Sensitive_Security_Information_Acknowledgement_Form.docx

DOCX document 20 KB Posted

Attached to
Sodium Bisulfite
Solicitation number
IFB-26-0156
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 conjunction with a state and local contract opportunity for sodium bisulfite supply managed by the City of Phoenix Water Services Department. The form establishes protocols for handling documents containing Sensitive Security Information regulated under 49 C.F.R. Parts 15 and 1520, restricting disclosure to authorized personnel with demonstrated "need to know." The City of Phoenix Water Services Department is soliciting sealed offers for a five-year sodium bisulfite supply contract (IFB-26-0156) commencing April 1, 2026, for liquid sodium bisulfite in two concentrations (25% and 38% by weight) to support water and wastewater treatment operations across multiple City facilities in the greater Phoenix area. The solicitation includes six line items covering full truckload, drum, and tote deliveries with estimated annual quantities ranging from 9,000 to 600,000 dry pounds. A non-mandatory pre-offer conference is scheduled for January 15, 2026, at 11:00 a.m. via Webex, with written inquiries due by January 22, 2026, at 2:00 p.m. Sealed offers are due February 2, 2026, at 2:00 p.m. through the City's Procurement Portal, and the contract term extends five years with potential extensions.

Offerors must submit prices on a per-active-pound and per-gallon basis, with prices firm and fixed for the initial one-year period and subsequent annual price adjustments permitted with 60 days' written notice. Contractors must demonstrate five years of operational history, obtain National Sanitation Foundation (NSF) certification, provide Safety Data Sheets, and submit certified quality analysis from an independent third-party laboratory. The solicitation includes Disadvantaged Business Enterprise requirements under 49 C.F.R. Part 26. Contractors must maintain sufficient local inventory to support daily City requirements and comply with Department of Transportation, Environmental Protection Agency, and Occupational Safety and Health Administration regulations. Insurance requirements include Commercial General Liability ($2,000,000 aggregate), Automobile Liability ($1,000,000 combined single limit), Workers' Compensation coverage, and Pollution Liability Insurance of $1,000,000 per occurrence and $2,000,000 annual aggregate. The City reserves the right to award multiple contracts, modify quantities, and terminate the agreement with 30 days' written notice. Acknowledgement of the Sensitive Security Information form must be signed by an authorized company representative and returned prior to accessing controlled documents.

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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

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