Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Chlorine
- Solicitation number
- IFB-26-0153
- 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, applicable to the chlorine supply contract solicitation (IFB-26-0153) for the City of Phoenix Water Services Department. The form requires authorized representatives of bidding companies to acknowledge receipt of documents containing sensitive security information controlled under 49 C.F.R. Parts 15 and 1520 and to agree to restrict disclosure to personnel with documented "need to know." The City of Phoenix is seeking sealed bids for a five-year chlorine supply contract commencing on or about February 1, 2026, requiring delivery of chlorine in 1-ton containers (estimated 3,000 annual units) and 150-pound containers (estimated 275 annual units) to multiple water and wastewater treatment plant locations. A non-mandatory pre-offer conference is scheduled for December 11, 2025, at 10:00 a.m. via WebEx, with written inquiries due by December 18, 2025, at 2:00 p.m., and sealed offers due December 23, 2025, at 2:00 p.m. through the City's Procurement Portal.
Vendors must comply with NSF standards 60 and 61, provide certificates of analysis with each delivery, maintain 24-hour emergency service capabilities, and possess appropriate Department of Transportation certifications. Contractors are required to have been in continuous operation for a minimum of five years providing similar goods or services and must carry commercial general liability insurance with minimum $2,000,000 limits. Pricing will be evaluated on a per-unit basis for active pounds at 100% dry weight equivalent, with firm fixed pricing for the initial one-year period and allowances for annual price increase requests with 60 days' notice and supporting documentation. The solicitation includes comprehensive nondiscrimination requirements and specific compliance mandates for disadvantaged business enterprises under 49 CFR Parts 26 and 23, with the contract awarded to the lowest responsive and responsible offeror whose offer conforms to all material requirements, subject to final approval through City Council action.
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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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