Sensitive_Security_Information_Acknowledgement_Form.docx

DOCX document 20 KB Posted

Attached to
Eviction Legal Services
Solicitation number
HSD-RFQu-26-071526
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 in connection with an Eviction Legal 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. The City of Phoenix is soliciting sealed offers for Eviction Legal Services through its Procurement Portal, with an initial contract term of one year commencing upon final signature and recording by the City Clerk's department. The agreement includes two optional one-year extension periods exercisable at the City's sole discretion. Technical support for the Procurement Portal is available through the platform's support feature or by contacting procurement-support@opengov.com, while other solicitation-related inquiries should be directed to the designated procurement officer.

The Acknowledgement Form requires authorized company representatives to sign and agree to strict confidentiality protocols regarding Sensitive Security Information, with agreement to destroy all controlled documents upon the earlier of project completion or the contract end date. Unauthorized disclosure of this information may result in civil penalties or other legal action. The form serves as a prerequisite documentation requirement for vendors participating in this solicitation and must be completed with specific project details, document titles, contract end dates, and company representative information prior to accessing any sensitive materials related to the Eviction Legal Services contract.

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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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