Sensitive_Security_Information_Acknowledgement_Form.docx

DOCX document 20 KB Posted

Attached to
Electric Actuators - Supplemental
Solicitation number
IFB-26-0343
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 contract opportunity. The form addresses compliance requirements for documents containing Sensitive Security Information controlled under 49 C.F.R. Parts 15 and 1520. The related contract opportunity concerns electric actuators, parts, valves, gearboxes, accessories, and related software for a four and a half-year contract commencing on or about September 1, 2026. The contract will be awarded by City Council and becomes effective upon signature and recording by the City Clerk's department, in accordance with Phoenix City Code requirements. Sealed offers are being solicited through the City's Procurement Portal, with technical support available through the portal interface or via email at procurement-support@opengov.com. The agreement will terminate upon the earliest occurrence of contract term expiration, including any exercised extensions, or termination pursuant to the agreement's provisions.

The acknowledgement form requires authorized representatives of bidding companies to acknowledge receipt of sensitive security documents, confirm understanding of restricted disclosure requirements, and agree to destroy the documents upon the earlier of the company's completion of its need to review and use the materials or by the contract end date. Unauthorized release of the controlled 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 and the referenced CFR regulations. The form requires completion of company name, authorized representative information including printed name, signature, title, phone number, and business address.

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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 .