Sensitive_Security_Information_Acknowledgement_Form.docx

DOCX document 20 KB Posted

Attached to
Transit Vehicle Decommissioning Services
Solicitation number
IFB PTD26-009
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 related to a Transit Vehicle Decommissioning Services contract. The form establishes protocols for handling documents containing sensitive security information controlled under 49 C.F.R. Parts 15 and 1520. The City of Phoenix is soliciting sealed offers for transit vehicle decommissioning services with an effective date upon final signature and recording by the City Clerk's department. The agreement commencement date is on or about February 1, 2027, or the effective date, whichever is later. The initial contract term is five years with one two-year renewal option available. Sealed offers are being accepted through the City's Procurement Portal, with technical support available through the portal's support function or by contacting procurement-support@opengov.com. The agreement will terminate upon the earliest occurrence of reaching the end of the term including any exercised extensions or upon termination pursuant to the agreement's provisions.

The acknowledgement form requires authorized representatives from bidding companies to sign and acknowledge receipt of sensitive security information documents, affirming their understanding of restricted disclosure requirements and agreeing to destroy such documents upon completion of their review and use or no later than the current contract end date. Unauthorized release of the sensitive security information may result in civil penalties or other legal action. All signatories must provide their printed name, signature, title, phone number, and complete address. Bidders should direct technical issues to the Procurement Portal support team and other solicitation-related inquiries to the procurement officer listed in the contract opportunity 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

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