DD-254 .doc
DOC document 98 KB Posted
- Solicitation number
- 19PK4026Q5012
- Issued by
-
Department of State
About this file
This is a DD Form 254, Contract Security Classification Specification, which establishes security requirements and safeguarding procedures for classified information on a Department of Defense or federal contract. The form serves as a security specification document that outlines the level of facility clearance required, types of classified material that may be accessed or generated, and specific security protocols the contractor must follow in accordance with the DoD Industrial Security Manual.
The DD Form 254 template includes sections for identifying the prime contract or subcontract number, contractor and subcontractor information with CAGE codes, cognizant security offices, and the actual performance location. It specifies security classification levels required, types of classified information access (such as Sensitive Compartmented Information, restricted data, intelligence information, NATO information, and COMSEC), and contractor activities involving classified material (receiving, generating, fabricating, modifying, or storing classified hardware). The form requires designation of security guidance documentation, identification of any additional security requirements beyond Industrial Security Manual standards, certification by an authorized official, and mandated distribution to the contractor, subcontractor, cognizant security office, and other government entities. This particular form is related to solicitation 19PK4026Q5012 for preventive maintenance services on HVAC equipment at the U.S. Consulate General in Karachi, Pakistan, indicating that security clearances and classified information handling procedures apply to this Department of State contract opportunity.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| RFQ _SAM 19PK4026Q5012_.pdf | ||
| SOW - PMSC Chiller PCC Chiller and DAIKOOL Condensing Unit.pdf |
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Text version
1. CLEARANCE AND SAFEGUARDING
DEPARTMENT OF DEFENSE
a. FACILITY CLEARANCE REQUIRED
CONTRACT SECURITY CLASSIFICATION SPECIFICATION
(The requirements of the DoD Industrial Security Manual apply
b. LEVEL OF SAFEGUARDING REQUIRED to all security aspects of this effort.)
2. THIS SPECIFICATION IS FOR: (X and complete as applicable)
3. THIS SPECIFICATION IS: (X and complete as applicable)
a. PRIME CONTRACT NUMBER
a. ORIGINAL (Complete date in all cases) Date (YYYYMMDD)
b. SUBCONTRACT NUMBER
b. REVISED (Supersedes Revision No.
Date (YYYYMMDD) all previous specs)
c. SOLICITATION OR OTHER NUMBER Due Date (YYYYMMDD)
c. FINAL (Complete Item 5 in all cases) Date (YYYYMMDD)
4. IS THIS A FOLLOW-ON CONTRACT?
YES
NO. If Yes, complete the following:
Classified material received or generated under _______________________________________ (Preceding Contract Number) is transferred to this follow-on contract.
5. IS THIS A FINAL DD FORM 254?
YES
NO. If Yes, complete the following:
In response to the contractor’s request dated __________________________ , retention of the classified material is authorized for the period of ___________________________________________
6. CONTRACTOR (Include Commercial and Government Entity (CAGE) Code)
a. NAME, ADDRESS, AND ZIP CODE
b. CAGE CODE
c. COGNIZANT SECURITY OFFICE (Name, Address, and Zip Code)
7. SUBCONTRACTOR
a. NAME, ADDRESS, AND ZIP CODE
b. CAGE CODE
c. COGNIZANT SECURITY OFFICE (Name, Address, and Zip Code)
8. ACTUAL PERFORMANCE
a. LOCATION
b. CAGE CODE
c. COGNIZANT SECURITY OFFICE (Name, Address, and Zip Code)
9. GENERAL IDENTIFICATION OF THIS PROCUREMENT
10. THIS CONTRACT WILL REQUIRE ACCESS TO:
YES
NO
11. IN PERFORMING THIS CONTRACT, THE CONTRACTOR WILL:
YES
NO
a. COMMUNICATIONS SECURITY (COMSEC) INFORMATION
a. HAVE ACCESS TO CLASSIFIED INFORMATION ONLY AT ANOTHER CONTRACTOR’S
FACILITY OR A GOVERNMENT ACTIVITY
b. RESTRICTED DATA
b. RECEIVE CLASSIFIED DOCUMENTS ONLY
c. CRITICAL NUCLEAR WEAPON DESIGN INFORMATION
c. RECEIVE AND GENERATE CLASSIFIED MATERIAL
d. FORMERLY RESTRICTED DATA
d. FABRICATE, MODIFY, OR STORE CLASSIFIED HARDWARE
e. INTELLIGENCE INFORMATION:
e. PERFORM SERVICES ONLY
(1) Sensitive Compartmented Information (SCI)
f. HAVE ACCESS TO U.S. CLASSIFIED INFORMATION OUTSIDE THE U.S.
PUERTO RICO, U.S. POSSESSIONS AND TRUST TERRITORIES
(2) Non-SCI
g. BE AUTHORIZED TO USE THE SERVICES OF DEFENSE TECHNICAL INFORMATION
CENTER (DTIC) OR OTHER SECONDARY DISTRIBUTION CENTER
f. SPECIAL ACCESS INFORMATION
h. REQUIRE A COMSEC ACCOUNT
g. NATO INFORMATION
i. HAVE TEMPEST REQUIREMENTS
h. FOREIGN GOVERNMENT INFORMATION
j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS
i. LIMITED DISSEMINATION INFORMATION
k. BE AUTHORIZED TO USE THE DEFENSE COURIER SERVICE
j. FOR OFFICIAL USE ONLY INFORMATION
l. OTHER (Specify)
k. OTHER (Specify)
DD FORM 254, DEC 1999
PREVIOUS EDITION IS OBSOLETE.
12. PUBLIC RELEASE. Any information (classified or unclassified) pertaining to this contract shall not be released for public dissemination except as provided by the Industrial
Security Manual or unless it has been approved for public release by appropriate U.S. Government authority. Proposed public releases shall be submitted for approval prior to release.
Direct Through (Specify):
to the Directorate for Freedom of Information and Security Review, Office of the Assistant Secretary of Defense (Public Affairs)* for review.
* In the case of non-DoD User Agencies, requests for disclosure shall be submitted to that agency.
13. SECURITY GUIDANCE. The security classification guidance needed for this classified 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. Add additional pages as needed to provide complete guidance.)
Contracting Officer’s Representative (COR)
Office Symbol
Phone
14. ADDITIONAL SECURITY REQUIREMENTS. Requirements, in addition to ISM requirements, are established for this contract.
YES
NO
(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 cognizant security office. Use Item 13 if additional space is needed.)
15. INSPECTIONS. Elements of this contract are outside the inspection responsibility of the cognizant security office.
YES
NO
(If Yes, explain and identify specific areas or elements carved out and the activity responsible for inspections. Use Item 13 if additional space is needed.)
16. CERTIFICATION AND SIGNATURE. 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.
a. TYPED NAME OF CERTIFYING OFFICIAL
b. TITLE
c. TELEPHONE (Include Area Code)
d. ADDRESS (Include ZIP Code)
17. REQUIRED DISTRIBUTION.
a. CONTRACTOR
b. SUBCONTRACTOR
c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR
e. SIGNATURE
d. A/FBO/PE/CSM
e. DS/PSD/CSB
f. CO/COR
DD FORM 254 (BACK), DEC 1999
File details come from the government source that posted it. Updated .