Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Solicitation number
- IFB-26-0352
- 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 state and local contract opportunity in Arizona. The form requires authorized representatives from bidding companies to acknowledge receipt of documents containing Sensitive Security Information governed by 49 C.F.R. Parts 15 and 1520, which restrict disclosure to personnel with a legitimate "need to know." The form stipulates that recipients must destroy all provided documents upon the earlier of either completion of their review and use or the contract end date, with unauthorized release subject to civil penalties and other legal action in accordance with federal regulations and the Freedom of Information Act.
The related contract opportunity involves Electrical Shop Rubber Glove Personal Protective Equipment Testing for the City of Phoenix with no contract value stated. The agreement commences on October 1, 2026 or upon approval of an ordinance, whichever is later, with a five-year term beginning from the commencement date and no extension options available. The solicitation is conducted through the City's Procurement Portal, and the agreement terminates upon the earliest occurrence of reaching the contract term's end or pursuant to termination provisions outlined in the agreement. Bidders are required to submit sealed offers through the designated procurement portal, with technical support available through the portal or at procurement-support@opengov.com.
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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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