Sensitive_Security_Information_Acknowledgement_Form.docx
DOCX document 20 KB Posted
- Attached to
- Traffic Signal Cabinet Art Wrap
- Solicitation number
- RFQu-26-0114
- 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 in accordance with federal regulations (49 C.F.R. Parts 15 and 1520). This form is associated with a City of Phoenix Street Transportation Department contract for Traffic Signal Cabinet Art Wrap, a three-year solicitation (RFQu-26-0114) seeking artists to design vinyl wraps for traffic signal cabinets. The contract, which can potentially be extended for two additional one-year terms, is set to commence around January 1, 2026. Key dates include a non-mandatory pre-offer conference on October 29, 2025, and a response deadline of November 7, 2025, at 4:00 pm.
The contract offers artists up to $1,500 per individual design request, covering all services, materials, and expenses. Evaluation criteria include artistic merit (25%), potential for successful outcome (50%), and community engagement (25%). The solicitation includes robust Disadvantaged Business Enterprise (DBE) and small business participation requirements, mandating contractors to make good faith efforts to engage DBE-certified firms. Design guidelines strictly prohibit political, religious, offensive, or violent content, and artists must use lighter color palettes. Contractors must submit initial and annual Small Business Participation Plans and comply with federal regulations, including Title VI of the Civil Rights Act. The solicitation is available through the City's Procurement Portal, with technical support accessible via email or an online support bubble.
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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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