Sensitive_Security_Information_Acknowledgement_Form.docx

DOCX document 20 KB Posted

Attached to
Communication Tower Inspection, Maintenance, and Repair Services
Solicitation number
IFB-26-0240
Issued by
Maricopa County, Phoenix City, Arizona

About this file

This is a Sensitive Security Information Acknowledgement Form for the City of Phoenix Aviation Department related to communication tower inspection, maintenance, and repair services. The form establishes protocol for handling documents containing Sensitive Security Information as controlled under 49 C.F.R. Parts 15 and 1520. The City of Phoenix issued a solicitation for a five-year communication tower inspection, maintenance, and repair services contract with an anticipated commencement date of September 1, 2026. The contract will become effective upon award by City Council and signature and recording by the City Clerk's department, in accordance with Phoenix City Code requirements, whichever occurs later. The agreement will terminate upon the earliest occurrence of reaching the end of the contract term, including any exercised extensions, or termination pursuant to contract provisions.

The form requires authorized representatives of participating companies to acknowledge their understanding of security protocols and agree to destroy all controlled documents upon the earlier of either completion of their need to review and use the materials or by the contract end date. All disclosures of Sensitive Security Information are limited to individuals with requisite "need to know" status as defined in applicable federal regulations. Unauthorized release of this information may result in civil penalties or other legal 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. Offerors may access the solicitation through the City's Procurement Portal, with technical support available through the portal's support function or at procurement-support@opengov.com.

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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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