Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Ice Supply, Delivery and Storage
- Solicitation number
- IFB-25-0709
- 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. It relates to a contract opportunity for ice supply, delivery, and storage, set to commence on or about November 1, 2025, with a proposed five-year contract term. The solicitation is available through the City's OpenGov e-Procurement Portal, and the contract will terminate upon reaching the end of its term or through specific termination provisions.
The acknowledgement form emphasizes strict handling of sensitive security information, requiring signatories to comply with federal regulations (49 C.F.R. Parts 15 and 1520) regarding document disclosure and destruction. Authorized company representatives must sign the form, confirming their understanding of the information sensitivity and agreeing to destroy documents upon contract completion or by the specified contract end date. Technical support for the procurement process is available through OpenGov's support channels, with additional contact options provided for procurement-related inquiries.
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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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