Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Solicitation number
- PKS-IFB-25-0740
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
The document is a Sensitive Security Information Acknowledgement Form from the City of Phoenix Aviation Department. This form is a legal document requiring authorized representatives to acknowledge and agree to protect sensitive security information controlled under federal regulations (49 C.F.R. Parts 15 and 1520). The form relates to a Swimming Pool Maintenance Supplies, Accessories and Repair contract for the City of Phoenix, which is a five-year contract expected to commence on or about July 1, 2025. The solicitation will be conducted through the City's OpenGov e-Procurement Portal, with technical support available via email or an online support bubble.
The contract opportunity is specifically for swimming pool maintenance supplies, accessories, and repair services within the state of Arizona. The final contract term will be determined by either reaching the end of the contracted period (including potential extensions) or through early termination as specified in the agreement's provisions. Potential bidders must carefully review and comply with the sensitive security information protocols, which include strict guidelines about document handling, disclosure, and destruction. The contract will be officially awarded upon City Council approval and recording by the City Clerk's department, with the exact effective date contingent upon these administrative processes.
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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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