Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Unemployment Cost Management Services
- Solicitation number
- RFP PS-26-0009
- 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 under federal regulations. This form is part of a broader procurement process for Unemployment Cost Management Services, with a five-year contract term commencing on or about March 1, 2026. The City of Phoenix Finance Central Procurement Department is seeking a contractor to manage unemployment claims, with a non-mandatory pre-offer conference scheduled for August 28, 2025, written inquiries due by September 16, 2025, and a final proposal response deadline of October 3, 2025, at 2:00 pm.
The solicitation includes specific requirements for Disadvantaged Business Enterprise (DBE) and Small Business Participation, mandated by the United States Department of Transportation. Vendors must track and report DBE and small business participation monthly and submit an annual Small Business Participation Plan. The evaluation will consider an annual fee as the primary cost factor, with 250 points (25% of the total 1,000-point score) allocated to the lowest cost. Qualified vendors must have a minimum of five years of experience in unemployment cost management services, and the proposal will be assessed across 64 specific areas, including claims management, hearing representation, benefit charge audits, reporting capabilities, and data security protocols. Contractors must also complete Federal Transit Administration (FTA) certifications covering various compliance areas.
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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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