Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Occupational Physical Therapy Services State and local contract opportunity
- Solicitation number
- RFP PS-26-0006
- 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 Occupational Physical Therapy Services contract opportunity (RFP PS-26-0006). The form establishes the framework for handling security-sensitive documentation related to the five-year occupational physical therapy services contract, which targets comprehensive physical therapy support for over 16,000 City of Phoenix municipal employees across a minimum of 35 locations throughout the Phoenix Metropolitan area in Maricopa County. The contractor must provide services including immediate electronic patient status reporting, scheduling initial evaluations within one business day, and maintaining a network of licensed therapists with extended hours from Monday through Saturday with evening availability. Key deadlines include a non-mandatory pre-offer conference on September 8, 2025, written inquiries due by September 15, 2025, and proposal submissions due by October 1, 2025, at 2:00 p.m. The contract is anticipated to commence on or about July 1, 2026, subject to City Council approval, with a five-year term.
The acknowledgement form requires authorized company representatives to certify compliance with 49 C.F.R. Parts 15 and 1520 regarding the control and protection of Sensitive Security Information contained within project documents. Signatories must agree to destroy specified documents upon completion of their need to review materials or by the contract end date, whichever is earlier. This form establishes that disclosure of the identified documents is restricted to personnel with requisite "need to know" as defined in federal regulations, and that unauthorized release may result in civil penalties or other enforcement actions. The form serves as a prerequisite acknowledgement for vendors accessing sensitive security documentation related to the City's aviation and security infrastructure relevant to the physical therapy services procurement.
View the file
Other files for this state and local contract opportunity
Show all 20
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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
File details come from the government source that posted it. Updated .