Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Electric Meter Testing, Calibration, and Repairs
- Solicitation number
- IFB-26-0013
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
The document is a Sensitive Security Information Acknowledgement Form issued by the City of Phoenix Aviation Department. This form is related to a state and local contract opportunity for Electric Meter Testing, Calibration, and Repairs, which is a five-year contract expected to commence on or about September 1, 2025. The solicitation is available through the City's Procurement Portal, with technical support provided via OpenGov e-Procurement Portal.
The acknowledgement form emphasizes strict handling of sensitive security information, requiring compliance with 49 C.F.R. Parts 15 and 1520 regarding document disclosure and destruction. Authorized representatives must sign the form, agreeing to protect and ultimately destroy the documents upon contract completion. The contract will terminate upon reaching the end of its term or through other provisions specified in the agreement. The opportunity is located in Arizona and involves electric meter services for the City of Phoenix, with the exact procurement details to be determined through the city's procurement process.
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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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