Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Hydrofluorosilicic Acid 24. 5%
- Solicitation number
- IFB-26-0165
- 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 in conjunction with a hydrofluorosilicic acid procurement solicitation. The form establishes compliance requirements for parties receiving access to security-controlled documentation related to the project and specifies obligations under 49 C.F.R. Parts 15 and 1520. The City of Phoenix Water Services Department issued Invitation for Bid (IFB-26-0165) for hydrofluorosilicic acid 24.5%, a water treatment chemical, under a five-year contract commencing April 1, 2026. The solicitation requests sealed offers for an estimated annual quantity of 1,500,000 dry pounds. A non-mandatory pre-offer conference is scheduled for January 15, 2026, at 1:00 pm via webex, with written inquiries due by January 22, 2026, at 2:00 pm. The offer submission deadline is February 2, 2026, at 2:00 pm. Award will be made to the lowest responsive and responsible offeror whose offer conforms to all requirements.
Pricing must be quoted on a per-dry-pound basis with F.O.B. destination terms to specified City delivery locations. Offerors must maintain NSF certification, comply with AWWA B703-84 specifications, provide certified quality analysis with each delivery, and demonstrate a minimum of five years of operational experience. The contract includes potential price adjustment provisions after the initial one-year period, requiring 60 days' notice and supporting documentation. Contractors must carry comprehensive insurance coverage, including general liability, automobile liability, and pollution liability. The solicitation incorporates Disadvantaged Business Enterprise (DBE) requirements consistent with 49 C.F.R. Part 26. All offers remain firm and fixed for 180 calendar days from the solicitation opening date. Recipients of sensitive security documentation must acknowledge the confidentiality requirements and agree to destroy documents upon completion of their need to review and use them, no later than the contract end date, in compliance with applicable federal regulations.
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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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