Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Solicitation number
- IFB-26-FSD-0288
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This is a Sensitive Security Information Acknowledgement Form for the City of Phoenix Aviation Department related to a Vehicle Glass Supply, Install, Repair & Tint Services contract. The form establishes that bidders and contractors receiving specified documents must acknowledge their understanding of security restrictions governing the materials under 49 C.F.R. Parts 15 and 1520. The City of Phoenix is soliciting sealed offers for vehicle glass supply, installation, repair, and tinting services through a three-year initial term with two optional renewal years, with an effective date on or about August 1, 2026. Bidders must access the solicitation through the City's Procurement Portal, and questions regarding the solicitation should be directed to the designated procurement officer.
Authorized representatives of bidding companies must execute the acknowledgement form, confirming they will maintain confidentiality of sensitive security information and destroy all documents upon completion of their need to review and use them or no later than the contract end date, in accordance with federal regulations. Unauthorized disclosure of the sensitive security information may result in civil penalties or other legal action. The form requires the authorized representative's printed name, signature, title, phone number, and company address. This acknowledgement is a standard requirement for any party receiving security-controlled documentation related to airport or aviation operations.
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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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