Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Solicitation number
- IFB-26-FSD-0291
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This is a Sensitive Security Information Acknowledgement Form for the City of Phoenix Aviation Department related to an Automotive Lifts - Inspection, Maintenance and Repair contract opportunity. The City of Phoenix is soliciting sealed offers for annual inspections, maintenance, and repair services of automotive lifts under a three-year base term with two optional renewal years, commencing on or about November 1, 2026. The contract will be awarded by City Council, with the effective date upon award, signature, and recording by the City Clerk's department, or upon satisfaction of Phoenix City Code requirements, whichever occurs later. Solicitation materials are available through the City's Procurement Portal, with technical support available through the portal's support function or via procurement-support@opengov.com. The agreement will terminate upon the earliest occurrence of either reaching the end of the term including any exercised extensions or termination pursuant to the agreement's provisions.
The documents related to this procurement 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." All authorized recipients must acknowledge this restriction and agree to destroy the documents upon completion of their need to review and use them or by the contract end date, whichever is earlier. Unauthorized release of this information may result in civil penalties 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.
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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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