Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Asphalt and Striping Services
- Solicitation number
- IFB 26-FMD-030
- 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 controlled under federal regulations (49 C.F.R. Parts 15 and 1520). The form is associated with a concurrent City of Phoenix Public Works Department Invitation for Bid (IFB 26-FMD-030) for Asphalt and Striping Services, which seeks a contractor to provide comprehensive infrastructure maintenance services. The contract is set to commence on or about February 1, 2026, with an initial two-year term and three optional one-year extensions, potentially totaling five years. Key services include asphalt paving, crack filling, sealing, milling, saw cutting, installing safety bollards, wheel stops, handicap signage, and road striping. Critical procurement dates include a pre-offer conference on October 2, 2025, written inquiries due by October 7, 2025, and final offer responses due October 15, 2025.
The solicitation includes robust Disadvantaged Business Enterprise (DBE) and Small Business Participation requirements, mandating contractors track and report monthly DBE participation. Insurance requirements are comprehensive, with $5,000,000 in Commercial General Liability and Automobile Liability coverage. Contractors must demonstrate a minimum of five years' experience, provide written quotes within ten calendar days, and commence work within fifteen calendar days of assignment. The City reserves the right to make multiple contract awards and requires compliance with extensive nondiscrimination provisions. While no specific contract value is explicitly stated, the procurement includes stringent documentation requirements, such as maintaining payment records for at least three years and providing detailed reporting on DBE participation and expenditures.
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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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