80TECH22Q0029_NF1707.pdf

NASA Form 1707 01/22 (6.1) PREVIOUS EDITIONS ARE OBSOLETE. Validate prior to use. NRRS 5/1

National Aeronautics and Space Administration

Special Approvals and

Affirmations of Requisitions Center KSC (John F Kennedy Space Center) 4200805379

Requesting Organization

UB-E

Brief Description of this Requirement

JEOL IT800HL

Date 04/28/2022

Requisition Number

Drop-down List jennifer.g.williams@nasa.gov

Approver Full Name (Use lookup button to assign) Jennifer Garrett Williams

Approver Email jennifer.g.williams@nasa.gov

Approver Approval

SECTION 1 - NASA STRATEGIC SOURCING INITIATIVE (Ref. NFS 1808.003-72 and Office of Procurement Strategic Sourcing website)

The requestor has reviewed the information on the Office of Procurement NASA Strategic Sourcing website and the requirement IS AVAILABLE through Contract Number

OR

The requestor has reviewed the information on the Office of Procurement NASA Strategic Sourcing website and the requirement IS NOT AVAILABLE through a Mandatory Source Contract. Documentation indicating the review is attached.

SECTION 2 - INFORMATION SYSTEMS AND INFORMATION AND COMMUNICATION TECHNOLOGY ACCESSIBILITY (SECTION 508)

I. INFORMATION SYSTEMS

This procurement does not involve the acquisition of an information system, information technology hardware or software, nor does it involve services where the contractor will have access to NASA information systems.

This procurement does involve the acquisition of an information system, information technology hardware or software, or services where the contractor will have access to NASA information systems. It has been reviewed by the Center CIO or the Headquarters operations CIO to determine if the purchase has a System Security Plan (SSP) that includes a FIPS-199 for a moderate- or high-impact information system, as defined by the National Institute of Standard and Technology (NIST).

IT Product Procurement IT Cloud Services Procurement

The items are on Headquarters' Assessed and Cleared List (ACL) as of the date of this form.

AND

Provide a list(s) of the ACL/Request for Investigation (RFI) or new Covered Articles & Technology Supply Chain Assessment Needed (CATSCAN) Required Item Ticket Management (RITM) number(s).

AND / OR

The Center OCIO provided the ITAM Authorization Number ITAM.KSC.FY22.Q3.05288

OR

This procurement's electronic and information technology items HAVE NOT been reviewed for supply chain risk management because the manufacturer has yet to be determined. I understand that a review for supply chain risk management may be required once the manufacturer is determined.

System Security Plan Number

CD-9999-M-KSC-3094

FEDERAL INFORMATION TECHNOLOGY ACQUISITION REFORM ACT (FITARA)

Ref: OMB Memorandum M-15-14: Management and Oversight of Federal Information Technology FITARA statute interprets IT broadly using the definition given below. Note, that it includes IT software, hardware, and telecommunications equipment and services, except as excluded in Paragraph D.

This procurement does not include information technology in accordance with the definition by FITARA (see C. below).

OR

This procurement does include:

A. Any services or equipment, or interconnected system(s) or subsystem(s) of equipment, that are used in the automatic acquisition, storage, analysis, evaluation, manipulation, management, movement, control, display, switching, interchange, transmission or reception of data or information by the agency;

B. such services or equipment are ‘used by an agency’ if used by the agency directly or if used by a contractor under a contract with the agency that requires either use of the services or equipment or requires use of the services or equipment to a significant extent in the performance of a service or the furnishing of a product;

C. the term "information technology" is any equipment or interconnected system or subsystem of equipment that is used in the automatic acquisition, storage, manipulation, management, movement, control, display, switching, interchange, transmission, or reception of data or information by any executive agency. It also includes computers, ancillary equipment including imaging peripherals, input, output, and storage devices necessary for security and surveillance, peripheral equipment designed to be controlled by the central processing unit of a computer, software, firmware and similar procedures, services (including support services), and related resources.

D. the term "information technology" does not include any equipment that is acquired by a contractor incidental to a contract that does not require use of the equipment.

Drop-down List

Chief Information Officer or Designee Full Name (Use lookup button to assign)

Chief Information Officer or Designee Email

Chief Information Officer or Designee Concurrence is required

The FIPS 199 impact designation for this procurement is The CIO recommends inclusion of the following clauses:

FAR 52.204-9 Personal Identity Verification of Contractor Personnel NFS 1852.204-76 Security Requirements for Unclassified Information Technology Resources

To ensure compliance with federal and NASA information system requirements.

II. INTERNET PROTOCOL VERSION SIX (IPv6) This procurement is out of scope of the IPv6 acquisitions compliance requirement for one of the following reasons:

The procurement is classified The procurement is for licenses or maintenance The procurement is for software that does not use the Internet Protocol (IP) or store IP addresses The procurement does not include items that can use Internet Protocol (IP) networking to communicate

OR

This procurement is in scope of the IPv6 acquisitions compliance requirement because it includes items that are capable of using Internet Protocol (IP) networking to communicate.

AND

The following three documents are attached:

Attached is the Suppliers Declaration of Conformity (SDOC) for the specific IT items to be purchased. (Request from the vendor or see if available at: https://www.iol.unh.edu/registry/usgv6)

Attached is a written analysis that compares the specified IPv6 capability requirements with the tested capabilities claimed in the SDOC.

OR

The items to be purchased will be determined via competitive procurement. The review for IPv6 compliance will be performed once the items are determined but prior to award. Attached are the required IPv6 capabilities for networked IT components of this procurement.

OR

Attached is the IPv6 Compliance Procurement Waiver (NF 1835) that has been signed by the Center CIO and/or Agency CIO as appropriate.

Attached are the required IPv6 capabilities (USGv6 Profile: http://www-x.antd.nist.gov/usgv6/) for networked IT components of this procurement.

III. SOFTWARE AND / OR MAINTENANCE ACQUISITIONS (Ref. NFS 1807.70 and https://www.nssc.nasa.gov/elmt) This procurement does not involve the acquisition of software and/or software maintenance.

OR

This procurement does involve the acquisition of software and/or software maintenance.

AND

The requestor has coordinated with the ELMT and determined that the requirement shall be fulfilled through the ELMT program. Documentation indicating the coordination is required to be attached.

OR

The requestor has coordinated with the center CIO and ELMT and obtained approval to acquire the requirement outside the ELMT program (e.g.

placement of a new contract or order, exercising an option on an existing contract, requesting a contractor to procure through an existing contract, or placing an order by a Government-wide purchase card). Documentation indicating the coordination is required to be attached.

IV. INFORMATION AND COMMUNICATION TECHNOLOGY (ICT) ACCESSIBLIITY (SECTION 508)

This procurement does not include Information and Communication (ICT) items.

OR

This procurement includes ICT items.

AND

The ICT items included in this procurement meet the applicable accessibility standards at CFR part 1194. (Attach Section 508 conformance documentation)

OR

Is excepted from conformance with applicable accessibility standards based on the following exception identified in section E202 of Appendix A to Part 1194 - Section 508 of the Rehabilitation Act; Application and Scoping Requirements:

Legacy ICT (Section E202.2) National Security Systems (Section E202.3) ICT Acquired Incidental to a Federal Contract (Section E202.4) ICT Located in Maintenance or Monitoring Spaces (Section E202.5) Undue Burden (Section E202.6 and NFS 1839.203-7, Attach "Undue Burden" Documentation) Fundamental Alteration (Section E202.6, Attach "Fundamental Alteration" Documentation) Best Meets (Section E202.7 ICT, Attach "Best Meets" Documentation)

SECTION 3 - ENVIRONMENTAL / SUSTAINABLE ACQUISITION

Ref. FAR subpart 23.1 and NPR 8530.1. The request originator has searched the Green Procurement Compilation (GPC) to identify applicable federal green/sustainable acquisition requirements for products and services.

This procurement does not acquire any products or services listed in the GPC.

OR

This procurement does acquire products or services listed in the GPC in the following programs (check all that apply):

EPA's Comprehensive Procurement Guidelines Electronic Product Environmental Assessment Tool (EPEAT) EPA's Significant New Alternatives Policy (SNAP) Program EPA's Watersense Program Energy Star FEMP (Federal Energy Management Program) Energy Efficient Products USDA's Biopreferred Designated Products

AND

The specifications or statement of work include applicable sustainable acquisition program requirements.

OR

This procurement does acquire products or services listed in the GPC; however, the sustainable product or service does not meet the functional requirements of the requestor. The appropriate waiver or justification documentation for not including the sustainable acquisition requirements is attached.

NASA's requirements for National Environmental Policy Act (NEPA) are outlined in NPR 8580.1. Contact the Center NEPA Manager for assistance in completing the Center-specific environmental checklist.

GPC Products to be procured or GPC Services to be procured

Non-GPC Products or Services

KSC Waiver for Sustainable Acquisition

This procurement requires the purchase of products or services listed in the GPC; however the originator request a waiver from this requirement due to once of the following reasons (check all that apply):

Inadequate competition Unreasonable price Lack of quality / performance specification or standard Unavailable within reasonable time frame

Fill out KSC Form 28-825 and submit to the NASA-KSC Environmental / SI-E3 for approval.

Drop-down List

KSC Environmental Management Branch Full Name (Use lookup button to assign)

KSC Environmental Management Branch Email

KSC Environmental Management Branch Approval

SECTION 4 - SERVICE CONTRACTING

This is a requirement for supplies and no services are being procured.

OR

This requirement is for, or includes, services. The services to be performed (check all that apply):

1. Will not be used for the performance of personal services. (Ref. FAR 37.104 and NFS 1837.104)

2. Will not be used for the performance of inherently governmental functions. (Ref. FAR 7.503)

3. Are not presently being performed, nor recently performed, by government employees. (Contracting out for services performed by civil servants requires a public-private competition) (Ref. OMB Circular A-76)

4. Will be advisory and assistance services. (See definition at FAR 2.1, and FAR 37.204 and NFS 1837.204)

SECTION 5 - TECHNICAL APPROVAL

(The following affirmations are to be made by the Program or Project Technical Authority(ies))

I. SPACE FLIGHT AND GROUND SUPPORT PROGRAMS

This procurement is not for space flight hardware and/or software, nor for any ground systems or components that are in direct support of space flight operations.

OR

This procurement is for space flight hardware and/or software and ground systems or components. Additionally, technical standards and specifications cited in the solicitation/resultant award are:

1) The most recent version, 2) tailored to the needs of the project and its elements, and 3) registered in a watch list at https://standards.nasa.gov to receive notification when standards or specification change.

OR

Exceptions have been approved by the technical authorities and are attached hereto. (See NPR 7120.5)

II. COMMUNICATION AND NAVIGATION CAPABILITIES

This procurement has no requirements related to Space Communication and Navigation (SCaN) capabilities of NASA, of other US Government agencies, or of other nations.

OR

This procurement has requirements related to Space Communication and Navigation (SCaN) capabilities of NASA, of other US Government agencies, or of other nations, and the requisition has been coordinated with the office of SCaN in the Office of Human Exploration and Operations Mission Directorate (HEOMD).

(See NPD 8074.1, "Management and Utilization of NASA's Space Communication and Navigation Infrastructure")

III. EARNED VALUE MANAGEMENT SYSTEM (Ref. NASA FAR Supplement (NFS) 1834.201 and NASA Procedural Requirements (NPR) 7120.5)

This procurement does not require an Earned Value Management System (EVMS) to be utilized.

OR

This procurement requires an EVMS to be utilized. Data Requirements Descriptions (DRDs) to be included in the solicitation and resultant contract are attached. (See NASA's EVM Contract Requirements Checklist located at (https://www.nasa.gov/evm/regulations)

AND

No exception(s) to the EVMS requirements apply to this procurement.

OR

One or more exceptions to the EVMS requirements apply to this procurement and have been approved by the Center EVM Point of Contact. The approved exceptions are attached hereto.

IV. COMMUNICATIONS (Ref. NASA Policy Directive (NPD) 2521.1) This procurement does not involve the design, preparation or creation of communications material.

OR

This procurement involves the design, preparation or creation of communications material and is subject to the compliance requirements outlined in NPD 2521.1, Communications and Material Review (http://nodis3.gsfc.nasa.gov/displayDir.cfm?t=NPD&c=2521&s=1B), to include the NASA Graphics Standards Manual (Style Guide), and NASA Communications Portfolio system.

V. MANNED COMMERCIAL AVIATION SERVICES & UNMANNED AIRCRAFT SYSTEMS (Ref. NASA Procedural Requirements (NPR) 7900.3) This procurement (1) involves neither the acquisition nor the use of manned or unmanned aircraft systems (UAS), including charter, lease, and acquisition of related aircraft services for manned and unmanned aircraft, and (2) NPR 7900.3 is not applicable.

OR

This procurement (1) involves acquisition or use of manned or unmanned aircraft systems (UAS), including charter, lease, and acquisition of related aircraft services for manned or unmanned aircraft, and (2) NPR 7900.3 is applicable. The necessary Center Flight Operations Office, in accordance with NPR 7900, has provided concurrence or approvals have been obtained and the aviation requirements identified will be included in the solicitation and resultant contract. See NPR 7900.3 for specific guidance.

VI. SOFTWARE ENGINEERING PER NPR 7150.2 CLASSES A-E

This procurement is not subject to software engineering requirements as specified in NPR 7150.2 See http://nodis3.gsfc.nasa.gov/displayDir.cfm?t=NPR&c=7150&s=2A NPR 7150.2 is applicable to: 1) ALL R&D requirements and 2) ALL service requirements other than construction, routine maintenance and repair, or institutional services such as custodial, grounds maintenance, security services, etc.

Generally, COTS applications used outside of a NASA system/subsystem are not subject to software engineering requirements. However, COTS applications (e.g., spreadsheet programs, database programs) used within a NASA system/subsystem application, need to be assessed and classified as part of the software subsystem in which they reside.

OR

This procurement is subject to software engineering requirements as specified in NPR 7150.2 Software Class (Check appropriate class)

Class A: Human rated space software systems Class B: Non-Human rated space software systems or large-scale aeronautics vehicles Class C: Mission support software or aeronautic vehicles, or major engineering/research facility software Class D: Basic science/engineering design and research and technology software Class E: Small light weight design concept and research and technology software

SECTION 6 - QUALITY ASSURANCE

I. GOVERNMENT CONTRACT QUALITY ASSURANCE REQUIREMENTS

This procurement pertains to one of the following types of acquisitions. If any of these blocks are checked, NPD 8730.5 and NPR 8735.2 are not applicable, skip to Section 6-II, GIDEP Screening.

Information technology or institutional infrastructure projects.

Information Technology (IT) services.

Software assurance functions defined by NASA-STD-8739.8 and NPR 7150.2.

Contractor support services where such services do not directly affect product configuration.

OR

Acquisition of NASA institutional facilities or for facility maintenance.

Grants and cooperative agreements covered by 31 U.S.C. 6301 et seq. or Space Act agreements covered by 51 USC 20113.

OR

This procurement is for commercial or Commercial Off the-Shelf (COTS) item(s) to be acquired under FAR Part 12 procedures and NPR 8735.2 paragraph 5.1 is applicable.

This procurement is classified as "research and development" and NPR 8735.2 paragraph 5.2 is applicable.

AND

The acquisition items are NEITHER Critical NOR Complex. Higher-Level Quality is not required by the acquiring organization.

OR

This procurement is for Critical items defined by NPR 8735.2, Appendix A or Critical Work defined by NPD 8730.5.

This procurement is for Complex acquisition items defined by NPR 8735.2, Appendix A or Complex Work defined by NPD 8730.5.

II. HIGHER LEVEL QUALITY ASSURANCE REQUIREMENTS

This procurement is subject to higher-level quality requirements as specified in FAR 46.202-4, NFS 1846, Quality Assurance and NPD 8730.5, Attachment A.

Select the applicable higher-level quality standards: ISO 17025, AS9100, AS9003 or ISO 9001.

SAE AS9100 (If hardware is any combination of Critical/Complex) ISO 9001 (If hardware is NOT BOTH Critical AND Complex) SAE AS9003 (If hardware is NOT Complex) ISO 17025 (Critical Calibration or Testing Services) The test and inspection requirements as specified by the acquiring organization. (If hardware is NEITHER Critical NOR Complex)

III. OTHER QUALITY APPLICABILITIES

Select the following that are applicable to this procurement:

This acquiring organization requires completion of acceptance testing by the government within days (typically 14 to 30 days) of delivery to the Center to ensure suitability under FAR 52.212-4 or FAR 52.246-2, -3, -4, -5 or -6.

This acquiring organization requires Certificate(s) of Conformance per FAR 52.246-15.

This acquiring organization requires a Certificate of Chemical Analysis certifying the requirements were met as specified in

This acquiring organization requires Government Source Inspections (GSI) under FAR 52.246-2, -3, -4, -5, or -6.

This acquiring organization requires First Article Approval under FAR 52.209-3.

The acquiring organization requires the work to be performed in accordance with further quality requirements as stated in the attached Statement of Work or Specification(s).

This acquiring organization requires completion of acceptance testing by the government. Please attach Form KSC 2-66.

Drop-down List

Quality Point of Contact Full Name (Use lookup button to assign)

Quality Point of Contact Email

Quality Point of Contact Signature

IV. GOVERNMENT-INDUSTRY DATA EXCHANGE PROGRAM (GIDEP) SCREENING

This procurement is not for safety critical items as defined in NPR 8735.1

OR

This procurement is for safety critical items and has been GIDEP screened as specified in NPR 8735.1. Center GIDEP Coordinator signature required.

(Note: GIDEP screening may be requested on any item as desired by the user.)

Drop-down List

Center GIDEP Coordinator Full Name (Use lookup button to assign)

Center GIDEP Coordinator Email

Center GIDEP Coordinator Signature

V. KSC PRESSURE VESSEL SYSTEMS

OR

This procurement does not procure new Pressure Vessel Systems (PVS) or result in modification(s) to existing PVS. KSC Pressure Systems Manager (PSM) signature is not required.

This procurement procures new PVS or results in modifications to existing PVS and has been reviewed and evaluated by the KSC PSM or designee per NPD 8710.5 paragraphs 5.d(3) and 5.f(1). KSC PSM signature is required.

SECTION 7 - HEALTH AND SAFETY

I. HAZARDOUS SUBSTANCES AND ARTICLES

This procurement will not result in the acquisition, production, or use of any hazardous or potentially hazardous substances, equipment, or services that may present safety and health risk to the public and/or personnel and property.

OR

Select what applies:

This procurement will result in the acquisition, production, or use of any hazardous or potentially hazardous substances or articles, examples of which are listed in NPR 1800.1, or items that requires safety review as identified in NPR 8715.1, such as:

Ionizing Radiation Sources and Devices, Lasers and Sources of Hazardous Non-Laser Optical Radiation, High Intensity, Ultraviolet, and Infrared Lights, Radio Frequency (RF) and Microwave Emitters, Devices That Produce Hazardous Noise (Equal to or Above 80 DBA at 1 Meter or Less), Pyrotechnic Devices and Explosives, Pressurized Vessels, Toxic or Hazardous Substances, Materials or Chemicals, Nano and Ultrafine Particles, Any Infectious or Biological Agents, Or other articles or substances listed in the Appendix D

This procurement will result in the acquisition (purchase, lease, or rent) of equipment or services that requires the Center Safety and Mission Assurance (SMA) Organization review and approval per Center requirements. Examples of equipment that may require Center review are lifting devices and equipment and fall protection equipment. Construction services is an example of a services that may require Center review by the SMA organization.

AND

The procurement has been reviewed, in accordance with as required in chapter 4 of NPR 1800.1 and NPR 8715.1, to identify risks, controls, alternatives, and safety requirements.

Health & Safety Signature

Drop-down List

Health & Safety Full Name (Use lookup button to assign) Sherri M Nickell

Health & Safety Email sherri.m.nickell@nasa.gov

KSC ADDITIONAL DETAILS

KSC-DL-1707-Health@mail.nasa.gov Approval

II. KSC PYROTECHNIC DEVICES AND EXPLOSIVES

OR

This procurement does not procure Pyrotechnic Devices or Explosives. NASA Explosives Safety Manager signature is not required.

This procurement procures Pyrotechnic Devices or Explosives and has been reviewed and evaluated by the NASA Center Explosives Safety Manager per NASA-STD-8719.12. NASA Explosives Safety Officer Signature is required.

III. KSC SAFETY EQUIPMENT

This procurement is for Personal Protection Equipment (PPE) for NASA Civil Servants and has been reviewed by NASA Safety Office. (Attach KSC Form 50-413).

This procurement is for equipment requiring Lockout/Tagout and has been reviewed by the NASA Safety Office. Signature of NASA Safety Office is required.

SECTION 8 - PROPERTY MANAGEMENT

This procurement will not involve the purchase or fabrication of property with unit value $500,000 or greater, to which the government will take title.

OR

This procurement will involve the purchase or fabrication of property $500,000 or greater per item, either as a line item deliverable or as contractor-acquired property to which the government will take title. NASA Form 1739, "Capitalization Determination Form (CDF)", is attached.

The following applies if any of the sections involve the procurement of property (i.e., equipment, supplies or material(s) that require control and accountability in accordance with NPR 4100.1, NPR 4200.1, NPR 4300.1, and/or NPR 9250.1:

I. EQUIPMENT OTHER THAN CAPITAL

II. CAPITAL EQUIPMENT

Primary source of supply/acquisition/reutilization efforts have been exhausted in accordance with NPR 4200.1 and NPR 4300.1.

Arrangement with local Equipment Management personnel/branch have been coordinated for proper control and accountability of equipment in accordance with NPR 4200.1

SECTION 9 - REQUIRED SPECIAL APPROVALS, CENTER SPECIFIC SUPPLEMENTS

There are no items requiring special approval.

OR

Approvals for special items have been obtained through the established SAP release strategy.

OR

Approvals for special items are attached.

For a listing of KSC approvals for all sections, please reference the following document: TechDoc Document

SECTION 10 - FOREIGN TRAVEL BRIEFINGS FOR NASA CONTRACTORS

Ref. NPR 1660.1, NASA Counterintelligence and Counterterrorism

This procurement does not require NASA contractor employees to go on official travel to Designated Countries, Russia and other high-threat locations. (For additional information see the NASA Counterintelligence Division’s website at:

http://www.hq.nasa.gov/office/ops/nasaonly/internal/ci/foreign.htm)

OR

This procurement does require NASA contractor employees to go on official travel to Designated Countries, Russia and other high-threat locations. The Performance Work Statement, Statement of Work, Description, or Specification includes language that NASA contractor employees going on official travel to Designated Countries, Russia and other high-threat locations, receive pre- and post-travel Counterintelligence threat briefings/debriefings per NPR 1660.1. (For additional information see the NASA Counterintelligence Division’s website at: http://www.hq.nasa.gov/office/ops/nasaonly/internal/ci/foreign.htm)

SECTION 11 - EXTRANEOUS PROMOTIONAL & PERSONAL USE ITEMS

Ref. MSC-2011-12-001, Eliminating Extraneous Promotional & Personal Use Items

This procurement does not involve the direct purchase by a NASA civil servant or indirect purchase through a NASA contractor or subcontractor of any of the prohibited extraneous promotional or personal use items set forth in the NASA Mission Support Council (MSC) Memorandum MSC-2011-12-001, Eliminating Extraneous Promotional & Personal Use Items, as amended.

(https://www.hq.nasa.gov/office/procurement/regs/memos/msc-memo-MSC-2011-12-001a.pdf).

SECTION 12 - OTHER CURRENT NASA DIRECTIVES

A review of the NASA Online Directives Information System (NODIS) of current NASA Directives (NPR, NPD, and NID) not already indicated in the above Sections of this form has been performed. There are no additional NASA Directives applicable to this procurement.

OR

A review of the NASA Online Directives Information System (NODIS) of current NASA Directives (NPR, NPD, and NID) not already indicated in the above Sections of this form has been performed. There are additional NASA Directives applicable to this procurement. The list of applicable Directive(s) is attached.

Instruction Page 1 of 2

Instructions for Special Approvals and Affirmations of Requisitions

A. GENERAL INFORMATION

Purpose NASA Form (NF) 1707, "Special Approvals and Affirmations of Requisitions" is required by the NASA Federal Acquisition Regulation Supplement, section 1804.7301, to document procurement request coordination. The procurement office will not accept a requisition until all required coordinations have been documented.

When and How to Submit the NF 1707 The procurement request (PR) is known as a "purchase requisition" (requisition) and is developed in NASA's Integrated Enterprise Management Program/Core Financial Module (CF). For a requisition to be sent forward for action, CF requires that several coordinations be obtained first.

However, there are additional required coordinations at the Agency level and sometimes at the Center level. The initiator of the requisition is responsible for obtaining those additional coordinations. This form must be used to document additional coordinations. The completed NF 1707 and any additional special approvals or affirmations required must be electronically attached to the requisition in CF and must include the name of the approver and date approved. The contracting officer must include a hard copy in the contract file, or a link to the electronic copy. The procurement office must not accept a requisition until all required coordinations have been documented. The NF 1707 is not required for within scope actions for which special approvals and affirmations have previously been obtained. In addition, the NF 1707 is not required for grants, cooperative agreements, and space act agreements.

Who Completes the Form The initiator of the requisition signs the form affirming that the coordinations have been completed.

B. DETAILED INSTRUCTIONS

Section 1 - NASA STRATEGIC SOURCING INITIATIVE The requestor shall check the appropriate block to indicate that a review of the NASA strategic sourcing contract database available on the Office of Procurement Strategic Sourcing website has been performed. The requestor shall indicate that the requirement IS AVAILABLE through the NASA Strategic Sourcing Initiative and provide the mandatory source contract number. If the review finds that the requirement IS NOT AVAILABLE through the NASA strategic Sourcing Initiative, then supporting documentation e.g., memorandum needs to be attached which indicates why the requirement cannot be met utilizing a mandatory source contract.

Section 2 - INFORMATION SYSTEMS AND ELECTRONIC AND INFORMATION TECHNOLOGY ACCESSIBILITY There are four subsections. In the first subsection, the requestor shall check the appropriate block to indicate if the procurement is for information systems or services involving information systems. NASA will include all commodity IT (Hardware and Software), ground systems, mission control centers and data centers. Onboard flight avionics and flight software that are a non-severable and an integral part of the flight system are not considered IT for the purpose of OMB IT budget reporting. However, such avionics/software are included within the cyber security portfolio. Defining a device/service as IT does not exclude its’ classification as an R&D or engineering device/services. If it is, the cognizant Center Chief Information Officer (CIO) will determine if the purchase has a System Security Plan (SSP) that includes a FIPS-199 for a moderate- or high-impact information system, as defined by the National Institute of Standard and Technology (NIST). The CIO will check the box recommending the appropriate NFS security clauses based on the level of access the contractor will have to the system and the SSP requirements.

In the second subsection, INTERNET PROTOCOL VERSION SIX (IPv6), the requestor shall check the appropriate block to indicate if the procurement is for information technology (IT) items that can use Internet Protocol to communicate. The requestor shall specify IPv6 requirements, provide them to the vendor and obtain the vendor's Suppliers Declaration of Conformity (SDOC) for the specific item being purchased. The requestor shall compare the IPv6 requirements to the capabilities captured in the SDOC, provide the necessary IPv6 requirements analysis and indicate whether it is prudent to proceed with purchasing this item if any IPv6 deficiencies have been identified in the item. Requestors shall provide the IPv6 Compliance Procurement Waiver (NF 1835) for any items that have no IPv6 capabilities. For purchases under $100K, such waivers shall be signed by the Center CIO. Purchases valued at or above $100K shall require waivers to be signed by the agency CIO. For further guidance, please review the NASA IPv6 Compliance Users Guide on NASA's internal IPv6 websites: http://inside.nasa.gov/ocio/content/nasa-ipv6.

In the third subsection, the requestor must check the appropriate block to indicate if the procurement is for software and/or maintenance acquisition.

The requestor must indicate coordination with the Center CIO and the ELMT Program Office on the acquisition and authorization to acquire any software licenses or software maintenance outside of the ELMT program, if applicable.

In the fourth subsection the requestor must check the appropriate block to indicate if the PR is for information and communication technology (ICT) items. If the PR is to acquire ICT, the requestor must check the appropriate boxes to indicate if the item meets accessibility standards. If an accessible item is not available, or if the item is exempt from the standards, additional documentation is required.

Section 3 - ENVIRONMENTAL / SUSTAINABLE ACQUISITION The requestor must search a Government-wide website of environmental programs to determine if one or more of these program requirements apply to the procurement, if the procurement acquires the product directly or if a contractor will acquire the product in performance of the contract. If the product will be procured, the requestor must indicate if the procurement specification includes the environmentally preferred product or if a waiver or other required documentation is attached.

Section 4 - SERVICE CONTRACTING If the procurement is to acquire services, the requestor must check the appropriate boxes to indicate the services will comply with Federal requirements.

Instruction Page 2 of 2

Instructions for Special Approvals and Affirmations of Requisitions

Section 5 - TECHNICAL APPROVAL There are six subsections to this section. For all subsections, the requestor shall coordinate with the program or project technical authority. For the first subsection, if the purchase request (PR) is for space flight or ground support programs, the requestor shall check the appropriate box to affirm that the most recent specifications are cited, or a waiver is attached. For the second subsection, the requestor shall check the appropriate box to indicate if the PR is related to space communication and navigation capabilities. If it is, then the requestor shall affirm that the PR has been coordinated with Human Exploration and Operations Mission Directorate (HEOMD). For the third subsection the requestor shall check the appropriate boxes to indicate if the acquisition will require utilization of Earned Value Management System (EVMS) requirements, and if any exceptions apply. Exceptions will require approval by the Center EVM Point of Contact. For the fourth subsection, the requestor shall check the appropriate box to affirm that the acquisition will or will not involve the design, preparation or creation of communications material. For the fifth subsection the requestor shall check the appropriate box to affirm that the requisite Center Flight Operations Office has provided concurrence as listed in NPR 7900.3 or that it is not applicable. For the sixth subsection the requestor must indicate if the procurement is subject to the software engineering requirements specified in NPR 7150.2, NASA Software Engineering Requirements.

Section 6 - QUALITY ASSURANCE There are three subsections to this section. In the first section, the requestor must indicate which quality assurance requirements, as listed in NPR 8735.2, apply. In the second section, if the PR acquires a safety critical item, the requestor must indicate that the item has been screened as required by NPR 8735.1. In the third section, the requestor must indicate if the PR is for items requiring higher level quality assurance. For items requiring higher level quality assurance, the requestor must specify which higher-level quality assurance standard applies.

Section 7 - HEALTH AND SAFETY The requestor must indicate if the PR is to acquire hazardous or potentially hazardous substances or articles, as defined in NPR 1800.1 and NPR

8715.1. If the PR is for hazardous or potentially hazardous substances or articles, the requestor must affirm that it has been screened in accordance with NPR 1800.1 and NPR 8715.1.

Section 8 - CAPITAL EQUIPMENT The requestor must indicate if the PR is to acquire capital equipment. If the PR is to acquire capital equipment, then the requestor must check the appropriate box and attach NF 1739.

Section 9 - REQUIRED SPECIAL APPROVALS, CENTER SPECIFIC SUPPLEMENTS This section is designed to allow for center-specific or special approvals added by the center. Follow center policy when completing this section.

Section 10 - FOREIGN TRAVEL BRIEFINGS FOR NASA CONTRACTORS The requestor must indicate if the PR will require NASA contractor employees to go on official travel to Designated Countries, Russia and other high-threat locations. If the PR requires NASA contractor employees to go on official travel to Designated Countries, Russia and other high-threat locations, the requestor must check the appropriate box and affirm that the Performance Work Statement, Statement of Work, Description, or Specification includes language that NASA contractor employees going on official travel to Designated Countries, Russia and other high-threat locations, receive pre- and post-travel Counterintelligence threat briefings/debriefings per NPR 1660.1. For additional information see the NASA Counterintelligence Division’s website at: http://www.hq.nasa.gov/office/ops/nasaonly/internal/ci/foreign.htm.

Section 11 - EXTRANEOUS PROMOTIONAL & PERSONAL USE ITEMS The requestor must indicate that the PR does not involve the direct purchase by a NASA civil servant or indirect purchase through a NASA contractor or subcontractor of any of the prohibited extraneous promotional or personal use items set forth in the NASA Mission Support Council (MSC) Memorandum MSC-2011-12-001, Eliminating Extraneous Promotional & Personal Use Items, as amended (https://www.hq.nasa.gov/office/procurement/regs/memos/msc-memo-MSC-2011-12-001a.pdf).

Section 12 - OTHER CURRENT NASA DIRECTIVES The requestor must indicate that a review of the NASA Online Directives Information System (NODIS) of current NASA Directives (NPR, NPD, and NID) not already indicated in the above Sections of this form has been performed. There are no additional NASA Directives applicable to this PR. If the review finds there are additional NASA Directives applicable then the list of applicable Directive(s) is attached with the PR and are appropriately included in Performance Work Statement, Statement of Work, or Specification.

DRAFT

NASA Form 1707 01/22 (6.1) PREVIOUS EDITIONS ARE OBSOLETE. Validate prior to use.

NRRS 5/1

Page of NASA Form 1707 01/22 (6.1) PREVIOUS EDITIONS ARE OBSOLETE. Validate prior to use.

NRRS 5/1

Instruction Page of Instructions for Special Approvals and Affirmations of Requisitions National Aeronautics and Space Administration ..\..\..\NF_AgencyForms-NF1845\1.0\Forms\Nasa_MB_Color.png Special Approvals and Affirmations of Requisitions

LOAN OF NASA EQUIPMENT

(To Fill out this Form see NPD 4200.1) –Review the Instructions for detailed completion and approval requirements– When the requirement does not exceed $250K and is not critical and complex, the requisitioner (i.e., end user) shall sign as "Approver."

For all other requirements, the requisitioner shall sign as "Requisitioner" and obtain appropriate "Approver" signature.

Task Order / Delivery Order Exception (When applicable, this statement may be checked for task order or delivery order requirements to be issued under GRC Indefinite Delivery, Indefinite Quantity (IDIQ) contracts. Insert the signature date and PR No. from the appropriate, previously completed NF 1707. IMPORTANT NOTE: The previously completed NF 1707 being referenced must have a signature date that is later than the date appearing at the end of the first sentence below.)

The specific statements and affirmations included on NF 1707 signed on for PR No. apply to this requirement as well, and represent all statements and affirmations required by the Agency and GRC as of March 2018. Therefore, Sections 1 through 12 below need not be completed.

SECTION 1 - NASA STRATEGIC SOURCING INITIATIVE (Ref. NFS 1808.003-72 and Office of Procurement Strategic Sourcing website) The requestor has reviewed the information on the Office of Procurement NASA Strategic Sourcing website and the requirementIS AVAILABLE through Contract Number

OR

The requestor has reviewed the information on the Office of Procurement NASA Strategic Sourcing website and the requirement IS NOT AVAILABLE through a Mandatory Source Contract. Documentation indicating the review is attached.

SECTION 2 - INFORMATION SYSTEMS AND INFORMATION AND COMMUNICATION TECHNOLOGY ACCESSIBILITY (SECTION 508)

I. INFORMATION SYSTEMS

This procurement does not involve the acquisition of an information system, information technology hardware or software, nor does it involve services where the contractor will have access to NASA information systems.

This procurement does involve the acquisition of an information system, information technology hardware or software, or services where the contractor will have access to NASA information systems. It has been reviewed by the Center CIO or the Headquarters operations CIO to determine if the purchase has a System Security Plan (SSP) that includes a FIPS-199 for a moderate- or high-impact information system, as defined by the National Institute of Standard and Technology (NIST).

IT Product Procurement IT Cloud Services Procurement The items are on Headquarters' Assessed and Cleared List (ACL) as of the date of this form.

AND

Provide a list(s) of the ACL/Request for Investigation (RFI) or new Covered Articles & Technology Supply Chain Assessment Needed (CATSCAN) Required Item Ticket Management (RITM) number(s).

AND / OR

OR

This procurement's electronic and information technology items HAVE NOT been reviewed for supply chain risk management because the manufacturer has yet to be determined. I understand that a review for supply chain risk management may be required once the manufacturer is determined.

FEDERAL INFORMATION TECHNOLOGY ACQUISITION REFORM ACT (FITARA)

Ref: OMB Memorandum M-15-14: Management and Oversight of Federal Information Technology FITARA statute interprets IT broadly using the definition given below. Note, that it includes IT software, hardware, and telecommunications equipment and services, except as excluded in Paragraph D.

This procurement does not include information technology in accordance with the definition by FITARA (see C. below).

OR

This procurement does include:

Any services or equipment, or interconnected system(s) or subsystem(s) of equipment, that are used in the automatic acquisition, storage, analysis, evaluation, manipulation, management, movement, control, display, switching, interchange, transmission or reception of data or information by the agency;such services or equipment are ‘used by an agency’ if used by the agency directly or if used by a contractor under a contract with the agency that requires either use of the services or equipment or requires use of the services or equipment to a significant extent in the performance of a service or the furnishing of a product;the term "information technology" is any equipment or interconnected system or subsystem of equipment that is used in the automatic acquisition, storage, manipulation, management, movement, control, display, switching, interchange, transmission, or reception of data or information by any executive agency. It also includes computers, ancillary equipment including imaging peripherals, input, output, and storage devices necessary for security and surveillance, peripheral equipment designed to be controlled by the central processing unit of a computer, software, firmware and similar procedures, services (including support services), and related resources.the term "information technology" does not include any equipment that is acquired by a contractor incidental to a contract that does not require use of the equipment.

The CIO recommends inclusion of the following clauses:

FAR 52.204-9 Personal Identity Verification of Contractor Personnel NFS 1852.204-76 Security Requirements for Unclassified Information Technology Resources To ensure compliance with federal and NASA information system requirements.

II. INTERNET PROTOCOL VERSION SIX (IPv6) This procurement is out of scope of the IPv6 acquisitions compliance requirement for one of the following reasons:

The procurement is classified The procurement is for licenses or maintenance The procurement is for software that does not use the Internet Protocol (IP) or store IP addresses The procurement does not include items that can use Internet Protocol (IP) networking to communicate

OR

This procurement is in scope of the IPv6 acquisitions compliance requirement because it includes items that are capable of using Internet Protocol (IP) networking to communicate.

AND

The following three documents are attached:

Attached is the Suppliers Declaration of Conformity (SDOC) for the specific IT items to be purchased. (Request from the vendor or see if available at: https://www.iol.unh.edu/registry/usgv6) Attached is a written analysis that compares the specified IPv6 capability requirements with the tested capabilities claimed in the SDOC.

OR

The items to be purchased will be determined via competitive procurement. The review for IPv6 compliance will be performed once the items are determined but prior to award. Attached are the required IPv6 capabilities for networked IT components of this procurement.

OR

Attached is the IPv6 Compliance Procurement Waiver (NF 1835) that has been signed by the Center CIO and/or Agency CIO as appropriate.

Attached are the required IPv6 capabilities (USGv6 Profile: http://www-x.antd.nist.gov/usgv6/) for networked IT components of this procurement.

III. SOFTWARE AND / OR MAINTENANCE ACQUISITIONS (Ref. NFS 1807.70 and https://www.nssc.nasa.gov/elmt) This procurement does not involve the acquisition of software and/or software maintenance.

OR

This procurement does involve the acquisition of software and/or software maintenance.

AND

The requestor has coordinated with the ELMT and determined that the requirement shall be fulfilled through the ELMT program. Documentation indicating the coordination is required to be attached.

OR

The requestor has coordinated with the center CIO and ELMT and obtained approval to acquire the requirement outside the ELMT program (e.g. placement of a new contract or order, exercising an option on an existing contract, requesting a contractor to procure through an existing contract, or placing an order by a Government-wide purchase card). Documentation indicating the coordination is required to be attached.

IV. INFORMATION AND COMMUNICATION TECHNOLOGY (ICT) ACCESSIBLIITY (SECTION 508)

This procurement does not include Information and Communication (ICT) items.

OR

This procurement includes ICT items.

AND

The ICT items included in this procurement meet the applicable accessibility standards at CFR part 1194. (Attach Section 508 conformance documentation)

OR

Is excepted from conformance with applicable accessibility standards based on the following exception identified in section E202 of Appendix A to Part 1194 - Section 508 of the Rehabilitation Act; Application and Scoping Requirements:

Legacy ICT (Section E202.2) National Security Systems (Section E202.3) ICT Acquired Incidental to a Federal Contract (Section E202.4) ICT Located in Maintenance or Monitoring Spaces (Section E202.5) Undue Burden (Section E202.6 and NFS 1839.203-7, Attach "Undue Burden" Documentation) Fundamental Alteration (Section E202.6, Attach "Fundamental Alteration" Documentation) Best Meets (Section E202.7 ICT, Attach "Best Meets" Documentation) (See standards available at Section 508 Standards Guide)

SECTION 3 - ENVIRONMENTAL / SUSTAINABLE ACQUISITION

Ref. FAR subpart 23.1 and NPR 8530.1. The request originator has searched the Green Procurement Compilation (GPC) to identify applicable federal green/sustainable acquisition requirements for products and services.

This procurement does not acquire any products or services listed in the GPC.

OR

This procurement does acquire products or services listed in the GPC in the following programs (check all that apply):

EPA's Comprehensive Procurement Guidelines Electronic Product Environmental Assessment Tool (EPEAT) EPA's Significant New Alternatives Policy (SNAP) Program EPA's Watersense Program Energy Star FEMP (Federal Energy Management Program) Energy Efficient Products USDA's Biopreferred Designated Products

AND

The specifications or statement of work include applicable sustainable acquisition program requirements.

OR

This procurement does acquire products or services listed in the GPC; however, the sustainable product or service does not meet the functional requirements of the requestor. The appropriate waiver or justification documentation for not including the sustainable acquisition requirements is attached.

NASA's requirements for National Environmental Policy Act (NEPA) are outlined in NPR 8580.1. Contact the Center NEPA Manager for assistance in completing the Center-specific environmental checklist.

KSC Waiver for Sustainable Acquisition This procurement requires the purchase of products or services listed in the GPC; however the originator request a waiver from this requirement due to once of the following reasons (check all that apply):

Fill out KSC Form 28-825 and submit to the NASA-KSC Environmental / SI-E3 for approval.

Ref. NPR 8580.1 and LPR 8500.1. The Requestor has confirmed that National Environmental Policy Act (NEPA) environmental review has been completed.

Action meets requirements of the Langley Research Center Excluded Activities List and no further NEPA environmental review is required.

OR

NEPA environmental review for this action is completed under LF461

SECTION 4 - SERVICE CONTRACTING

This is a requirement for supplies and no services are being procured.

OR

This requirement is for, or includes, services. The services to be performed (check all that apply):

1. Will not be used for the performance of personal services. (Ref. FAR 37.104 and NFS 1837.104)

2. Will not be used for the performance of inherently governmental functions. (Ref. FAR 7.503)

3. Are not presently being performed, nor recently performed, by government employees. (Contracting out for services performed by civil servants requires a public-private competition) (Ref. OMB Circular A-76)

4. Will be advisory and assistance services. (See definition at FAR 2.1, and FAR 37.204 and NFS 1837.204) FAR 52.204-9 Personal Identity Verification of Contractor…