Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Lower-Level Displays
- Solicitation number
- IFB-PCC-26-0084
- 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 requires authorized representatives to acknowledge and agree to handle sensitive documents in compliance with federal regulations (49 C.F.R. Parts 15 and 1520), including destroying documents upon completion of contract needs or by the contract end date.
The related contract opportunity involves replacing digital signage monitors at the Phoenix Convention Center's Lower Level with new LED displays. The project requires furnishing and installing two 8.5 ft x 15 ft LED video wall displays and three 5 ft x 8 ft LED advertisement displays with a 1.9mm pixel pitch. The contract term is five years, starting approximately January 1, 2026, with a pre-offer conference and site visit scheduled for September 25, 2025. The procurement emphasizes Disadvantaged Business Enterprise (DBE) and small business participation, requiring contractors to track and report DBE involvement and submit a Small Business Participation Plan within 30 calendar days after contract award. Contractors must comply with federal regulations under 49 CFR Part 26 and demonstrate good faith efforts in promoting DBE-certified supplier 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
| ______ | ||
| TITLE | PHONE NUMBER |
ADDRESS CITY, STATE AND ZIP CODE
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