Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Sandblasting and Coating Services
- Solicitation number
- IFB-26-0284
- 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 the sandblasting and coating services contract opportunity. The form establishes compliance requirements for all parties receiving access to security-sensitive documentation related to this procurement, which is governed by 49 C.F.R. Parts 15 and 1520. The five-year sandblasting and coating services contract is scheduled to commence on or about July 1, 2026, with the effective date occurring upon City Council award and signature by the City Clerk's department in accordance with Phoenix City Code. All recipients of sensitive security information must acknowledge their understanding of disclosure restrictions and agree to destroy the documents upon the earlier of contract completion or the current contract end date. Failure to comply with these requirements may result in civil penalties or other legal action.
The form requires authorized representatives from interested companies to sign and return the acknowledgement, certifying that they understand the restrictions on information sharing and their obligation to limit disclosure only to individuals with a documented need to know. The City of Phoenix is utilizing its Procurement Portal for submission of sealed offers, with technical support available through the portal interface. This acknowledgement form is a mandatory requirement for participation in the procurement process and demonstrates the sensitive nature of airport security-related specifications and provisions contained within the solicitation documents.
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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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