Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- PVC / CPVC Pipe, Valves and Fittings
- Solicitation number
- IFB-26-0271
- 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 PVC/CPVC pipe, valves, and fittings procurement contract. The form is designed to control the dissemination of documents containing Sensitive Security Information regulated under 49 C.F.R. Parts 15 and 1520. The City of Phoenix is soliciting sealed offers for PVC/CPVC pipe, valves, and fittings under a five-year contract term commencing on or about June 1, 2026. The solicitation is being conducted through the City's Procurement Portal, and the effective date will be upon award by City Council, conditioned upon signature and recording by the City Clerk's department, or such later date as required by Phoenix City Code. The contract will terminate upon the earliest occurrence of reaching the end of the term including any extensions exercised or termination pursuant to the provisions of the agreement.
Authorized representatives of bidding companies must acknowledge receipt of sensitive security information and agree to comply with federal regulations governing its disclosure and handling. Signatories commit to limiting disclosure to persons with a "need to know" as defined in applicable federal regulations and agree to destroy all documents containing sensitive security information upon the earlier of the company's completion of its need to review and use the documents or the contract end date. Unauthorized release of this information may result in civil penalties or other legal action. Offerors requiring technical support related to the procurement portal should contact the support function through the portal or email procurement-support@opengov.com, while other solicitation-related inquiries should be directed to the listed procurement officer.
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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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