Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Solicitation number
- IFB 26-SW-0379
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This is a Sensitive Security Information Acknowledgement Form prepared by the City of Phoenix Aviation Department for use in conjunction with a supply contract for industrial pipe, miscellaneous fittings, and equipment. The City of Phoenix is soliciting sealed offers for a three-year initial term with two optional one-year extensions, with an anticipated commencement date of December 1, 2026, or upon City Council award approval and recording by the City Clerk's department, whichever is later. The solicitation is administered through the City's Procurement Portal, and interested offerors should direct technical inquiries to procurement-support@opengov.com or contact the designated procurement officer for other solicitation-related questions.
The documents provided to offerors in this procurement contain Sensitive Security Information controlled under 49 C.F.R. Parts 15 and 1520 and may only be disclosed to persons with requisite need-to-know authorization. All recipients must acknowledge their understanding of these restrictions and agree to destroy the provided documents upon the earlier of their completion of review and use or the contract end date. Unauthorized release of this information may result in civil penalties or other enforcement actions. The contract term will terminate upon the earliest occurrence of the scheduled end date, including any exercised extensions, or upon termination pursuant to the agreement's provisions.
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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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