Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Aquatic Rescue, Training Supplies and Equipment
- Solicitation number
- PKS-IFB-25-0743
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
The document is a Sensitive Security Information Acknowledgement Form issued by the City of Phoenix Aviation Department. This form is associated with a procurement opportunity for aquatic rescue, training supplies, and equipment, with a proposed contract term beginning on or about July 1, 2025, and lasting five years. The solicitation is being conducted through the City's OpenGov e-Procurement Portal, with technical support available via email or an online support bubble. The contract will terminate upon reaching the end of its term or through other specified provisions.
The acknowledgement form emphasizes strict handling of sensitive security information, controlled under 49 C.F.R. Parts 15 and 1520, with specific requirements for document disclosure and destruction. Authorized representatives must sign the form, confirming their understanding of the information sensitivity and agreeing to destroy documents in compliance with federal regulations. While specific pricing details are not provided in this document, the solicitation indicates a comprehensive procurement process for aquatic rescue equipment and training supplies for the City of Phoenix, with potential implications for local emergency and safety services.
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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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