Sensitive_Security_Information_Acknowledgement_Form.docx

DOCX document 20 KB Posted

Attached to
Forcible Entry Props and Related Accessories
Solicitation number
IFB-27-0393
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 contract opportunity for Forcible Entry Props and Related Accessories. The form serves as a template to ensure that all parties with access to sensitive security information controlled under 49 C.F.R. Parts 15 and 1520 acknowledge their understanding of disclosure restrictions and their obligations regarding document handling. The contract has an effective date upon final signature and recording by the City Clerk's department, with a commencement date of January 1, 2027, or the effective date, whichever is later. The agreement term is five years from the commencement date with no options to extend. The contract will terminate upon the earliest occurrence of reaching the end of the term or termination pursuant to the agreement's provisions.

The solicitation is issued by the City of Phoenix for no monetary value and is available through the City's Procurement Portal. Offerors must acknowledge their receipt of documents containing sensitive security information and agree to destroy such documents upon the earlier of their company's completion of review and use or by the contract end date, in compliance with applicable federal regulations. Unauthorized release of the sensitive security information may result in civil penalties or other legal action. Interested offerors should direct technical questions regarding the procurement portal to procurement-support@opengov.com and other solicitation-related inquiries to the listed procurement officer.

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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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