22R5435 Attachment IX (H) - DD Form 254 25 JUL 2022 1.1.pdf
PDF 173 KB Posted
- Attached to
- Medium Range Tanker Time Charter Federal contract opportunity
- Solicitation number
- N32205-22-R-5435
About this file
This document is a DD Form 254, which specifies security requirements and classification guidance for a federal contract. The contract is between the Military Sealift Command and a contractor to provide one clean, double hull tanker capable of carrying a minimum of 310,000 barrels of clean petroleum products. The tanker must have an Inert Gas System and Segregated Ballast Tanks, and provide a secure space onboard meeting DoD requirements for handling classified information. The contractor will require access to Secret information regarding operational employment and ship navigation. Designated personnel must have U.S. citizenship and a minimum Secret clearance. The contractor must comply with DoD and Navy regulations regarding personnel security, classified information handling and document destruction, operations security, and controlled unclassified information. Subcontractors are also subject to the security requirements and guidance specified in the form.
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SAMPLE
PREVIOUS EDITION IS OBSOLETE.
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DD FORM 254, APR 2018
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:
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
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.)
List of Attachments (All Files Must be attached Prior to Signing, i.e., for any digital signature on the form)
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"
| CurrentPage: |
| PageCount: |
| Select classification from drop-down list.: Unclassified |
| Enter serial number.: |
| a. Facility clearance level. Select one.: 2 |
| b. Level of safeguarding for classified information/material required at contractor facility. Select one.: 4 |
| Select for "original.": 0 |
| Select for "original.": 1 |
| Enter prime contract number.: N3220522R5435 |
| Select for "revised.": 0 |
| Select for "revised.": 0 |
| Enter subcontract number.: |
| Select for "final.": 0 |
| Select for "final.": 0 |
| Enter solicitation or other number.: |
| Enter due date in format YYYYMMDD.: |
| Enter date in format YYYYMMDD.: 20230201 |
| Enter revision number.: |
| Enter date in format YYYYMMDD.: |
| Enter final specification.: |
| Enter date in format YYYYMMDD.: |
| Select for "no.": 1 |
| Select for "no.": 1 |
| Select for "no.": 0 |
| Select for "no.": 1 |
| Select for "yes.": 0 |
| Select for "yes.": 0 |
| Select for "yes.": 1 |
| Select for "yes.": 0 |
| Enter preceding contract number.: |
| Enter contractor's request date in format YYYYMMDD.: |
| Enter period.: |
| Enter typed name of certifying official (last, first, middle initial).: INDOPACOM AOR |
| Enter typed name of certifying official (last, first, middle initial).: Schotter Eric C |
| Enter CAGE code of the prime contractor.: |
| Enter cognizant security office(s) (Name, Address, ZIP Code, Telephone required; Email Address optional).: |
| Select to add row to locations.: |
| Select to remove last row from locations.: |
| Select to delete all signatures.: |
| Enter location(s).: |
| Enter general unclassified description of this procurement.: One clean, approved upon delivery U.S. Flag, double hull tanker with an Inert Gas System (IGS) and Segregated Ballast Tanks (SBTs) that is capable of carrying a minimum of 310,000 BBLS of clean petroleum products (intention JP8, JP5, F76) within the vessel’s natural segregation in designated cargo tanks with double valve isolation.The Contractor shall provide a secure space on-board the ship that can meet the specified by DoD 5220.22-M. |
| Select for "a. CONTRACTOR.": 1 |
| Select for "a. CONTRACTOR.": 1 |
| Select for "a. CONTRACTOR.": 0 |
| Select for "f. OTHER AS NECESSARY.": 0 |
| Select for "f. OTHER AS NECESSARY.": 1 |
| Select for "f. OTHER AS NECESSARY.": 0 |
| Select for "b. SUBCONTRACTOR.": 1 |
| Select for "b. SUBCONTRACTOR.": 1 |
| Select for "b. SUBCONTRACTOR.": 0 |
| Select for "g. BE AUTHORIZED TO USE THE SERVICES OF DEFENSE TECHNICAL INFORMATION CENTER (DTIC) OR OTHER SECONDARY DISTRIBUTION CENTER.": 0 |
| Select for "g. BE AUTHORIZED TO USE THE SERVICES OF DEFENSE TECHNICAL INFORMATION CENTER (DTIC) OR OTHER SECONDARY DISTRIBUTION CENTER.": 0 |
| Select for "c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR.": 0 |
| Select for "c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR.": 1 |
| Select for "c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR.": 0 |
| Select for "h. REQUIRE A COMSEC ACCOUNT.": 0 |
| Select for "h. REQUIRE A COMSEC ACCOUNT.": 0 |
| Select for "d. U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECURITY ADMINISTRATION.": 0 |
| Select for "d. U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECURITY ADMINISTRATION.": 1 |
| Select for "d. U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECURITY ADMINISTRATION.": 0 |
| Select for "i. HAVE A TEMPEST REQUIREMENT.": 0 |
| Select for "i. HAVE A TEMPEST REQUIREMENT.": 0 |
| Select for "e. NATIONAL INTELLIGENCE INFORMATION: - (1) Sensitive Compartmented Information (SCI).": 0 |
| Select for "e. NATIONAL INTELLIGENCE INFORMATION: - (2) Non-SCI.": 0 |
| Select for "j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS.": 1 |
| Select for "j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS.": 1 |
| Select for "k. BE AUTHORIZED TO USE DEFENSE COURIER SERVICE.": 0 |
| Select for "k. BE AUTHORIZED TO USE DEFENSE COURIER SERVICE.": 0 |
| Enter infomration for "other.": |
| Select for "e. ADMINISTRATIVE CONTRACTING OFFICER.": 0 |
| Select for "e. ADMINISTRATIVE CONTRACTING OFFICER.": 0 |
| Select for "l. RECEIVE, STORE, OR GENERATE CONTROLLED UNCLASSIFIED INFORMATION (CUI). .": 0 |
| Select for "m.OTHER.": 0 |
| Select for "direct.": 0 |
| Select for ": 1 |
| Enter specification for "through".: Military Sealift Command Office of Public Affairs |
| Enter public release authority.: Military Sealift Command Office of Public Affairs |
| Select to add signature.: |
| Select to remove last signature.: |
| text: A. The Contractor shall be responsible for Controlled Cryptographic Instruments (CCI), such as a STE telephone, issued by the MSC Operational or Administrative Commander. The Contractor shall provide a secure space on-board the ships identified in Block 9 for use of CCI equipment and shall designate accountable personnel as specified by DoD 5220.22-M, National Industrial Security Program Operating Manual (NISPOM). The Contractor may also be issued COMSEC keying material which requires that two-person integrity (TPI) be maintained on board the ship as specified in DoD 5220.22-M NISPOM Supplement 1. Any two ship's officers who hold a SECRET clearance granted by DISCO are acceptable as COMSEC keying material users. Physical safeguards for all classified material shall be provided by Contractor personnel as specified in DoD 5220.22-M. |
B. Information Security Requirements(InfoSec). The Contractor shall handle, store, and maintain classified material in compliance with requirements set by DOD 5220.22(series), National Industrial Security Program Operating Manual, and the DD Form 254, DOD Contracts Security Classification Specification for classified contracts. All members who require access to classified information, sensitive information, controlled unclassified information (to include Privacy Act and Personally Identifiable Information (PII) or access to the classified information network shall comply with DoD Manual 5200.01 Vol I - IV (DoD Information Security Program), SECNAV M5510.36 (SECNAV Information Security Program), and DoDD 5240.06 (Counterintelligence Awareness and Reporting - CIAR). The Contractor shall implement InfoSec measures for its contractor furnished unclassified information technology system(s) used in performance of this contract. InfoSec measures shall be compliant with DFARS 252.204-7012, Safeguarding Covered Defense Information and Cyber Incident Reporting. At a minimum, the security standards extracted from the referenced National Institute of Standards and Technology (NIST) Special Publication 800-171, Protecting Controlled Unclassified Information in Nonfederal Information Systems and Organizations or accepted equivalents, shall be incorporated into any InfoSec program the contractor establishes.
C. The Contractor shall be responsible for the storage requirements. See DoD 5220.22-M National Industrial Security Operating Manual (NISPOM) for industrial security guidance, SECNAV M-5510.30 Personnel Security Program for personnel security guidance, and SECNAV M-5510.36 Information Security Program, for information security guidance and guidance on handling FOUO. All classified documents, when no longer needed, shall be destroyed as classified waste in accordance with DoD 5220.M and SECNAV 5510.36.
D. Contract performance requires that designated personnel employed onboard the ship have access to SECRET information regarding the operational employment and safe navigation of the ship. The Contractor shall ensure that any classified information disclosed to its employees is not further released or made available to other employees, or any other person who does not have a comparable clearance and a "Need to Know.
E. The Contractor shall provide annually to the COR, an updated list of all crew members who are designated to have access to classified information.
F. This form must be modified to include subcontractor information, if they are used. The contractor will ensure all subcontractors follow security guidance.
G. See Section C 1.6.12 Operational Security (OPSEC) in the PWS for OPSEC requirements and additional details.
H. Contractor shall provide a Visit Authorization Letter (VAL) listing for all contract personnel located on the installation(s) and on-board the ship(s) that require or will have access to classified information. Contractor shall provide a VAL listing for the other contractors that perform contractual services on the installation(s) or on-board ship(s) that require or will have access to sensitive unclassified information, which includes the other contractors that require routine or frequent "entry" to the installation(s) or on-board the ship(s) in the performance of other types of contracts, services or maintenance. During the performance period of the contract, the Facility Security Officer, shall notify Command Security Manager within 7 working days of any changes to the VAL listing of the contractor personnel.
I. Specific key billets as specified in the contract shall have access to Secret information regarding mission operation employment must be US citizens and possess at least a Secret clearance. All designated personnel who maintain a security clearance and handle classified information must attend Counterintelligence Awareness and Reporting (CIAR) Training. See DoD Directive Number 5240.06 for guidance.
J: All Controlled Unclassified Information (CUI) associated with this contract must be protected per the guidance provided for Item 11(l) of this DD Form 254
| Click on this button to attach a file(s).: |
| rep: Eric C. Schotter |
| Enter signature.: |
| Explain and identify specific areas and government activity responsible for inspections.: Personnel shall have OPSEC requirements that flow down from the prime contract, Section C-2.6.6. All vessel personnel are required to complete OPSEC awareness on an annual basis: https://securityawareness.usalearning.gov/opsec/index.htm. |
IAW DoD 5220.22-M, National Industrial Security Operating Manual (NISPOM) all contracting marine personnel who have access to classified information must comply with DoD Directive 5240.06 Counterintelligence Awareness and Reporting and will complete training located at https://www.cdse.edu/Training/eLearning/CI112/.
| Enter GCA name.: |
| Enter AAC of the contracting office.: |
| Enter address (include zip code).: Naval Station Norfolk |
471 East C Street, Bldg. SP-47 Norfolk, VA 23511-2419
| Enter POC name.: |
| Enter telephone number (include area code).: 7575433287 |
| Enter email address.: eric.c.schotter.civ@us.navy.mil |
| Enter title.: Security Director |
| Enter the datesigned in format YYYYMMDD.: 20220810 |
File details come from the government source that posted it. Updated .