Sensitive_Security_Information_Acknowledgement_Form.pdf

PDF 79 KB Posted

Attached to
Automatic Transfer Switch Testing, Maintenance, and Repair Services
Solicitation number
AVN IFB-26-0125
Issued by
Maricopa County, Phoenix City, Arizona

About this file

This is a Sensitive Security Information Acknowledgement Form issued by the City of Phoenix Aviation Department for the Automatic Transfer Switch Testing, Maintenance, and Repair Services contract opportunity in Arizona. The form serves as a required acknowledgment that bidders and their representatives understand and will comply with security protocols governing sensitive information related to the project. Bidders and their authorized representatives must sign the form to confirm they have a legitimate "need to know" regarding the controlled documents and agree to handle all materials in accordance with 49 C.F.R. Parts 15 and 1520. The three-year contract term with two optional one-year extensions is scheduled to commence on or about June 1, 2026, with the effective date to be determined upon City Council award, signature, and recording by the City Clerk's department, whichever occurs later. Offers must be submitted through the City's Procurement Portal.

Bidders must acknowledge their responsibility to destroy or return all documents upon the earlier of either their company's completion of its need to review and use the materials or no later than the current contract end date. Unauthorized disclosure of the sensitive security information contained in the project documents may result in civil penalties or other enforcement actions under federal regulations. The form requires the authorized company representative to provide their printed name, signature, title, phone number, and complete address. This acknowledgment is a mandatory component of the bidding process and must be executed prior to accessing project-related sensitive security information, ensuring compliance with federal transportation security requirements.

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Text version

ATTACHMENT E

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

File details come from the government source that posted it. Updated .