Sensitive_Security_Information_Acknowledgement_Form.docx

DOCX document 20 KB Posted

Attached to
PUMPS, NEW, REPAIR, PARTS, ACCESSORIES- Supplemental Aurora, Jacuzzi, Stranco
Solicitation number
IFB-26-0287
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 five-year pump supply and services contract commencing July 1, 2026. The form notifies recipients that certain contract documents contain Sensitive Security Information governed by 49 C.F.R. Parts 15 and 1520 and restricts disclosure to individuals with an established need to know. The City of Phoenix is soliciting sealed offers for pumps, new equipment, repair services, parts, and accessories through its Procurement Portal, with the contract effective upon City Council award and signature by the City Clerk's department in accordance with Phoenix City Code requirements. The agreement will terminate upon the earlier of reaching the end of the five-year term, including any exercised extensions, or upon termination pursuant to contract provisions.

Recipients of the restricted documents are required to acknowledge understanding of the security requirements and agree to destroy all controlled documents upon the earlier of completion of their need to review and use the materials or upon the contract end date. 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 in addition to the federal aviation security regulations. Technical support for the City's Procurement Portal is available through an embedded support feature or via email at procurement-support@opengov.com, with other solicitation-related inquiries directed to the listed procurement officer.

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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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