Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Portland Cement (Bulk)
- Solicitation number
- IFB-26-0033A
- 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 requires authorized representatives to acknowledge the sensitive nature of documents, agreeing to destroy them upon completion of their review or by the contract end date, with signatories mandated to provide company details, contact information, and a signature certifying their understanding of information handling requirements.
The associated state and local contract opportunity is an Invitation for Bid (IFB-26-0033A) issued by the City of Phoenix Finance Central Procurement for a five-year Portland Cement (Bulk) contract with the Street Transportation Department. The solicitation seeks approximately 300 tons of ASTM C-150, Type II Low Alkali cement annually, with delivery requirements between 7:00 am and 2:00 pm, Monday through Friday. Key procurement elements include a non-mandatory pre-offer conference on November 4, 2025, written inquiries due by November 19, 2025, and final offer submissions due November 24, 2025. The contract emphasizes Disadvantaged Business Enterprise (DBE) and Small Business participation, requiring contractors to submit annual participation plans, maintain detailed documentation, and report monthly through the City's Certification and Compliance System, with pricing to be firm and fixed for the initial two years and potential annual adjustments thereafter.
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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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