Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Sodium Hypochlorite
- Solicitation number
- IFB-26-0155
- 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 related procurement opportunity. The form serves as a template for establishing controlled access to security-sensitive documents related to the City of Phoenix Water Services Department's five-year sodium hypochlorite supply contract (IFB-26-0155). The procurement covers liquid sodium hypochlorite with 12.5 percent active ingredient meeting AWWA Standard B-501 and NSF certification requirements, with estimated annual quantities of approximately 821,000 dry pounds across four line items: truckload delivery, small bulk non-NSF, small bulk NSF-certified, and drums. The solicitation includes a pre-offer conference on January 15, 2026, with questions due by January 22, 2026, and sealed offers due by February 2, 2026, at 2:00 p.m. Phoenix local time. Contract inception is upon City Council award and City Clerk recording, with the contract term commencing on or about April 1, 2026, for five years with potential extensions.
Vendors must demonstrate a minimum of five years of operation in the chemical supply industry and provide comprehensive documentation including Safety Data Sheets, NSF certification proof, certified quality analysis from EPA-certified laboratories, and product samples upon request. Pricing will be firm and fixed for the initial one-year period, with annual price increase requests permitted with 60 days' notice and supporting documentation; unit prices must be quoted per active pound or gallon. The City requires comprehensive insurance coverage, including $2,000,000 general aggregate liability, $1,000,000 automobile liability, and statutory workers' compensation. Contractors must comply with DOT, EPA, and OSHA regulations for hazardous materials transportation and handling, maintain emergency response procedures, and meet delivery requirements between 8:00 a.m. and 2:00 p.m., Monday through Friday, excluding City holidays. The acknowledgement form itself requires authorized representatives to confirm understanding of 49 C.F.R. Parts 15 and 1520 restrictions on sensitive security information disclosure and commit to document destruction upon contract completion or specified end date.
View the file
Other files
On GovTribe
Work with this file
- 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 .