Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Solicitation number
- IFB-27-0496
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This file is a Sensitive Security Information Acknowledgement Form from the City of Phoenix Aviation Department, designed for use in connection with a forcible entry door training systems procurement. The form requires authorized representatives from bidding companies to acknowledge receipt of documents containing Sensitive Security Information controlled under 49 C.F.R. Parts 15 and 1520, which restrict disclosure to individuals with a demonstrated "need to know." Signatories agree to comply with federal regulations governing the protection and destruction of sensitive security materials and acknowledge that unauthorized release may result in civil penalties or other legal action. The form is a template requiring completion with specific document titles, project names, company information, and contract end dates.
The related procurement opportunity is for forcible entry door training systems, including parts and related accessories, issued by the City of Phoenix. The agreement will commence on May 1, 2027, or upon final signature by the City Clerk, whichever is later, with a five-year term and no renewal options. The form itself contains no pricing information, set-asides, funding sources, or other financial terms, as it serves solely as a compliance and acknowledgment document for handling sensitive security information related to the procurement process.
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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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