Sensitive_Security_Information_Acknowledgement_Form.docx

DOCX document 20 KB Posted

Attached to
Evidence Bags
Solicitation number
IFB-26-0116
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 in connection with an Evidence Bags procurement contract. The form establishes requirements for handling classified security documentation related to the project and applies to authorized representatives of bidding companies. All recipients must acknowledge their understanding that the documents contain Sensitive Security Information controlled under 49 C.F.R. Parts 15 and 1520 and may only be disclosed to individuals with a legitimate need to know. Unauthorized disclosure of this information may result in civil penalties or other legal action.

By signing the acknowledgement form, company representatives agree to destroy all controlled documents upon the earlier of either their company's completion of review and use or the contract end date, in full compliance with federal regulations governing security information. The form requires completion with the company name, authorized representative's printed name and signature, title, phone number, and address. This acknowledgement must be executed by any bidder seeking access to sensitive security materials related to the City of Phoenix's Evidence Bags procurement, which is a five-year contract with five option years commencing May 1, 2026.

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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

File details come from the government source that posted it. Updated .