Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Solicitation number
- RFQu-26-0341-1
- 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 related to a Housing Services – Property Management, Master Leasing, and Housing-Based Supports contract opportunity in Arizona. The form serves as a template for documenting that recipients of sensitive security information understand and agree to comply with federal regulations governing the handling of such materials. The acknowledgement form requires authorized representatives of bidding companies to sign and date the document, confirming their awareness that disclosed materials contain Sensitive Security Information controlled under 49 C.F.R. Parts 15 and 1520 and may only be shared with individuals with a legitimate "need to know." Signatories must provide their name, title, phone number, and company address on the form.
The form obligates recipients to destroy all sensitive security information upon the earlier of either the company's completion of its need to review and use the documents or by the contract end date specified by the City. Unauthorized disclosure of this information may result in civil penalties or other legal action. For U.S. government agencies, public disclosure is governed by 5 U.S.C. 552 and the aforementioned Code of Federal Regulations sections. This acknowledgement form appears to be a standard requirement for all parties receiving bid documents related to this City of Phoenix housing services solicitation to ensure compliance with federal security protocols and protect critical infrastructure information.
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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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