Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Sodium Hypochlorite
- Solicitation number
- IFB-26-0155
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This is a Sensitive Security Information Acknowledgement Form from the City of Phoenix Aviation Department, designed to control access to security-sensitive documentation related to aviation operations in compliance with federal regulations. The form serves as a template requiring authorized representatives from bidding companies to acknowledge receipt of security-sensitive materials and agree to their proper handling and destruction. Bidders participating in City of Phoenix Aviation Department contracts must complete this form, providing company identification, authorized representative details, and signatures confirming understanding of restricted disclosure requirements and destruction obligations upon contract completion or a specified termination date, whichever occurs first.
The acknowledgement enforces compliance with 49 C.F.R. Parts 15 and 1520, federal regulations governing Sensitive Security Information, and 5 U.S.C. 552 for government agencies. Unauthorized disclosure carries potential civil penalties or other legal action. The form functions as a prerequisite document for procurement activities involving aviation security matters, requiring signatory commitment to restrict document access to individuals with documented need-to-know and to destroy materials according to federal standards. This form is standard procedure for state and local aviation contracts where security protocols govern contract execution and vendor participation.
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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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