Sensitive_Security_Information_Acknowledgement_Form.docx

DOCX document 20 KB Posted

Attached to
Atmospheric Monitoring Instruments - Fixed
Solicitation number
IFB-27-0435
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 conjunction with an Atmospheric Monitoring Instruments - Fixed contract opportunity. The form establishes requirements for handling documents containing Sensitive Security Information controlled under 49 C.F.R. Parts 15 and 1520. The related contract solicitation invites sealed offers for atmospheric monitoring instruments designated as fixed installations. The contract term is five years beginning on the commencement date established by Phoenix City Council, with no options to extend. The effective date is upon final signature and recording by the City Clerk's department, and the agreement will terminate upon reaching the end of the term or upon termination pursuant to contract provisions. Technical support for the City's Procurement Portal is available through the support feature or by contacting procurement-support@opengov.com, with other solicitation questions directed to the listed procurement officer.

The acknowledgement form requires authorized representatives of bidding companies to sign and agree to comply with federal security information regulations. Signatories must acknowledge receipt of sensitive documents and commit to destroying all materials upon the earlier of either the company's completion of its need to review and use the documents or the contract end date, whichever occurs first. Unauthorized disclosure of the sensitive security information may result in civil penalties or other legal action, with public disclosure by U.S. government agencies governed by 5 U.S.C. 552 and applicable CFR regulations. The form functions as a mandatory compliance requirement for all parties receiving access to restricted project documentation.

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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

File details come from the government source that posted it. Updated .