Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Concrete Flatwork Services
- Solicitation number
- IFB 26-0078
- 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 the Concrete Flatwork Services contract solicitation (IFB 26-0078). The form establishes protocols for handling documents containing Sensitive Security Information controlled under 49 C.F.R. Parts 15 and 1520, which are applicable to concrete work being performed at the Phoenix Aviation Department. The five-year contract commences on or about June 1, 2026, and encompasses comprehensive concrete installation and replacement services including sidewalks, ramps, walls, curbs, steps, and light pole bases across the Phoenix Metro area. A pre-offer conference is scheduled for October 15, 2025, at 9:00 a.m., with written inquiries due by October 29, 2025, and sealed bids due by November 12, 2025, at 2:00 p.m. Estimated annual quantities range from 2 to 10,000 units depending on the specific service category, with concrete work specifications ranging from 2,500 to 6,000 PSI.
All recipients of the Sensitive Security Information must acknowledge and agree to comply with the restrictions on disclosure and use as defined in federal transportation security regulations. Authorized representatives must sign the acknowledgement form, committing to destroy all documents upon the earlier of completion of their need to review and use the materials or by the contract end date. Contractors must submit detailed unit costs covering all associated expenses including licenses, traffic control, administration, materials, and equipment across multiple service categories. The procurement emphasizes Disadvantaged Business Enterprise (DBE) and Small Business participation requirements, mandating contractors submit initial and annual DBE/Small Business Participation Plans with monthly documentation of expenditures to certified DBEs through the City's Certification and Compliance System. The contract also includes provisions for heat safety, immigration compliance, and adherence to federal aviation and transportation department 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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