Sensitive_Security_Information_Acknowledgement_Form.docx

DOCX document 20 KB Posted

Attached to
Housing Services – Property Management, Master Leasing, and Housing Based Supports
Solicitation number
RFQu-26-0341
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 housing services contract opportunity in Arizona. The form establishes protocols for handling documents containing Sensitive Security Information controlled under 49 C.F.R. Parts 15 and 1520, limiting disclosure to authorized personnel with a demonstrated need to know. The related contract opportunity involves providing housing services including property management, master leasing, and housing-based support services to individuals or families experiencing or exiting homelessness. The agreement becomes effective upon final signature and recording by the City Clerk's department, with a commencement date of October 1, 2026 or the effective date, whichever is later. The initial contract term is one year, with four one-year renewal options exercisable at the City's sole discretion.

All parties receiving documents subject to this acknowledgement form agree to comply with federal security protocols and commit to destroying the sensitive materials upon the earlier of completion of their review and use or the contract end date. Unauthorized release of the information may result in civil penalties or other enforcement actions. The form requires authorized representatives from responding companies to sign and provide company contact information, acknowledging their company's responsibility for maintaining document security and compliance with applicable federal regulations governing sensitive security information disclosure.

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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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