[SENSITIVE SECURITY INFORMATION]{.underline}

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  WARNING: This solicitation contains Sensitive Security Information that
  is controlled under Federal Aviation Administration (FAA) Order 1600.75
  and 49 CFR parts 15 and 1520. No part of this record may be disclosed
  to persons without a "need to know", as defined in FAA Order 1600-75
  and 49 CFR parts 15 and 1520, except with the written permission of the
  Administrator of the Federal Aviation Administration, Administrator of
  the Transportation Security Administration, or the Secretary of
  Transportation. Unauthorized release may result in civil penalty or
  other action. For US Government agencies, FAA Order 1600-75, 5USC 552,
  and 49 CFR parts 15 and 1520 govern public disclosure.

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Screening Information Request
Number:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Project Name or
Description:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

# DOCUMENT SECURITY

**NOTICE TO PROSPECTIVE OFFERORS**

This solicitation includes For Official Use Only (FOUO) or Sensitive
Security Information (SSI) Specification and Drawings. FOUO and SSI
documents provided under this solicitation are intended for use by
authorized users only. In support of this requirement, Federal Aviation
Administration (FAA) (we) requires bidders/Offerors (you) to exercise
prudent caution when handling documents relating to FOUO and SSI
Specification and Drawings per the solicitation.

**FOUO and SSI Documents will not be released to any individual or firm
who has not supplied a signed Document Security Notice.**

1.  **[Limiting dissemination to authorized users.]{.underline}**
    Dissemination of information shall only be made upon determination
    that the recipient is authorized to receive it. The criterion to
    determine authorization is need-to-know. Those with a need-to--know
    are those who are specially granted access for the conduct of
    business on behalf of or with FAA. This includes all persons or
    firms necessary to do work at the request of the Government, such as
    architects and engineers, consultants, contractors, sub-contractors,
    suppliers, and others that the contractor deems necessary in order
    to submit an offer/bid or to complete the work or contract, as well
    as maintenance and repair contractors and equipment service
    contractors. **Dissemination of FOUO and SSI documents shall be
    made, only upon receipt, by the Contracting Officer of the duly
    signed Document Security Notice (DSN) from each vendor requesting
    the solicitation package. Each vendor receiving FOUO and SSI
    documents shall be responsible for maintaining the original copy of
    all signed DSN's and to provide said DSN's to the Contracting
    Officer upon request.**

> NOTE: **It is the responsibility of the person or firm disseminating
> the FOUO and SSI documents to assure that the recipient is an
> authorized user and to keep records of the recipients. This record
> shall be maintained by the person/firm and must be presented on demand
> when requested by the FAA.**
>
> Authorized users shall provide identification as set forth below:
>
> [Valid identification for non-Government users:]{.underline}
> Authorized non-Government users shall provide valid identification to
> receive FOUO and SSI Specification and Drawings. The identification
> shall be presented and verified for each dissemination. Valid
> identification shall be all items (a) through (c).

(a) **Business Declaration:** The primary contractor must ensure that
    the attached Business Declaration is complete (contains all
    pertinent information (i.e., Name of Firm, Tax Identification
    Number, DUNS Number, etc.) and is true and accurate to the best of
    their knowledge.

(b) **List of Employees:** The prime contractor must provide a list of
    all employees that will have access to the specifications and
    drawings.

(c) **List of Sub-contractors:** The prime contractor shall provide a
    list of all their subcontractors that will have access to the
    specifications and drawings.

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2.  **[Retaining and destroying documents:]{.underline}** The efforts
    required above shall continue throughout the entire term of the
    contract and for whatever specific time thereafter as may be
    necessary. Necessary record copies for legal purposes (such as those
    retained by the architect, engineer, or contractor) must be
    safeguarded against unauthorized use for the term of retention.
    Documents no longer needed shall be destroyed (such as after
    contract award, after completion of any appeals process or
    completion of the work). Destruction shall be done by burning or
    shredding hardcopy, and/or physically destroying CD's, deleting and
    removing files from the electronic recycling bins, and removing
    material from computer hard drives using a permanent erase utility
    or similar software.

3.  **[Term of Effectiveness:]{.underline}** The efforts required above
    shall continue throughout the entire term of contract and for what
    specific time thereafter as may be necessary, as determined by the
    Government. Necessary record copies for legal purposes (such as
    those retained by the architect, engineer, or contractor) must be
    safeguarded against unauthorized use for the term of retention.

> The recipient acknowledges the requirement to use **reasonable care**,
> as outlined above, to safeguard the documents and, if not awarded, the
> contract (and at the completion of any protest/appeal process) will
> make every reasonable and prudent effort to destroy or render useless
> all FOUO and SSI Specification and Drawings received during the
> solicitation.

I AGREE THAT I AM DULY AUTHORIZED TO EXECUTE THIS AGREEMENT ON BEHALF OF
THE BELOW-NAMED ENTITY AND AGREE THAT THE BELOW WILL ABIDE BY THIS
AGREEMENT AND WILL ONLY DISSEMINATE FOUO AND SSI DOCUMENTS TO OTHER
AUTHORIZED USERS UNDER THE CONDITIONS SET FORTH ABOVE.

> Signature:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
>
> Name of
> Company:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
>
> Title:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Date:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_