Sensitive_Security_Information_Acknowledgement_Form.docx

DOCX document 20 KB Posted

Attached to
Evaporative Cooler Maintenance and Repair
Solicitation number
IFB-27-FMD-0415
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 the Evaporative Cooler Maintenance and Repair contract opportunity. The form notifies recipients that project documents contain Sensitive Security Information controlled under 49 C.F.R. Parts 15 and 1520 and may only be disclosed to individuals with requisite need-to-know authorization. The City of Phoenix seeks electronic offers for evaporative cooler maintenance and repair services under a three-year agreement commencing on or about January 18, 2027, with two optional one-year extension periods exercisable at the City's sole discretion. The contract becomes effective upon final signature and recording by the City Clerk's department and terminates upon the earliest occurrence of reaching the end of the contract term including any exercised extensions or termination under the agreement's provisions.

All recipients of sensitive security information must acknowledge compliance with federal regulations governing disclosure and agree to destroy the documents upon the earlier of completion of their need to review and use the materials or by the contract end date. Unauthorized release of the controlled information may result in civil penalties or other legal action. Offerors may access the solicitation through the City's Procurement Portal and should contact the listed procurement officer for solicitation-related issues or use the portal's support function for technical assistance.

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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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