Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Performance Entertainment Coordination Services
- Solicitation number
- RFQu-24-0427
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This document is a Sensitive Security Information Acknowledgement Form issued by the City of Phoenix Aviation Department. The form is part of a broader contract opportunity for Performance Entertainment Coordination Services with the City of Phoenix Parks and Recreation Department. While specific details about the entertainment services are not fully elaborated in this document, the form is designed to protect sensitive security information controlled under federal regulations (49 C.F.R. Parts 15 and 1520).
The acknowledgement form requires authorized company representatives to formally recognize the sensitive nature of associated documents, commit to protecting those documents, and agree to destroy them in compliance with federal regulations upon completion of their review or by the contract's end date. Signatories must provide their company name, printed name, signature, title, contact information, and address. The form is specifically tied to a Request for Qualifications (RFQu) for Events and Entertainment Services in Phoenix, Arizona, with an emphasis on maintaining strict confidentiality of any sensitive security-related information throughout the procurement process.
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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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