70Z04422RESD30016 DD 254 Draft - Final Sol Doc.pdf

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DRAFT

SAMPLE

PREVIOUS EDITION IS OBSOLETE.

Page of AEM LiveCycle Designer

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:

October 31, 2020 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.)

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

7323 Telegraph Road Stop 7300 Alexandria, VA 20598-7300

(703) 313-5430

DCSA - See Item 6.c

2. Per Item 8.a, the contractor is required to work at the government facility. For other locations, the contractor shall support other Coast Guard shore facilities and vessels as specified in the USCG Standard Distribution List, COMDTNOTE 5605, as required by the task order. Cleared personnel shall access classified areas where classified information/systems are located. Access to classified information cannot be precluded by escorting personnel due to the nature of work. The contractor must adhere to the USCG rules and regulations while working at the government locations.

Note: There is no requirement for the contractor to process or store classified information at company owned facilities.

3. Per Item 10.j, the term CUI is used interchangeably with FOUO. The contractor is responsible to control and safeguard FOUO in accordance with DHS MD 11042.1, "Safeguarding SBU/FOUO information." All contractor employee with access to sensitive information (i.e, FOUO, etc.) shall execute a Non-Disclosure Agreement (NDA), DHS Form 11000-6, as a condition of access to such information.

Contractor shall provide an OPSEC Plan detailing how SBU/FOUO material will be handled, discussed, disseminated, and protected by their employees (i.e. Refer to Item 11.j and Item 14). Further, the contractor must adhere to the applicable DHS HSAR Class Deviation 15-01 clauses for safeguarding sensitive information.

4. Contractor must provide a training plan of how procedures are implemented for employee's security briefings and certification that the appropriate employees have executed a current SF-312 according to NISPOM Chapter 3. On-site contractor's employees shall require attending and participating in the USCG Security Education and Awareness Training program as appropriate to the responsibilities associated with assigned duties.

5. Contractor shall implement procedures whereby any loss, compromise, or suspected loss or compromise of classified, or sensitive but unclassified information or material issued under this contract is promptly reported to both the DCSA (formerly named DSS) Cognizant Security Office and designed COR. The COR shall provide a complete report of the loss to the servicing USCG CSO and KO.

6. Per Item 11.e, this contract is for technical support services. Classification markings on the material to be furnished shall provide the classification guidance necessary for the performance of this contract. Questions regarding security classification, not governed by specific security classification guidance, shall be addressed to the COR.

7. The contractor is responsible for safeguarding all government equipment, information and property provided for contractor use. 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 appropriate clearance and need-to-know. Per Item 12, documentation obtained for use with this contract shall not be used for any purpose unless prior authorization has been obtained from the U.S. Coast Guard, Command, Control, & Communication Engineering Center.

8. Contractor shall provide a visit authorization letter (VAL) to the place of performance. All requests shall contain the information required by the NISPOM and shall not exceed the completion date of the contract or a 12 month period, whichever is shorter. Additionally, the VAL shall note the applicable government COR or Technical Assistant (TA) responsible for coordinating the visit so that the host location can verify “Need-To-Know,” as necessary.

9. Subcontractor's DD Form 254s (if applicable) are prepared by the prime contractor and are forwarded to the USCG POC for concurrence. The contractor is obligated to pass on the security requirements IAW NISPOM, DoD 5220.22-M, tailored to the task being sought.

10. Biennial review shall be conducted to ensure current guidelines unless special circumstances occur. A revised DD Form 254 shall be issued as necessary only upon any changes to the security requirements. Upon termination of this contract, all government furnished material, equipment, documentation/materials or any deliverable items shall be returned to the USCG COR, as appropriate.

11. The designated COR, TBD, U.S. Coast Guard, C5I Service Center, 4000 Coast Guard Blvd., Portsmouth, VA 23703; 4000 Coast Guard Blvd., Portsmouth, VA 23703; @uscg.mil, Ph # (757)

Note: Contractor is bound by the contract, non-disclosure agreements and clauses, such as the FAR 52.204-2, Security Requirements Clause (Aug 1996). The classification level is SECRET.

[End of Item 13] text:

a) Coast Guard Industrial Security Program – COMDTINST 5520.13 (series) b) Classified Information Management Program Manual - COMDTINST M5510.23 (series) c) Operations Security Program Manual – COMDTINST 5510.24 (series) d) Physical Security and Force Protection Program Manual, COMDTINST M5530.1 (series) e) Personnel Security and Suitability Program, COMDTINST M5520.12 (series) f) DHS Management Directive (MD) 11042.1 for the handling of Sensitive but Unclassified / For Official Use Only (SBU/FOUO) information g) United States Coast Guard Cybersecurity Manual – COMDTINST M5500.13 (series) h) U.S. Insider Threat Security Classification Guide, Version 1.0 (series) i) DHS Sensor and Instrument Performance Security Classification Guide, DHSSCG USCG 002.1 (SIP)

Per Item 10.j, the contractor must abide by guidelines outlines in the DHS Management Directive (MD) 11042.1 as well as COMDTINST M5510.24 (series). Per Item 11.j, OPSEC requirements apply. OPSEC plans are required to be approved by the GCA.

4000 Coast Guard Blvd.

Portsmouth, VA 23703 Address: USCG C4ITSC-CPD-C5ISC 4000 Coast Guard Blvd.

Portsmouth, VA 23703