Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Parks and Recreation Event-Related Services
- Solicitation number
- PKS-RFQu-26-0119
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This is a Sensitive Security Information Acknowledgement Form from the City of Phoenix Aviation Department that establishes protocols for handling classified security documentation. The form serves as a legal instrument requiring authorized representatives from bidding companies to acknowledge receipt of documents containing Sensitive Security Information controlled under 49 C.F.R. Parts 15 and 1520, which relate to airport security matters. Signatories commit to limiting document disclosure to personnel with demonstrated "need to know" and agree to destroy all materials upon completion of their review or at the contract end date, whichever occurs first. The form requires completion of specific fields including document titles, project names, contract end dates, company information, authorized representative credentials, and signature attestation.
This acknowledgement form is part of the City of Phoenix Parks and Recreation Event-Related Services solicitation, a five-year Qualified Vendors List contract commencing February 1, 2026. However, the form's inclusion appears administratively inconsistent with the stated contract scope, as the aviation department form does not logically align with event-related services such as entertainment vendors, balloon artists, and carnival games. This discrepancy suggests either a document filing error or that certain contract elements involve aviation facilities where security protocols require heightened information handling procedures. Vendors responding to this opportunity must comply with all federal security regulations and understand that unauthorized disclosure of sensitive information may result in civil penalties or other enforcement 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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