Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Civil Case Management System
- Solicitation number
- RFP PS-26-0236
- 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 in connection with a Civil Case Management System contract opportunity. The form is designed to protect documents containing Sensitive Security Information governed by 49 C.F.R. Parts 15 and 1520. The Civil Case Management System procurement represents a seven-year base contract with three one-year renewal options, with an anticipated commencement date of November 1, 2026, or upon City Council award and recording by the City Clerk's office, whichever occurs later. The procurement is conducted through the City's Procurement Portal, and technical support is available through the portal's support function or via procurement-support@opengov.com.
The form requires authorized company representatives to acknowledge understanding of the security restrictions and certify compliance with federal regulations governing the handling of sensitive information. Signatories agree to destroy all controlled documents upon the earlier of the company's completion of its need to review and use the documents or no later than the contract end date. Unauthorized disclosure of the sensitive information may result in civil penalties or other legal action. The agreement will terminate upon reaching the end of the contract term, including any exercised extensions, or upon termination pursuant to the agreement's provisions. Offerors with questions regarding the solicitation should contact the procurement officer listed in the contract opportunity documentation.
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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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