1. DD Form 254.pdf

Please wait...

If this message is not eventually replaced by the proper contents of the document, your PDF viewer may not be able to display this type of document.

You can upgrade to the latest version of Adobe Reader for Windows®, Mac, or Linux® by visiting http://www.adobe.com/go/reader_download.

For more assistance with Adobe Reader visit http://www.adobe.com/go/acrreader.

Windows is either a registered trademark or a trademark of Microsoft Corporation in the United States and/or other countries. Mac is a trademark of Apple Inc., registered in the United States and other countries. Linux is the registered trademark of Linus Torvalds in the U.S. and other countries.

DRAFT

SAMPLE

PREVIOUS EDITION IS OBSOLETE.

Page of

DD FORM 254, MAY 2019

NEEDS DD67

DEPARTMENT OF DEFENSE

CONTRACT SECURITY CLASSIFICATION SPECIFICATION

(The requirements of the National Industrial Security Program (NISP) apply to all security aspects of this effort involving classified information.)

OMB No. 0704-0567 OMB approval expires:

20220531 The public reporting burden for this collection of information, 0704-0567, is estimated to average 70 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Washington Headquarters Services, at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

RETURN COMPLETED FORM AS DIRECTED IN THE INSTRUCTIONS.

1. CLEARANCE AND SAFEGUARDING

2. THIS SPECIFICATION IS FOR: (X and complete as applicable.)

3. THIS SPECIFICATION IS: (X and complete as applicable.)

a. ORIGINAL (Complete date in all cases.)

b. REVISED (Supersedes all previous specifications.)

4. IS THIS A FOLLOW-ON CONTRACT?

If yes, complete the following:

Classified material received or generated under

5. IS THIS A FINAL DD FORM 254?

If yes, complete the following:

6. CONTRACTOR (Include Commercial and Government Entity (CAGE) Code)

7. SUBCONTRACTOR(S) (Click button if you choose to add or list the subcontractors -- but will still require a separate DD Form 254 issued by a prime contractor to each subcontractor)

8. ACTUAL PERFORMANCE (Click button to add more locations.)

10. CONTRACTOR WILL REQUIRE ACCESS TO: (X all that apply. Provide details in Blocks 13 or 14 as set forth in the instructions.)

e. NATIONAL INTELLIGENCE INFORMATION:

11. IN PERFORMING THIS CONTRACT, THE CONTRACTOR WILL: (X all that apply. See instructions. Provide details in Blocks 13 or 14 as set forth in the instructions.)

12. PUBLIC RELEASE

Any information (classified or unclassified) pertaining to this contract shall not be released for public dissemination except as provided by the National Industrial Security Program Operating Manual (NISPOM) or unless it has been approved for public release by appropriate U.S. Government authority. Proposed public releases shall be submitted for review and approval prior to release to the appropriate government approval authority identified here with at least office and phone contact information and if available, an e-mail address. (See instructions)

13. SECURITY GUIDANCE

The security classification guidance for classified information needed for this effort is identified below. If any difficulty is encountered in applying this guidance or if any other contributing factor indicates a need for changes in this guidance, the contractor is authorized and encouraged to provide recommended changes; to challenge the guidance or the classification assigned to any information or material furnished or generated under this contract; and to submit any questions for interpretation of this guidance to the official identified below. Pending final decision, the information involved shall be handled and protected at the highest level of classification assigned or recommended.

(Fill in as appropriate for the classified effort. Attach, or forward under separate correspondence, any documents/guides/extracts referenced herein. The field will expand as text is added. When removing any expanded text area, use delete key or backspace key, then click out of the text field for it to shrink after the text has been deleted. Also allows for up to 6 internal reviewers to digitally sign. See instructions for additional guidance or use of the fillable PDF.)

14. ADDITIONAL SECURITY REQUIREMENTS

Requirements, in addition to NISPOM requirements for classified information, are established for this contract.

If Yes, identify the pertinent contractual clauses in the contract document itself, or provide an appropriate statement which identifies the additional requirements. Provide a copy of the requirements to the CSO. The field will expand as text is added or you can also use item 13. When removing any expanded text area, use delete key or backspace key, then click out of the text field for it to shrink after the text has been deleted. (See instructions for additional guidance or use of the fillable PDF.)

15. INSPECTIONS

Elements of this contract are outside the inspection responsibility of the CSO.

If Yes, explain and identify specific areas and government activity responsible for inspections. The field will expand as text is added or you can also use item 13. When removing any expanded text area, use delete key or backspace key, then click out of the text field for it to shrink after the text has been deleted. (See instructions for additional guidance or use of the fillable PDF.)

16. GOVERNMENT CONTRACTING ACTIVITY (GCA) AND POINT OF CONTACT (POC)

17. CERTIFICATION AND SIGNATURES

Security requirements stated herein are complete and adequate for safeguarding the classified information to be released or generated under this classified effort. All questions shall be referred to the official named below. Upon digitally signing Item 17h, no changes can be made as the form will be locked.

18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL

9.0.0.2.20120627.2.874785 DD 254, DoD Contract Security Classification Specification whs.mc-alex.esd.mbx.formswebmaster@mail.mil

WHS

List of Attachments (All Files Must be Attached Prior to Signing, i.e., for any digital signature on the form)

2000 E El Segundo Blvd El Segundo, CA 90246-4501 Name:

N/A

Los Angeles Field Office (IOFWL) 3452 E Foothill Blvd Suite 600 Pasadena, CA 91107 Phone: 626-463-0515

CSO:

N/A CSO: Defense Counterintelligence and Security Agency Detroit Field Office (IOFND) 17111 N. Laurel Park Drive, Suite 423 Loviovia, MI 48152-2659 Phone: 734-853-8410

6125 East 21st Street Indianapolis, IN 46219-2058 Classified Address: Mail Stop 22 ATTN: CMCC

AFLCMC IP 1801 Tenth St, Bldg 8, Rm 103, WPAFB, OH 45433-7629, AFLCMC.IPDDForm254.Workflow@us.af.mil

HQ Defense Counterintelligence and Security Agency, 27130 Telegraph Rd, Quantico, VA 22134.

Item 12. PUBLIC RELEASE Cont'd:

Ref Item 12: Contractor is to submit requests through the Contracting Officer for OPSEC Program Manager review and public release authorization. The Contracting Officer will provide contractor with written approval/disapproval. Information requiring AF or DoD–level review will be reviewed by the unit’s OPSEC Program Manager or Coordinator who will in-turn forward to the entry-level public affairs office through the AFIMSC Public Affairs Office to the Secretary of the Air Force, Office of Public Affairs, Security and Review Division (SAF/PAX), 1690 Air Force Pentagon, Washington DC 20330-1690. Transmission of public release request via e-mail is not authorized

AFLCMC/WIU, 235 Byron Street Suite 19A Robins AFB, Ga 31098.

Item 13. SECURITY GUIDANCE Cont'd:

The National Industrial Security Program Operating Manual (NISPOM), February 2006, Incorporating Change 2, 18 May 16, applies.

a. Ref Item 10a/11h: The Contractor is authorized to receive Government furnished cryptographic equipment. Access to classified COMSEC information requires a final U.S. Government clearance at the appropriate level. Further disclosure of COMSEC information by a contractor, to include subcontracting, requires prior approval of the Government Contracting Authority. Non-accountable COMSEC information, though not tracked in the COMSEC material control system, may still require a level of control within a document control system. Refer to NSA/CSS Manual 3-16, “Control of Communications Security Material,” and the Committee on National Security Systems Instruction (CNSSI) 4001, “Controlled Cryptographic Items,” for guidance.

(1) Contractor will comply with AFMAN 17-1302-O, Communications Security (COMSEC) Operations, 09 Apr 20.

b. Ref Item 10j/11l: The contractor shall comply with DoDI 5200.48, Controlled Unclassified Information, AFI 16-1404 Air Force Information Security Program, Air Force Guidance Memorandum 2020-16-01, Air Force Guidance Memorandum for CUI, 23 July 2020, and DoDM 5400.07-Air Force Manual 33-302, DoD Freedom of Information Act (FOIA) Program. The contractor shall monitor CUI aggregation and compilation based on the potential to generate classified information pursuant to security classification guidance addressing the accumulation of unclassified data or information.

c. Ref Item 11c: Contractor will reference the appropriate security classification guidance when generating or deriving classified material or hardware. All classified information received or generated will be properly stored and handled according to the markings on the material. All classified information received or generated is the property of the U.S. Government. At the termination or expiration of the contract, the U.S. Government will be contacted for proper disposition instructions. Contractor will abide by and shall apply derivative classification and markings governed by the current version of the following security classification guide: HH-60G Pave Hawk Helicopter, dated 13 Jan 2003, Revised 18 Apr 2011 & 06 Apr 2018. OPR: AFLCMC/WIU, Robins AFB, GA 31098

Prior to declassifying or downgrading information marked with a date or event on the "declassify on" line: The Contractor will confirm the OCA has not extended the classification period by reference to the applicable Security Classification or Declassification Guide or by consulting with the Program Office with the OCA.

d. Ref Item 11e: Contract is for equipment maintenance services on equipment which processes classified information. Actual knowledge of, generation, or production of classified information is not required for performance of the contract. Cleared personnel access to classified information cannot be precluded by escorting personnel. Any classification guidance will be provided by the using activity.

e. Ref Item 11m: The Following FARS and DFARS Clauses apply: Far Clause 52.204-2, FAR Clause 52.204-21, DFARS Clause 252.204-7012, DFARS 252.204-7000, DFARS 252.204-7008 and DFARS 252.204-7009.

The Contractor will notify the Government Contracting Activity and the Government Security Manager within 48 hours of any incident involving the actual or suspected compromise/loss of classified information to enable the Government to conduct immediate assessment of potential impact pending formal inquiry/investigation. Actual or suspected compromise of Covered Defense Information will be reported IAW DFARS Clause 252.204-7012.

Program Manager: Alan K. Singleton, AFLCMC/WIUBB, 478-222-8321, DSN 472-8321 Security Manager: Shatasha Estes, AFLCMC/WIUW, 478-222-8272, DSN 472-8272.

text: AFLCMC/IP Wright-Patterson AFB, OH 45433

Industrial/Information Security Protection

Ref Item 11j: OPSEC requirements apply. See Performance Work Statement for requirements.

235 Byron Street, Suite 19A Robins AFB, GA 31098 Address: AFLCMC/WIUKB 235 Byron Street, Suite 19A Robins AFB, GA 31098