Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- HVAC Filter Maintenance and Repair
- Solicitation number
- 27-FMD-007
- 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 a state and local contract opportunity. The form serves as a template for contractors and authorized representatives to acknowledge receipt of documents containing Sensitive Security Information controlled under 49 C.F.R. Parts 15 and 1520. The related contract opportunity involves HVAC filter maintenance and repair services for approximately 120 municipal facilities across multiple City of Phoenix departments, including fire stations, police precincts, public works buildings, libraries, and cultural institutions. The initial contract term is three years commencing September 1, 2026, with two optional one-year extension periods. Required services include supply and installation of MERV 13 rated filters in various configurations (1-inch, 2-inch, and 4-inch pleated panel filters, bag filters, and rigid box filters) with service intervals ranging from monthly to annual maintenance schedules. A pre-offer conference is scheduled for February 18, 2026, at 9:00 a.m. via Microsoft Teams; the written inquiry deadline is March 25, 2026, at 9:00 a.m.; and sealed offers are due April 8, 2026, at 11:00 a.m., submitted electronically through the City's Procurement Portal. All offers must be firm and fixed for 180 calendar days from the solicitation opening date.
The acknowledgement form requires authorized company representatives to certify compliance with federal security regulations and commit to destroying all sensitive documents upon completion of contract work or by the contract end date, whichever occurs first. Offerors must meet minimum qualifications including five years of operational history, appropriate licenses and certifications, and required insurance coverage within 14 calendar days of award notification. The City of Phoenix has established Disadvantaged Business Enterprise (DBE) and Small Business Participation Plan requirements in compliance with 49 C.F.R. Part 26, requiring successful contractors to submit comprehensive initial and annual DBE participation plans with documentation of good faith efforts and monthly reporting of all DBE and small business expenditures. Additional compliance requirements include federal civil rights regulations, Title VI of the Civil Rights Act of 1964, the Americans with Disabilities Act, Section 504 of the Rehabilitation Act of 1973, the Immigration Reform and Control Act, E-Verify employment eligibility verification, and City of Phoenix Equal Employment Opportunity requirements. Offerors must register with both the City's Procurement Portal and the procurePHX Self-Registration System prior to contract execution and may be subject to background screening.
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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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