Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Solicitation number
- PKS-IFB-26-0337
- 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 a Basketball Backboard Systems Repair and Preventive Maintenance Services contract. The City of Phoenix is soliciting sealed offers for basketball backboard systems and preventive maintenance services through its Procurement Portal. The contract will commence on September 1, 2026, or upon the later of the ordinance-approved start date or the Phoenix City Council's approved contract term start date, with a term of five years from the commencement date. No extension options are available beyond the five-year term. The agreement will terminate upon the earliest occurrence of reaching the end of the term or termination pursuant to the contract's provisions. The effective date will be upon final signature and recording by the City Clerk's department.
The documents associated with this solicitation 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" as defined in those regulations. All recipients must acknowledge receipt of the acknowledgement form and agree to destroy the documents upon the earlier of the company's completion of its need to review and use them or the contract end date. Unauthorized release of the sensitive security information may result in civil penalties or other legal action. Bidders requiring technical support with the City's Procurement Portal should contact the support team through the portal or email procurement-support@opengov.com.
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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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