Sensitive_Security_Information_Acknowledgement_Form.docx

DOCX document 20 KB Posted

Attached to
Park Ranger Safety Equipment & Uniforms
Solicitation number
PKS-IFB-27-0471
Issued by
Maricopa County, Phoenix City, Arizona

About this file

This is a Sensitive Security Information Acknowledgement Form from the City of Phoenix Aviation Department applicable to the Park Ranger Safety Equipment & Uniforms contract opportunity. The form establishes requirements for handling confidential information controlled under 49 C.F.R. Parts 15 and 1520, which governs sensitive security information related to airport and aviation operations. Authorized representatives of bidding companies must acknowledge and sign the form to confirm they understand the restrictions on disclosure and agree to comply with federal regulations regarding the protection and destruction of sensitive documents. The contract itself is a five-year agreement commencing on December 1, 2026, or the date approved by Phoenix City Council, whichever is later, with no extension options. The solicitation is open to sealed offers and is being conducted through the City's Procurement Portal, with technical support available through the portal's support system or at procurement-support@opengov.com.

The acknowledgement form requires that signatory companies certify their understanding that unauthorized release of sensitive security information may result in civil penalties or other legal action and that they will destroy all controlled documents either upon completion of their need to review or use them or by the contract end date, whichever occurs first. All bidders and their personnel must execute this form as a condition of receiving access to project-specific sensitive security information. The form includes fields for company name, authorized representative information, title, contact details, and physical address, all of which must be completed and signed by an authorized corporate officer prior to document receipt and contract participation.

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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 .