Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Copper Pipe State and local contract opportunity
- Solicitation number
- IFB-26-0311
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This is a Sensitive Security Information Acknowledgement Form from the City of Phoenix Aviation Department related to a copper pipe contract opportunity in Arizona. The form is designed to control access to documents containing Sensitive Security Information governed by 49 C.F.R. Parts 15 and 1520. Authorized representatives who receive access to the specified documents must acknowledge their understanding of disclosure restrictions and agree to destroy the documents upon the earlier of either completion of their need to review or use the materials, or by the contract end date. The form requires signature and authorization from company representatives along with contact information including name, title, phone number, and address.
The copper pipe contract represents a five-year agreement for the City of Phoenix with no value specified and no options to extend. The agreement becomes effective upon final signature and recording by the City Clerk's department, with the commencement date occurring upon City Council approval or the effective date, whichever is later. The solicitation is available through the City's Procurement Portal, with technical support available through the portal's support feature or via procurement-support@opengov.com. The agreement will terminate upon the earliest occurrence of reaching the end of the five-year term or termination pursuant to contract provisions.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| Copper_Pipe_(Addendum_#3_Revision).pdf | ||
| Copper_Pipe.pdf | ||
| SAP_Open_Catalog_Interface_5_1.pdf | ||
| Supplemental_-Terms-And-Conditions-To-All-Airport-Agreements-REV.-9.2.25.pdf | ||
| Acceptance_of_Offer_Form_2026.pdf | ||
| Addendum_Form.docx | DOCX document |
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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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