31310019R0008_Attachment_No._6_NRC_187.pdf

NRCMD 12

(03-2017) CONTRACT SECURITY AND/OR

CLASSIFICATION REQUIREMENTS

U.S. NUCLEAR REGULATORY COMMISSIONNRC FORM 187

NRC FORM 187 (03-2017) Page 1 of 4

1. Type of Submission

New

2. Type of Contract

Commercial

3. Contractor Company Full Name and Complete Address (Prime Contractor)

Solicitation Number 31310019R0008

4. Contract Number, IAA Number, or Job Code for DOE Projects

MAINTENANCE OF NRC COMPUTER CODES III (MONC-3)

5. Contract Start Date

TBD

6. Contract End Date

TBD

7. Is this contract a follow-on contract?

✔ Yes No

If “Yes”, provide previous Contract Number, IAA Number, or Job Code.

NRC-HQ-60-14-E-0002

8. Contractor Cage Code or DOE Facility Code

9. Contract Performance Requirements

A. Will the contract require access to classified matter (information, systems, and/or material) (e.g., 32 CFR Part 2004 or MD 12.2)?

Yes (continue) ✔ No (If “No”, proceed to Block 9.E.)

B. What is the highest level of classified matter the contractor will need to access to perform contract responsibilities?

Select 1st Level of Classification Select 2nd Level of Classification

C. To carry out requirements of the contract, will the contractor need to possess, generate, or store classified matter at the contractor facility location? Yes (continue) No (If “No”, proceed to Block 9.E.)

D. Choose all that apply: In regards to classified matter, the contractor will require:

1) Access to Foreign Intelligence Information 2) Receipt and storage (i.e., safeguarding) of classified matter

3) Access to cryptographic material or other classified COMSEC information

4) Access to classified matter or information processed by another agency

5) Use of a classified information technology processing system

6) Generation of classified at Contractor facility location

7) Generation of classified matter at an NRC facility

E. Will the contractor require access to Safeguards Information (SGI) or Safeguards Information - Modified Handling Information (e.g., MD 12.7, 10 CFR 73.21, 73.22, and/or 73.23)? Yes ✔ No

F. Will the contractor possess, generate, or store SGI or SGI-M at the contractor facility? Yes ✔ No

G. Will the contractor require access to any Sensitive Unclassified Non-Safeguards Information (SUNSI) or sensitive information technology (IT) Systems (e.g., MD 12.6)? ✔ Yes No

H. Will the contractor possess, generate, or store SUNSI or have access to NRC sensitive IT systems at the contractor facility? ✔ Yes No

I. Was, “Yes”, checked to Block 9.A., or Block 9.C.?

Yes ✔ No (If “Yes”, then a Facility Clearance is required to be issued for the contractor and any known sub-contractors by the

Facilities Security Branch before final contract award and before work can begin on the contract.)

J. Choose all that apply:

1) Unescorted Access is required to Nuclear Power Plants.

2) Access is required to Safeguards Information.

✔ 3) Access is required to Sensitive IT Systems and Data.

4) Unescorted Access to NRC Headquarters, Region, or Technical Training Facility.

5) Require operation of government vehicles or transport passengers for the NRC.

6) Will operate hazardous equipment at NRC facilities.

7) Required to carry firearms.

8) Found to use or admit to use of illegal drugs.

NRC FORM 187

(03-2017)

NRCMD 12

CONTRACT SECURITY AND/OR

CLASSIFICATION REQUIREMENTS (Continued)

U.S. NUCLEAR REGULATORY COMMISSION

Page 2 of 4NRC FORM 187 (03-2017)

10. Classification and/or Designation Guidance (to be completed by the COR if contractor will have access to SGI and/or Classified information).

11. Does this contract contain any subcontractors?

Yes ✔ No If “No”, Leave area blank. (Note: It is the responsibility of the COR to notify FSB if the contractor adds a subcontractor to the contract during the execution of the contract. The sub-contractors may require a facility clearance before work can be allowed).

Subcontractor Company name, address and Defense Security Service cage code. (if applicable)

12. Review of contractor/subcontractor reports, documents for classified, SGI, SGI-M, and/or SUNSI will be reviewed by:

Typed or Printed Name and Title of NRC Employee to review for SUNSI

Christopher Murray

Typed or Printed Name and Title of Authorized Derivative Classifier (for Classified Information)

N/A

Typed or Printed Name and Title of a Qualified Designator for SGI and SGI-M (i.e., person must be qualified per MD 12.7)

N/A

13. Required Distribution of NRC Form 187 for Review (Check all appropriate boxes)

✔ 1) Originating NRC office or Division (Item 14A.)

3) Division of Facilities and Security (Item 14C.)✔

4) Division of Acquisition Management (Item 14D.)2) Information Security Branch Chief (If contractor has access to classified information and/or SGI) (Item 14B.)

A. Typed or Printed Name of Director, Office or Division Signature Date

C. Typed or Printed Name of Director, Division of Facilities and Security Signature Date

D. Typed or Printed Name of Director, Acquisitions Management Division

Jeffrey R. Mitchell, Contracting Officer

Signature Date

B. Typed or Printed Name of Chief, Information Security Branch Signature Date

14. Approvals

REMARKS

NRCMD 12

CONTRACT SECURITY AND/OR

CLASSIFICATION REQUIREMENTS (Continued)

U.S. NUCLEAR REGULATORY COMMISSION

Page 3 of 4NRC FORM 187 (03-2017)

INSTRUCTIONS FOR COMPLETING NRC FORM 187

NRC Form 187, “Contract Security and/or Classification Requirements,” including attachments and supplements, furnishes the basis for providing security and classification requirements to contractors, subcontractors, or others (e.g., bidders) who have or may have an NRC contractual relationship that requires access to classified information or matter, or unescorted access to nuclear power plants, access to Safeguards Information (SGI), sensitive unclassified non-Safeguards Information (SUNSI), sensitive IT systems or data and/or to NRC buildings.

WHO USES NRC FORM 187: All organizations that have or may have an NRC contractual relationship of the nature set forth above.

WHEN TO USE: Responsibility for initiation of NRC Form 187 rests with the office or division sponsoring a contract, project, agreement, consultant, or requesting that such work be conducted (e.g., at a Department of Energy (DOE) National Laboratory).

Early preparation and submission of this form will help assure that all necessary classification and security actions are initiated and, if applicable, a Facility Clearance must be granted prior to contract award. Experience has shown that incomplete information or untimely submission delays both the security and contractual process.

WHERE TO SEND: The form should be routed from the contract initiating office and signed by the appropriate Division Director. If the contractor will have access to classified information (confidential, secret, or top secret), or SGI, then the form needs to go to the Chief, Information Security Branch (NSIR) for review and signature. The form should then be sent to the appropriate contract specialist. A copy of the form should be sent with the Contract's Statement of Work to IndustrialSecurity@nrc.gov. The form will be signed off by the Director of Division of Facilities and Security (DFS) or an appropriate designee with the appropriate security clauses and/or additional actions. Finally, DFS will route the form back to the Acquisitions Management Division within the Office of Administration for final signature.

PREPARATION: Items listed below directly correlate to the numbered items on NRC Form 187.

1. Identify the type of submission: Is it new, revised or other? (Note: A revision supersedes all previously submitted NRC Form 187s for the same NRC contract number).

2. Identify the type of contract: Is it commercial, commercial-small business, sole source, interagency agreement, or interagency agreement with a Department of Energy (DOE) Lab?

3. Input the contracting company's full legal name and address.

4. Enter the contract number, interagency agreement number, or job code for DOE projects.

5. Enter the start date for the contract.

6. Enter the end date for the contract.

7. Indicate whether the contract is a follow-on contract (i.e., is the contract in addition to another "parent" contract). If “Yes”, then input the contract number, interagency agreement number, or job code that is being followed-on.

8. Enter the Cage Code for the Contractor Facility or DOE Facility Code.

9. Contract Performance Requirements

c. Determine if the contractor requires the ability to possess, generate, or store classified matter at the contractor's facility location. If “No”, is selected then proceed to Bock 9.E.

b. Determine the highest level of classified matter the contractor will need access to then select the appropriate levels (e.g., Top Secret, Secret, Confidential and Restricted Data [RD] or Secret National Security Information [NSI]).

a. Determine if the contract requires access to classified matter (e.g., information, systems, and/or material) then select the appropriate response. Look at Management Directive 12.2 and/or 32 CFR Part 2004 for guidance. If “No”, is selected then proceed to Block 9.E.

f. Indicate whether the contractor will possess, store and/or generate SGI or SGI-M.

e. Determine if the contractor will require access to SGI or SGI-M as defined in Management Directive 12.7 and 10 CFR 73.21, 73.22, and 73.23.

d. Identify the appropriate types of classified matter the contractor will require access and check all appropriate boxes.

h. Determine if the contractor will need to possess, generate, and/or store SUNSI at the contractor's facility location.

g. Indicate whether the contractor will require access to Sensitive Unclassified Non-Safeguards Information (SUNSI). Look at Management Directive 12.6 for guidance.

j. Identify other performance requirements that may be needed by the contractor. Check all that apply.

i. If “YES”, is checked on blocks 9A, and/or 9C, then the contractor will require a Facility Clearance issued by the Facilities Security Branch concurrent with the contract award. Without a facility clearance, the contractor cannot conduct classified work on the contract.

NRCMD 12

CONTRACT SECURITY AND/OR

CLASSIFICATION REQUIREMENTS (Continued)

U.S. NUCLEAR REGULATORY COMMISSION

Page 4 of 4NRC FORM 187 (03-2017)

10. Identify the classification and/or designation guides that the contractor will be required to abide by while operating under the NRC contract. Contact the Information Security Branch within NSIR if you have any questions.

INSTRUCTIONS FOR COMPLETING NRC FORM 187 (continued)

11. Indicate whether the contractor is, or will include the use of subcontractors in order to meet the performance requirements of the contract. If marked “Yes”, then provide the full legal name of the subcontractor company, the address, and the subcontractor's CAGE code, if any. Input this information in the box directly below item # 10 (Note: It is the COR's responsibility to notify FSB of any subcontractors added to a contract).

12. Enter the names of the individuals charged with reviewing the contractors and/or subcontractor's classified SUNSI, and SGI/SGI-M documents and reports.

13. Check the boxes of those required to be on distribution and signature. All the boxes in section 13 must be checked, if the contractor will work on classified information (i.e., Confidential, Secret, or Top Secret) or SGI. If the contractor will not be working on classified information, then only Boxes 1, 3, and 4 must be checked.

14. Populate the names of the approving authorities in Section 14 and route form through those authorities. Any remarks made by the approving authorities will be included in the “Remarks” section at the bottom of the form.