Sensitive_Security_Information_Acknowledgement_Form.docx

DOCX document 20 KB Posted

Attached to
Air Compressors, Dyers, Parts and Services: Supplemental
Solicitation number
IFB-26-0359
Issued by
Maricopa County, Phoenix City, Arizona

About this file

This document is a Sensitive Security Information Acknowledgement Form issued by the City of Phoenix Aviation Department for use in conjunction with a state and local contract opportunity. The form is designed to control access to sensitive security information governed by 49 C.F.R. Parts 15 and 1520, requiring authorized representatives to acknowledge receipt of classified documentation and commit to its proper handling. The related contract opportunity is for Air Compressors, Dryers, Parts and Services for the City of Phoenix, with a contract term commencing on or about September 1, 2026, for a five-year period. The solicitation is conducted through the City's Procurement Portal, with sealed offers invited in accordance with specified provisions and Phoenix City Code requirements.

The acknowledgement form requires signatories to restrict disclosure of sensitive security information to personnel with demonstrated need-to-know status as defined in applicable federal regulations. Authorized representatives must agree to destroy all classified documentation upon the earlier of either the company's completion of its need to review and utilize the materials or the contract end date. Unauthorized release of sensitive security information may result in civil penalties or other legal action. The form includes standard fields for company name, authorized representative signature, title, contact information, and address, with designated spaces for contract document titles and end dates to be completed as applicable to specific procurement actions.

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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

File details come from the government source that posted it. Updated .