Attachment J-4 Draft DD Form 254.pdf

CLASSIFICATION (When filled in): Unclassified - For Official Use Only - DRAFT

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DD FORM 254, APR 2018

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:

May 31, 2022

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)

Top Secret

b. LEVEL OF SAFEGUARDING FOR CLASSIFIED INFORMATION/

MATERIAL REQUIRED AT CONTRACTOR FACILITY

Top Secret

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

a. PRIME CONTRACT NUMBER (See instructions.)

b. SUBCONTRACT NUMBER

c. SOLICITATION OR OTHER NUMBER

70RTAC21R00000006

DUE DATE (YYYYMMDD)

20210108

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

a. ORIGINAL (Complete date in all cases.)

DATE (YYYYMMDD)

20210108

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)

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

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

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

TBD

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

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

9. GENERAL UNCLASSIFIED DESCRIPTION OF THIS PROCUREMENT

(U) To identify to industry the known security requirements to facilitate the development and completion of proposal associated with the contract solicitation.

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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.)

FOUO - See item 13.

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 DoDM 5200.01, Volume 4 only for specific CUI protection requirements. Non-DoD Components: see instructions.)

m. OTHER (Specify) (See instructions.)

FOUO - See item 13.

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)

NONE AUTHORIZED

Public Release Authority:

See item 13.

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 Item 10a: “Contractor is authorized to use U.S. Government 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 contracting activity. If the contractor must receive or take custody of accountable COMSEC material at its facility, it must have a COMSEC account. The NSA Central Office of Record has primary responsibility for the auditing of all COMSEC material governed by the DoD 5220.22-M. Contractor shall contact the DHS COMSEC Control Office of Record (COR), at Commercial (540) 542-3292 to receive current COMSEC guidance.”

Reference Item 10e (1)(2) Personnel: “All contractor personnel assigned to this contract shall possess security clearances issued by the Defense Security Service (DCSA) commensurate with the level of required access to classified information that is directly in support of this contract. Immigrant aliens, personnel cleared on an interim basis, or personnel holding contractor-generated Confidential clearances are not eligible for access to classified information released or generated under this contract. Contractor personnel who are specifically designated as requiring access to Sensitive Compartmented Information (SCI) must be eligible under the provisions of the Intelligence Community Directive (ICD) 704 without exception. Personnel will be submitted for access by their DHS manager and verified by their Contract

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Technical Representative. If approved for access, they will receive an indoctrination briefing by DHS security staff prior to being granted access to SCI. All personnel security reporting requirements of the ICD 704 will be made directly to the DHS SSO. Prior to leaving this contract, personnel will be scheduled for debriefing with the DHS SSO or by calling (202) 447-3033.”

Reference 10e (1)(2) and 11a: “Access to all sensitive compartmented information (SCI) will be at DHS facilities only. For the purposes of this contract, the contractor is not authorized to process and/or store any SCI at contractor locations.

a. All SCI will be handled in accordance with special security requirements, which will be furnished by the designated responsible special security office (SSO).

b. SCI will not be released to contractor employees without specific release approval of the originator of the material as outlined in governing directives; based on prior approval and certification of "need-to-know" by the designated contractor.

c. All Contractor personnel requiring access to SCI as part of this contract effort must be approved and indoctrinated by DHS. Requests for Access will be submitted by the government project manager who can validate the justification for access.

d. Inquiries pertaining to classification guidance on SCI will be directed to the Special Security Officer (SSO).

e. SCI furnished in support of this contract remains the property of the Department of Homeland Security (DHS), agency, or component originator. Upon completion or cancellation of the contract, SCI furnished will be returned to the direct custody of the supporting SSO or destroyed IAW instructions outlined by the Contract Officer.

f. Visits by contractor employees will only be certified by DHS when such visits are conducted as part of the contract effort.”

Reference Item 10k: “The Contractor is responsible for handling and marking FOUO information in accordance with DHS Directive (MD 11042.1) "Safeguarding Sensitive but Unclassified (For Official Use Only) Information," dated January 6, 2005; Furthermore, contractors must sign a special Non-Disclosure Agreement before receiving access to unclassified FOUO information. Contractors with questions on handling DHS FOUO shall contact DHS OCSO NSSD at DHSHQ.INDUSTRIALSECURITY2@HQ.DHS.GOV.”

Reference Item 11a: “Contract performance is restricted to Department of Homeland Security (DHS) (Name - TBD) (Location of Effort - TBD). All contractor personnel must: be U.S. citizens, have been granted a final security clearance by the U.S. Government (Interim Top Secret clearances are not accepted by DHS), have been approved as meeting criteria by DHS OCSO, and have been indoctrinated by a Non Disclosure Agreement, Standard Form 312 for this specific program prior to being given any access to such information released or generated under this contract. Immigrant aliens, personnel cleared on an interim basis, or personnel holding contractor granted CONFIDENTIAL clearances, are not eligible for access to classified information released or generated under this contract. Classified material released or generated under this contract is not releasable to foreign nationals without the expressed written permission of the OCSO. Recipients of classified information under this contract may not be released to subcontractors without permission of the DHS OCSO. The contractor and COR will revalidate all billets under this contract with the OCSO annually or when a revised DD Form 254 is issued, whichever is sooner."

Reference Item 11j: Have Operations Security (OPSEC) Requirements. “OPSEC requirements apply. The contractor will reference and comply with DHS Management Directive, 11060 “OPSEC Program” for guidance on OPSEC requirements, plus any additional supplements that may be added by DHS on a case-by-case basis. Contractors shall contact DHS OPSEC at 202-447-5690 for further OPSEC guidance.”

Reference Item 11m: “The Contractor is responsible for handling and marking FOUO information in accordance with DHS Directive (MD 11042.1) "Safeguarding Sensitive but Unclassified (For Official Use Only) Information," dated January 6, 2005; Furthermore, contractors must sign a special Non-Disclosure Agreement before receiving access to unclassified FOUO information. Contractors with questions on handling DHS FOUO shall contact DHS OCSO NSSD at DHSHQ.INDUSTRIALSECURITY2@HQ.DHS.GOV.”

Reference Item 12: NONE AUTHORIZED UNLESS CONTRACTOR HAS OBTAINED AUTHORITY TO RELEASE FROM THE DEPARTMENT OF HOMELAND SECURITY: CONTRACTOR SHALL COORDINATE WITH THE COR AND THE OFFICE OF

THE CHIEF SECURITY OFFICER (OCSO) NATIONAL SECURITY DIVISION (NSSD) @

DHSHQ.INDUSTRIALSECURITY2@HQ.DHS.GOV ON ALL CHANGES TO THIS GUIDANCE

This contract and its related attachments may impose strict security requirements for need-to-know access, special handling procedures, physical security measures, and administrative controls beyond those prescribed for collateral Department of Homeland Security (DHS) information. The provisions delineated in DoD 5220.22M, Department of Homeland Security Directives, applicable Intelligence Community Directives, and applicable Security Classification Guides are strictly enforced. This DD254 shall not be made accessible to persons without a valid need-to-know.

The contractor is responsible for returning all classified information (documents and other media) to the sponsoring DHS Component in accordance with the sponsoring DHS Component security directive. Furthermore, DHS contractors must end all work and performance associated with this effort based on the classification guidance provided through existing classified sources. Questions relating to handling, marking, and safeguarding Classified National Security Information can be addressed to the DHS Office of the Chief Security Officer, National Security Services Division, at DHSHQ.INDUSTRIALSECURITY2@HQ.DHS.GOV.

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Insider Threat training for Contractors can be found at: https://securityawareness.usalearning.gov/itawareness/index.htm Certificate of training is required for all cleared contractors who are working with classified information. All certificates must be sent to the DHS Training Office at: securitytraining@hq.dhs.gov and the DHS Contracting Officer Representative, before the Contractor or Subcontractor is granted access to classified information. All cleared contractor personnel are required to recertify Insider Threat training annually thereafter.

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.)

Access to intelligence information requires a special briefing and a final US Government clearance at the appropriate level for access.

Foreign nationals are prohibited from access to any classified information. SCI requirement will be authorized by DHS upon contract award.

All personnel assigned by the contractor for SCI access must meet Intelligence Community Directive (ICD) 704 eligibility requirements. No storage or processing of SCI is authorized at contractor location. Subcontracting requires prior approval of the GCA.

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.)

DHS has exclusive security responsibility for all SCI classified material released to or developed under this Contract/Task Order.

Defense Counterintelligence and Security Agency (DCSA) is relieved of security inspections responsibility for all such material.

DCSA retains oversight/inspection responsibilities for facility clearance requirements and collateral information outside of DHS facilities.

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

a. GCA NAME

Department of Homeland Security

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

70WSE1

c. ADDRESS (Include ZIP Code)

U.S. Dept. of Homeland Security Office of Procurement Operations 245 Murray Lane, SW, Mailstop 0115 Washington DC 20528-0115

d. POC NAME

Breean Jaroski

e. POC TELEPHONE (Include Area Code)

+1 (202) 447-0337

f. EMAIL ADDRESS (See Instructions) breean.jaroski@hq.dhs.gov

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)

Atkins, Patricia M

b. TITLE

Security Specialist

c. ADDRESS (Include ZIP Code)

U.S. Dept. of Homeland Security, HQ 301 7th St. SW Washington, District of Columbia 20528

d. AAC OF THE CONTRACTING OFFICE (See Instructions)

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

f. TELEPHONE (Include Area Code)

+1 (202) 447-5493

g. EMAIL ADDRESS (See Instructions) patricia.atkins@hq.dhs.gov

h. SIGNATURE

i. DATE SIGNED (See Instructions)

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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.)