Sensitive_Security_Information_Acknowledgement_Form.docx

DOCX document 20 KB Posted

Attached to
Pressure and Temperature Instrumentation Equipment
Solicitation number
IFB-26-0398
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 for use in connection with a Pressure and Temperature Instrumentation Equipment contract. The form establishes that certain contract documents contain Sensitive Security Information controlled under 49 C.F.R. Parts 15 and 1520 and may only be disclosed to individuals with a documented "need to know." The City of Phoenix is soliciting sealed offers for a five-year contract with a NO VALUE designation, commencing on or about October 15, 2026. The contract will become effective upon award by City Council and signature and recording by the City Clerk's department, in compliance with Phoenix City Code requirements. Technical support for the City's Procurement Portal is available through the portal's support feature or at procurement-support@opengov.com, with general solicitation inquiries directed to the listed procurement officer.

Authorized company representatives must acknowledge receipt of the documents and agree to comply with all federal security regulations governing the handling and destruction of sensitive information. Recipients must destroy all controlled documents upon the earlier of their company's completion of its need to review and use the materials or by the contract end date, whichever occurs first. Unauthorized disclosure of this information may result in civil penalties or other legal action. The contract will terminate upon the earliest occurrence of the end of the term 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

______
TITLEPHONE NUMBER

ADDRESS CITY, STATE AND ZIP CODE

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