensitive Security Information may result in civil penalties or other legal action. For U.S. government agencies, public disclosure of such information is governed by 5 U.S.C. 552 and applicable Code of Federal Regulations sections. The document is designed as a protective measure to ensure compliance with federal security protocols during the procurement and execution phases of the City of Phoenix Aviation Department project.