20 - DD254.pdf

CLASSIFICATION (When filled in): Unclassified

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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:

June 30, 2025

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

a. LEVEL OF FACILITY SECURITY CLEARANCE (FCL) REQUIRED

(See Instructions)

Secret

b. LEVEL OF SAFEGUARDING FOR CLASSIFIED INFORMATION/

MATERIAL REQUIRED AT CONTRACTOR FACILITY

None (See instructions)

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

a. PRIME CONTRACT NUMBER (See instructions )

b. SUBCONTRACT NUMBER

c. SOLICITATION OR OTHER NUMBER DUE DATE (YYYYMMDD)

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

a. ORIGINAL (Complete date in all cases )

DATE (YYYYMMDD)

b. REVISED (Supersedes all previous specifications )

REVISION NO. DATE (YYYYMMDD)

c. FINAL (Complete Item 5 in all cases ) DATE (YYYYMMDD)

4. IS THIS A FOLLOW-ON CONTRACT? No Yes 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? No Yes 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

TBD

b. CAGE CODE c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional)

TBD

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)

a. NAME, ADDRESS, AND ZIP CODE

TBD

b. CAGE CODE c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional)

TBD

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

a. LOCATION(S) (For actual performance, see instructions )

U.S. Department of Defense (OUSD P&R) Military Community and Family Policy (MC&FP) 4800 Mark Center Drive, Suite 14E08 Alexandria, VA 22311

b. CAGE CODE (If applicable, see Instructions.)

c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional)

U.S. Department of Defense (OUSD P&R) Military Community and Family Policy (MC&FP) 4800 Mark Center Drive, Suite 14E08 Alexandria, VA 22311

9. GENERAL UNCLASSIFIED DESCRIPTION OF THIS PROCUREMENT

The purpose of this contract is to provide services in support of the Military OneSource program for military members and their families, similar to a commercial Employee Assistance Program (EAP). This program provides members of the Armed Forces and their families, about

5.2 million persons “participants” at locations worldwide, with a broad array of information and referrals to both military and civilian resources as well as counseling services. Over the course of this contract, the DoD may also designate other categories of personnel to be participants. The scope of the Military OneSource program encompasses all resources and development of resources, processes, personnel, materials, training, equipment, and technology necessary to provide service members and their families with unlimited access (via 24-hour, toll-free telephone, electronic mail (e-mail), postal mail, video counseling, real-time messaging (chat), artificial-intelligence chatbot, and face-to-face counseling (which is provided upon request) to stateside and international information, referral, and counseling services available through a centralized source.

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

a. COMMUNICATIONS SECURITY (COMSEC) INFORMATION f. SPECIAL ACCESS PROGRAM (SAP) INFORMATION

b. RESTRICTED DATA g. NORTH ATLANTIC TREATY ORGANIZATION

(NATO) INFORMATION

c. CRITICAL NUCLEAR WEAPON DESIGN INFORMATION (CNWDI) (If CNWDI applies, RESTRICTED DATA must also be marked ) h. FOREIGN GOVERMENT INFORMATION

d. FORMERLY RESTRICTED DATA i. ALTERNATIVE COMPENSATORY CONTROL MEASURES

(ACCM) INFORMATION

e. NATIONAL INTELLIGENCE INFORMATION:

(1) Sensitive Compartmented Information (SCI)

(2) Non-SCI

j. CONTROLLED UNCLASSIFIED INFORMATION (CUI) (See instructions )

k. OTHER (Specify) (See instructions )

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 )

a. HAVE ACCESS TO CLASSIFIED INFORMATION ONLY AT

ANOTHER CONTRACTOR'S FACILITY OR A GOVERNMENT

ACTIVITY

(Applicable only if there is no access or storage required at contractor facility.

See instructions )

b. RECEIVE AND STORE CLASSIFIED DOCUMENTS ONLY

c. RECEIVE, STORE, AND GENERATE CLASSIFIED

INFORMATION OR MATERIAL

d. FABRICATE, MODIFY, OR STORE CLASSIFIED HARDWARE

e. PERFORM SERVICES ONLY

f. HAVE ACCESS TO U.S. CLASSIFIED INFORMATION OUTSIDE

THE U.S.,PUERTO RICO, U.S. POSSESSIONS AND TRUST

TERRITORIES

g. BE AUTHORIZED TO USE THE SERVICES OF DEFENSE

TECHNICAL INFORMATION CENTER (DTIC) OR OTHER

SECONDARY DISTRIBUTION CENTER

h. REQUIRE A COMSEC ACCOUNT

i. HAVE A TEMPEST REQUIREMENT

j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS

k. BE AUTHORIZED TO USE DEFENSE COURIER SERVICE

l. RECEIVE, STORE, OR GENERATE CONTROLLED UNCLASSIFIED

INFORMATION (CUI).

(DoD Components: refer to DoDI 5200.48, only for specific CUI protection requirements. Non-DoD Components: see instructions )

m. OTHER (Specify) (See instructions )

Require Suitability Investigations in accordance with Block 13 guidance on pages three and four of the DD254.

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)

DIRECT THROUGH (Specify below)

Military Community and Family Policy (MC&FP) 4800 Mark Center Drive, Alexandria, VA 22311

Public Release Authority:

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 )

REFERENCE BLOCK 10(j); The mandates in DoD Instruction (DoDI) 5200.48 , "Controlled Unclassified Information (CUI)," shall apply to the contractor and any subcontractors.

REFERENCE BLOCK 11(a); Access to Classified Information Only at Government Activity. The highest level of classification for the contract is SECRET.

REFERENCE BLOCK 11(e); All personnel assigned to perform duties under this contract shall be U.S. Citizens. Visit Authorization Requests / Letters (VARs / VALs) shall be electronically submitted for all personnel performing duties under this contract. The Visit Authorizations shall be submitted at least three (3) business days prior to personnel performing on the contract. All VAL/VARs shall be prepared and submitted in accordance with 32 Code of Federal Regulations (CFR) Part 117, “National Industrial Security Program Operating Manual (NISPOM).”

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REFERENCE BLOCK 11(l): The mandates in DoDI 5200.48 shall apply to the contractor and any subcontractors. CUI Markings shall be executed in accordance with prevailing policy mandates at https://www.dodcui.mil/Home/Policy.

REFERENCE BLOCK 11(m); References: 32 CFR Part 117 ("NISPOM"), DoDI 5220.22, "National Industrial Security Program (NISP)," DoD Manual 5200.02, "Procedures for the DoD Personnel Security Program (PSP)," DoDI 8510.01, and all applicable DoD Security Technical Implementation Guides (STIGs) and Security Requirements Guides (SRGs). BLOCK 11(m) Continued:

1. All Information Technology (IT) and Cybersecurity contractor and subcontractor positions supporting this contract shall be regarded and categorized as "Noncritical-Sensitive (NCS) Moderate Risk." Personnel occupying NCS Moderate Risk positions require a favorably adjudicated Tier 3 (T3/T3R) National Security Investigation, which entails a "National Agency Check With Local Agency Checks and Credit Check (NACLC)."

2. All other non-IT/Cybersecurity positions, if duties, responsibilities, and tasks require access to the Government’s eCMS platform, CUI, PII, PHI, or Privacy Act data must undergo a DoD-initiated Tier 2 (Non-Sensitive/Moderate-Risk) Suitability Investigation during the transition-in period or within 30 calendar days of hire/onboarding. The Tier 2 minimum requirements shall also apply to all contractor and subcontractor personnel that require issuance of a DoD Common Access Card (CAC), issuance of an External Certificate Authority (ECA) alternate token, or regular or periodic access to any U.S. military installation. The Government's Security Manager will work with the contractor to identify clear processes and procedures to facilitate and support the initiation of the requisite Tier 2 investigations.

3. The contractor shall lastly ensure that all personnel undergo a criminal history background, fingerprint, and credential review/verification (specific to counselors), as coordinated and executed by the contractor. The contractor shall not allow counselors to perform counseling services under the contract until verification that the criminal history background check has been initiated. The level of criminal history background and fingerprint checks shall explicitly conform to the standards established in Enclosure 3, Subsection 2(c), of DoDI 1402.05, "Background Checks on Individuals in DoD Child Care Services Programs."

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

NAME & TITLE OF REVIEWING OFFICIAL SIGNATURE

14. ADDITIONAL SECURITY REQUIREMENTS

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

No Yes 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.

No Yes 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)

a. GCA NAME

GSA/FEDSIM Acquisition

b. ACTIVITY ADDRESS CODE (AAC) OF THE CONTRACTING OFFICE (See Instructions)

QF0BBA

c. ADDRESS (Include ZIP Code) 1800 F Street, NW 3100 Washington, D.C. 20405

d. POC NAME

e. POC TELEPHONE (Include Area Code)

f. EMAIL ADDRESS (See Instructions)

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.

a. TYPED NAME OF CERTIFYING OFFICIAL (Last, First, Middle Initial) (See Instructions)

b. TITLE

Security Manager

PREVIOUS EDITION IS OBSOLETE. Page 4 of 4DD FORM 254, APR 2018

c. ADDRESS (Include ZIP Code)

OUSD P&R

Attn: Security Room, 5E604 4000 Defense Pentagon

d. AAC OF THE CONTRACTING OFFICE (See Instructions)

e. CAGE CODE OF THE PRIME CONTRACTOR (See Instructions )

f. TELEPHONE (Include Area Code)

g. EMAIL ADDRESS (See Instructions)

h. SIGNATURE

i. DATE SIGNED (See Instructions)

18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL

a. CONTRACTOR

b. SUBCONTRACTOR

c. COGNIZANT SECURITY OFFICE FOR PRIME AND

SUBCONTRACTOR

d. U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECURITY

ADMINISTRATION

e. ADMINISTRATIVE CONTRACTING OFFICER

f. OTHER AS NECESSARY (If more room is needed, continue in Item 13 or on additional page if necessary )