Sensitive_Security_Information_Acknowledgement_Form.docx

DOCX document 20 KB Posted

Attached to
Powdered Activated Carbon
Solicitation number
IFB-26-0248
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 Powdered Activated Carbon procurement (IFB-26-0248) by the City of Phoenix Water Services Department. The form certifies that documents containing Sensitive Security Information controlled under 49 C.F.R. Parts 15 and 1520 are restricted to authorized personnel with a demonstrated need to know. The City of Phoenix is soliciting sealed bids for powdered activated carbon supplies on an as-needed basis under a five-year contract commencing May 1, 2026. The powdered activated carbon must meet AWWA Standard 600 specifications and maintain National Sanitation Foundation (NSF) certification for water treatment applications with Total Organic Carbon removal capability. A non-mandatory pre-offer conference is scheduled for March 12, 2026 at 10:00 AM via Webex, with a written inquiry deadline of March 19, 2026 at 5:00 PM and bids due March 26, 2026 at 2:00 PM. Award is expected following City Council approval. The contract term is five years from the effective date with potential extension as determined by the City.

Pricing must be submitted on a per-pound basis (100% dry weight equivalent) and per-gallon with all prices quoted FOB destination and delivered; all prices are firm and fixed for the initial one-year period with annual price increase requests permitted upon 60 days' written notice and supporting documentation. Contractors must demonstrate the capability to deliver powdered activated carbon within five calendar days of order receipt while maintaining sufficient local inventory. All contractors must obtain comprehensive insurance coverage, comply with federal, state, and local regulations including Department of Transportation, Environmental Protection Agency, and Occupational Safety and Health Administration requirements, and provide proof of NSF certification and independent laboratory analysis with each shipment. Contractors must comply with the City's Supplemental Terms and Conditions applicable to airport agreements, including nondiscrimination compliance under Title VI of the Civil Rights Act, Immigration Reform and Control Act requirements with E-Verify verification, Disadvantaged Business Enterprise requirements under 49 CFR Part 26, and all heat safety mitigation protocols for outdoor workers. No specific incumbent vendor information, budget range, or award value has been disclosed.

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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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