Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Loop Detector Installation Services State and local contract opportunity
- Solicitation number
- IFB-26-0049
- 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, designed to protect confidential information related to a contract opportunity. The form pertains to a Loop Detector Installation Services contract, which is a five-year agreement set to commence on or about December 1, 2025. The solicitation is available through the City's Procurement Portal, with technical support provided via OpenGov e-Procurement Portal. The contract will terminate upon reaching the end of its term or through other specified termination provisions.
The acknowledgement form requires authorized representatives to understand and comply with federal regulations (49 C.F.R. Parts 15 and 1520) regarding sensitive security information. Signatories must agree to destroy documents upon completion of their review or by the contract end date. The contract is specific to Arizona and is being managed by the City of Phoenix, with potential civil penalties for unauthorized information disclosure. Interested parties must carefully review and adhere to the strict confidentiality requirements outlined in the document.
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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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