Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Inverted Marking Paint
- Solicitation number
- IFB-26-0237
- 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 connection with a contract opportunity involving Inverted Marking Paint. The form serves as a template for individuals and companies to acknowledge their understanding of confidentiality requirements governing documents containing Sensitive Security Information controlled under 49 C.F.R. Parts 15 and 1520. The City of Phoenix solicited sealed offers for Inverted Marking Paint under a five-year contract with a commencement date of approximately September 1, 2026, or upon City Council award and execution by the City Clerk's department, whichever is later. The contract will terminate upon the earliest occurrence of reaching the end of the term including any extensions exercised or upon termination pursuant to agreement provisions.
Signatories to this acknowledgement form agree to limit disclosure of the specified documents to individuals with an established "need to know" as defined by federal regulations and agree to destroy the documents either upon completion of their need to review or use them or no later than the contract end date, whichever occurs first. Unauthorized release of Sensitive Security 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. The solicitation is available through the City's Procurement Portal, with technical support available via the portal's support feature or through 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
| ______ | ||
| TITLE | PHONE NUMBER |
ADDRESS CITY, STATE AND ZIP CODE
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