Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Fire Station Furniture
- Solicitation number
- IFB-26-0318
- 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 fire station furniture procurement project. The form establishes protocols for handling documents classified as Sensitive Security Information under 49 C.F.R. Parts 15 and 1520. The City of Phoenix is soliciting sealed offers for fire station furniture through its Procurement Portal, with an effective date upon final signature and recording by the City Clerk's department. The commencement date is set for November 1, 2026, or the later of the ordinance-approved start date or Phoenix City Council approval date. The contract term will be five years from the commencement date with no extension options. Technical support for the Procurement Portal is available through the support feature or by contacting procurement-support@opengov.com, while other solicitation-related inquiries should be directed to the listed procurement officer.
The acknowledgement form requires authorized representatives of participating companies to confirm receipt and understand the restrictions governing the sensitive documents, including the requirement to destroy all materials upon completion of review and use or by the contract end date, whichever is earlier. Unauthorized disclosure of the controlled information may result in civil penalties or other legal action. The form serves as a protective mechanism to ensure that only personnel with demonstrated need-to-know access receive sensitive security information related to the fire station furniture project, consistent with federal aviation security protocols and public records exemptions under 5 U.S.C. 552.
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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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