Sensitive_Security_Information_Acknowledgement_Form.docx

DOCX document 20 KB Posted

Attached to
Escalator Cleaning
Solicitation number
IFB-PCC-26-0159
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 an escalator cleaning contract. The form is required for all parties who will have access to documents containing Sensitive Security Information controlled under 49 C.F.R. Parts 15 and 1520. The City of Phoenix is soliciting sealed offers for escalator cleaning services under a five-year contract with a commencement date on or about December 1, 2026. The effective date is upon award by City Council, conditioned upon signature and recording by the City Clerk's department, as required by Phoenix City Code. Technical support for the City's Procurement Portal is available via the support bubble on the portal or by contacting procurement-support@opengov.com. The agreement will terminate upon the earliest occurrence of reaching the end of the contract term including any exercised extensions or termination pursuant to the agreement's provisions.

The acknowledgement form requires authorized company representatives to sign and confirm their understanding that disclosure of Sensitive Security Information is restricted to persons with requisite "need to know" as defined in applicable federal regulations, and that unauthorized release may result in civil penalties or other action. Signatories agree to destroy all documents containing Sensitive Security Information upon the earlier of the company's completion of its need to review and use the documents or no later than the current contract end date, in compliance with 49 C.F.R. Parts 15 and 1520. For U.S. government agencies, public disclosure is governed by 5 U.S.C. 552 and the referenced C.F.R. regulations. Additional details regarding pricing, specific technical requirements, and other contractual terms are to be found in the full solicitation available through the City's Procurement Portal.

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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

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