A4 - DRAFT dd0254.pdf
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- Attached to
- Security Escorts at Vandenberg SFB, CA
- Solicitation number
- FA461026Q0004
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PREVIOUS EDITION IS OBSOLETE.
Page of
DD FORM 254, APR 2018
NEEDS DD67
(Updated 20250815)
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:
August 31, 2028 The public reporting burden for this collection of information, 0704-0567, is estimated to average 36 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Washington Headquarters Services, at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.
RETURN COMPLETED FORM AS DIRECTED IN THE INSTRUCTIONS.
1. CLEARANCE AND SAFEGUARDING
2. THIS SPECIFICATION IS FOR: (X and complete as applicable.)
3. THIS SPECIFICATION IS: (X and complete as applicable.)
a. ORIGINAL (Complete date in all cases.)
b. REVISED (Supersedes all previous specifications.)
4. IS THIS A FOLLOW-ON CONTRACT?
If yes, complete the following:
Classified material received or generated under
5. IS THIS A FINAL DD FORM 254?
If yes, complete the following:
6. CONTRACTOR (Include Commercial and Government Entity (CAGE) Code)
7. SUBCONTRACTOR(S) (Click button if you choose to add or list the subcontractors -- but will still require a separate DD Form 254 issued by a prime contractor to each subcontractor)
8. ACTUAL PERFORMANCE (Click button to add more locations.)
10. CONTRACTOR WILL REQUIRE ACCESS TO: (X all that apply. Provide details in Blocks 13 or 14 as set forth in the instructions.)
e. NATIONAL INTELLIGENCE INFORMATION:
11. IN PERFORMING THIS CONTRACT, THE CONTRACTOR WILL: (X all that apply. See instructions. Provide details in Blocks 13 or 14 as set forth in the instructions.)
12. PUBLIC RELEASE
Any information (classified or unclassified) pertaining to this contract shall not be released for public dissemination except as provided by the National Industrial Security Program Operating Manual (NISPOM) or unless it has been approved for public release by appropriate U.S. Government authority. Proposed public releases shall be submitted for review and approval prior to release to the appropriate government approval authority identified here with at least office and phone contact information and if available, an e-mail address. (See instructions)
13. SECURITY GUIDANCE
The security classification guidance for classified information needed for this effort is identified below. If any difficulty is encountered in applying this guidance or if any other contributing factor indicates a need for changes in this guidance, the contractor is authorized and encouraged to provide recommended changes; to challenge the guidance or the classification assigned to any information or material furnished or generated under this contract; and to submit any questions for interpretation of this guidance to the official identified below. Pending final decision, the information involved shall be handled and protected at the highest level of classification assigned or recommended.
(Fill in as appropriate for the classified effort. Attach, or forward under separate correspondence, any documents/guides/extracts referenced herein. The field will expand as text is added. When removing any expanded text area, use delete key or backspace key, then click out of the text field for it to shrink after the text has been deleted. Also allows for up to 6 internal reviewers to digitally sign. See instructions for additional guidance or use of the fillable PDF.)
List of Attachments (All Files Must be attached Prior to Signing, i.e., for any digital signature on the form)
14. ADDITIONAL SECURITY REQUIREMENTS
Requirements, in addition to NISPOM requirements for classified information, are established for this contract.
If Yes, identify the pertinent contractual clauses in the contract document itself, or provide an appropriate statement which identifies the additional requirements. Provide a copy of the requirements to the CSO. The field will expand as text is added or you can also use item 13. When removing any expanded text area, use delete key or backspace key, then click out of the text field for it to shrink after the text has been deleted. (See instructions for additional guidance or use of the fillable PDF.)
15. INSPECTIONS
Elements of this contract are outside the inspection responsibility of the CSO.
If Yes, explain and identify specific areas and government activity responsible for inspections. The field will expand as text is added or you can also use item 13. When removing any expanded text area, use delete key or backspace key, then click out of the text field for it to shrink after the text has been deleted. (See instructions for additional guidance or use of the fillable PDF.)
16. GOVERNMENT CONTRACTING ACTIVITY (GCA) AND POINT OF CONTACT (POC)
17. CERTIFICATION AND SIGNATURES
Security requirements stated herein are complete and adequate for safeguarding the classified information to be released or generated under this classified effort. All questions shall be referred to the official named below. Upon digitally signing Item 17h, no changes can be made as the form will be locked.
18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL
9.0.0.2.20120627.2.874785 DD Form 254, "DoD Contract Security Classification Specification"
| CurrentPage: |
| PageCount: |
| Classification (when form is filled in) (automatically filled from previous drop-down list): CUI |
| Serial Number: |
| 1. CLEARANCE AND SAFEGUARDING - a. LEVEL OF FACILITY SECURITY CLEARANCE (FCL) REQUIRED |
(See Instructions) - Select from drop-down list: 1
| 1. CLEARANCE AND SAFEGUARDING - b. LEVEL OF SAFEGUARDING FOR CLASSIFIED INFORMATION/MATERIAL REQUIRED AT CONTRACTOR FACILITY - select from drop-down list: 1 |
| 3. THIS SPECIFICATION IS: (X and complete as applicable.) - Select for "a. ORIGINAL (Complete date in all cases.) ": 1 |
| 3. THIS SPECIFICATION IS: (X and complete as applicable.) - Select for "a. ORIGINAL (Complete date in all cases.) ": 0 |
| 2. THIS SPECIFICATION IS FOR: (X and complete as applicable.) - a. PRIME CONTRACT NUMBER (See instructions.): |
| 3. THIS SPECIFICATION IS: (X and complete as applicable.) - Select for "b. REVISED (Supersedes all previous specifications.)": 0 |
| 3. THIS SPECIFICATION IS: (X and complete as applicable.) - Select for "b. REVISED (Supersedes all previous specifications.)": 0 |
| 2. THIS SPECIFICATION IS FOR: (X and complete as applicable.) - b. SUBCONTRACT NUMBER: |
| 3. THIS SPECIFICATION IS: (X and complete as applicable.) - Select for "c. FINAL (Complete Item 5 in all cases.)": 0 |
| 3. THIS SPECIFICATION IS: (X and complete as applicable.) - Select for "c. FINAL (Complete Item 5 in all cases.)": 1 |
| 2. THIS SPECIFICATION IS FOR: (X and complete as applicable.) - c. SOLICITATION OR OTHER NUMBER: |
| 2. THIS SPECIFICATION IS FOR: (X and complete as applicable.) - c. SOLICITATION OR OTHER NUMBER - DUE DATE (YYYYMMDD): |
| 3. THIS SPECIFICATION IS: (X and complete as applicable.) - a. ORIGINAL (Complete date in all cases.) : |
| 3. THIS SPECIFICATION IS: (X and complete as applicable.) - b. REVISED (Supersedes all previous specifications.) - REVISION NUMBER: |
| 3. THIS SPECIFICATION IS: (X and complete as applicable.) - b. REVISED (Supersedes all previous specifications.) - DATE (YYYYMMDD): |
| 3. THIS SPECIFICATION IS: (X and complete as applicable.) - c. FINAL (Complete Item 5 in all cases.): |
| 3. THIS SPECIFICATION IS: (X and complete as applicable.) - c. FINAL (Complete Item 5 in all cases.) - DATE (YYYYMMDD): |
| 15. INSPECTIONS - Elements of this contract are outside the inspection responsibility of the CSO. - Select for "no.": 1 |
| 15. INSPECTIONS - Elements of this contract are outside the inspection responsibility of the CSO. - Select for "no.": 0 |
| 15. INSPECTIONS - Elements of this contract are outside the inspection responsibility of the CSO. - Select for "no.": 0 |
| 15. INSPECTIONS - Elements of this contract are outside the inspection responsibility of the CSO. - Select for "no.": 0 |
| 15. INSPECTIONS - Elements of this contract are outside the inspection responsibility of the CSO. - Select for "yes.": 0 |
| 15. INSPECTIONS - Elements of this contract are outside the inspection responsibility of the CSO. - Select for "yes.": 1 |
| 15. INSPECTIONS - Elements of this contract are outside the inspection responsibility of the CSO. - Select for "yes.": 1 |
| 15. INSPECTIONS - Elements of this contract are outside the inspection responsibility of the CSO. - Select for "yes.": 1 |
| 4. IS THIS A FOLLOW-ON CONTRACT? - If yes - Classified material received or generated under (Preceding Contract Number) is transferred to this follow-on contract. - Enter preceding contract number.: |
| 5. IS THIS A FINAL DD FORM 254? - In response to the contractor's request dated (date), retention of the classified material is authorized for the period of (period) - Enter contractor's request date in format YYYYMMDD.: |
| E5. IS THIS A FINAL DD FORM 254? - In response to the contractor's request dated (date), retention of the classified material is authorized for the period of - Enter period.: |
| 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): Richardson, Charles, C |
| 17. CERTIFICATION AND SIGNATURES - e. CAGE CODE OF THE PRIME CONTRACTOR (See Instructions.): |
| 8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): |
| 8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): DCSA Los Angeles Field Office |
3452 E Foothill Blvd., Ste. 600 Pasadena, CA 91107 626-463-0515 dcsa.dcsa-western.dcsa-isfo.mbx.los-angeles-field-office@mail.mil
| 8. ACTUAL PERFORMANCE (Click button to add more locations.) - Select to add row : |
| 8. ACTUAL PERFORMANCE - Select to remove last row: |
| 13. SECURITY GUIDANCE - Select to delete all signature rows: |
| 8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): Vandenberg Space Force Base Bldg 10577 SCIF |
| Enter general unclassified description of this procurement.: This acquisition is to Escort contractors to upgrade the SLD 30 Headquarters Sensitive Compartmented Information Facility (SCIF) with new secured and unsecured telecommunications capability. Specifically, the Escort contractor will escort a separate DH Tech contract team to remove legacy communications cabling, install new cabling conveyance, install new cabling from the building entry way into the SCIF comm room and install new cabling from the SCIF comm room into all other rooms of the SCIF. The Escort contractor will escort DH Tech performing the cut over of active communication and data circuits from the legacy cabling onto the newly installed cabling, and removes and dispositions the legacy cabling and associated cabling patch panels. The Escort Contractor will escort DH Tech installing network switching and architecture components to connect to and active NIPRnet, SIPRnet, and JWICS networks in the SCIF. The Escort contractor will escort DH Tech installing end components devices (desktops, phones, and printers) to the new networks. The Escort contractor will escort DH Tech to ensure all network components are operational by the end of the period of performance. |
| 18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL - Select for "a. CONTRACTOR.": 0 |
| 18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL - Select for "a. CONTRACTOR.": 1 |
| 18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL - Select for "a. CONTRACTOR.": 1 |
| 18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL - Select for "f. OTHER AS NECESSARY.": 0 |
| 18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL - Select for "f. OTHER AS NECESSARY.": 0 |
| 18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL - Select for "f. OTHER AS NECESSARY.": 0 |
| 18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL - Select for "b. SUBCONTRACTOR.": 0 |
| 18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL - Select for "b. SUBCONTRACTOR.": 0 |
| 18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL - Select for "b. SUBCONTRACTOR.": 0 |
| 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.) - Select for "g. BE AUTHORIZED TO USE THE SERVICES OF DEFENSE TECHNICAL INFORMATION CENTER (DTIC) OR OTHER SECONDARY DISTRIBUTION CENTER.": 0 |
| 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.) - Select for "g. BE AUTHORIZED TO USE THE SERVICES OF DEFENSE TECHNICAL INFORMATION CENTER (DTIC) OR OTHER SECONDARY DISTRIBUTION CENTER.": 0 |
| 18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL - Select for "c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR.": 0 |
| 18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL - Select for "c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR.": 0 |
| 18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL - Select for "c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR.": 1 |
| 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.) - Select for "h. REQUIRE A COMSEC ACCOUNT.": 0 |
| 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.) - Select for "h. REQUIRE A COMSEC ACCOUNT.": 0 |
| 18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL - Select for "d. U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECURITY ADMINISTRATION.": 0 |
| 18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL - Select for "d. U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECURITY ADMINISTRATION.": 0 |
| 18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL - Select for "d. U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECURITY ADMINISTRATION.": 0 |
| 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.) - Select for "i. HAVE A TEMPEST REQUIREMENT.": 0 |
| 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.) - Select for "i. HAVE A TEMPEST REQUIREMENT.": 1 |
| 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: Select for "(1) Sensitive Compartmented Information (SCI).": 0 |
| 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: Select for "(2) Non-SCI.": 1 |
| 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.) - Select for "j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS.": 1 |
| 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.) - Select for "j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS.": 1 |
| 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.) - Select for "k. BE AUTHORIZED TO USE DEFENSE COURIER SERVICE.": 0 |
| 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.) - Select for "k. BE AUTHORIZED TO USE DEFENSE COURIER SERVICE.": 0 |
| 18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL - Enter specification for "other." (If more room is needed, continue in Item 13 or on additional page if necessary.): SLD-30 PMD |
SLD-30 IP
SSC SSO
SLD-30 COR
| 18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL - Select for "e. ADMINISTRATIVE CONTRACTING OFFICER.": 0 |
| 18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL - Select for "e. ADMINISTRATIVE CONTRACTING OFFICER.": 1 |
| 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.) - Select for "l. RECEIVE, STORE, OR GENERATE CONTROLLED UNCLASSIFIED INFORMATION (CUI)." (DoD Components: refer to DoDI 5200.48, only for specific CUI protection requirements. Non-DoD Components: see instructions.): 0 |
| 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.) - Select for "m. OTHER.": 0 |
| 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) - Select for "DIRECT": 0 |
| 12. PUBLIC RELEASE - Select for "THROUGH": 1 |
| 12. PUBLIC RELEASE - Enter specification for "through".: SLD 30 Public Affairs |
747 Nebraska Ave, Suite 7, VSFB CA, 93437
| 12. PUBLIC RELEASE - Public Release Authority:: Office of Public Affairs, Security and Review Division (SAF/PAX), 1690 Air Force Pentagon, Washington DC 20330 |
| 13. SECURITY GUIDANCE - Select to add signature row: |
| 13. SECURITY GUIDANCE - Select to remove last signature row: |
| Reviewing Official’s Office Symbol, phone and email (6): Block 10e(1). Access to SCI and non-SCI information will be at the performance locations identified in Block 8a. |
Block 10e(2). NON-SCI. The contractor shall handle non-SCI or “collateral” intelligence information IAW 32 CFR Part 117 National Industrial Security Program Operating Manual, (NISPOM), DoDM 5200.01-V1-V3, Information Security Program and AFMAN16-1404, Air Force Information Security Program. As classified material, the contractor shall afford collateral intelligence information the same protections, safeguards, and precautions required by any classified material required by DoDM 5200.01 V1-V3, unless special intelligence related handling instructions are specifically imposed. The CSSO must ensure all contractor employees who have access to this material are fully trained in the ICD 703 requirements. The contractor shall neither disclose, nor release intelligence derived information, whether its status is collateral or SCI, without prior consent.
Item 10.k. Contractor will require TS/SCI clearance for Escorting other contractors installing, configuring, and optimizing network-connected components for JWICS and SIPRnet. Access will be be granted only after justification is approved by gov program manager and verification of required eligibility/access.
Block 11.a. Access to classified information only at another contractor facility. All contractor classified work and related access will be conducted at location/s on Vandenberg SFB, CA as specified by Section 8, performance location.
Block 11.i. TEMPEST security measures must be considered if electronic processing of classified information is involved, to include SAP and SCI. The Contractor shall comply with AFI 17-101 Air Force Certification and Accreditation Process (AFCAP), DoDI 8500.01 Cybersecurity, DoDI 8510.01 Risk Management Framework (RMF) for DoD Information Technology (IT). The contractor shall select, implement, and assess Security Controls IAW the above AF and DoD, DoDIs policies and evaluate and comply with all applicable DISA Security Technical Implementation Guides (STIGs).
Block 11.j. The contractor will comply with installation OPSEC programs. Contractor personnel will know who their organization's OPSEC coordinator is and contact them for questions, concerns, or recommendations for OPSEC or Signature Management (SM) related topics. AFI 10-701 OPSEC requirements apply to include being familiar with the organization's critical information and protecting critical and/or sensitive information from disclosure.
Block 12. Contractor is to submit requests through the Contracting Officer for OPSEC Program Manager review and public release authorization. The Contracting Officer will provide contractor with written approval/disapproval. (T-1) Information requiring AF or DoD–level review will be reviewed by the unit’s OPSEC Program Manager or Coordinator.
13.1. The security escort provider must comply with Air Force Instruction (AFI) 31-101, SLD 30 Integrated Defense Plan (IDP); DoDM5220.22V2_AFMAN16-1406V2, 8 MAY 2020;
local security requirements; and must possess a valid Facility Clearance at the Top Secret or higher level issued by the Defense Counterintelligence and Security Agency (DCSA).
13.2. Protect sensitive unclassified activities that could compromise classified information or operations, or degrade the planning and execution of military.
Reference Block 14: This contract requires access to TS/SCI. The directives below provide the necessary guidance for physical, personnel, information, and information systems security measures and is part of the SCI security specifications for the contract.
Executive Order 12333 – United States Intelligence Activities (AMENDED by EO 13470, 2008) Executive Order 13526 – Classified National Security Information (2009 December 29) {replaced EO 12958} ICD 503 - Information Technology Systems (2008 September 15) ICD 704 - Personnel Security (2008 October 01) and ICPG 704.2 (2008 October 02) ICD 705 Physical Security (2010 May 26) and ICS/Tech Specs 705 Ver. 1.5 (2020 March 13) DCID 1/20P – Policies for Personnel with Access to SCI (1991 December 29) DCID 6/1 – Security Policy for Sensitive Compartmented Information and Security Policy DCID 6/9 - Physical Security (for facilities accredited under 6/9 standards) DDoDI 5200.48_DAFI 16-1403, Controlled Unclassified Information DoDM 5105.21 V1, V2, V3 - SCI Administrative Security Manual(s) DoDM 5200.01 V1, V2, V3 – DoD Information Security Program Manual(s) DoDM5200.02_DAFMAN 16-1405, Department of Air Force Personnel Security Program DoDM5220.22V2_AFMAN16-1406 V2, National Industrial Security Program: Industrial Security Procedures for Government Activities 32 CFR 117 - National Industrial Security Program (NISP) (2018 August 1) AFMAN 14-403 - Security, Use, and Dissemination of SCI (2019 September 3) AFMAN 16-1405 – Air Force Personnel Security Program (2018 August 31) AFI 16-1406 – Air Force Industrial Security Program (2017 February 13) SSC/S2S SSO S2 SSO Handbook DIAM 50-4 - Defense Intelligence Agency Manual (1980 June 24) NISPOM Supplement NIST 800-53 Rev 4 (April 2013) SEAD 3, Reporting Requirements for Personnel with Access to Classified Information or Who Hold a Sensitive Position
| List of Attachments (All Files Must be attached Prior to Signing, i.e., for any digital signature on the form) - Click on this button to attach a file(s).: |
| NAME & TITLE OF REVIEWING OFFICIAL (6): SALLY DUENAS |
Industrial Security Program Manager
| 17. CERTIFICATION AND SIGNATURES - h. SIGNATURE : |
| 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.): The contractor and any subcontractors shall agree to follow SLD 30 Visitor Group Security Agreement (VGSA) distributed by the local Servicing Security Agency (SSA), SLD 30/IP and the on-site government functional for their operations on the USSF installation or USSF leased property. |
| 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.): DCSA is relieved of inspection responsibility. The contractor's security operations on Vandenberg SFB will be inspected annually by SLD |
| 16. GOVERNMENT CONTRACTING ACTIVITY (GCA) AND POINT OF CONTACT (POC) - a. GCA NAME: 30th Contracting Squadron |
| 17. CERTIFICATION AND SIGNATURES - d. AAC OF THE CONTRACTING OFFICE (See Instructions): FA4610 |
| 17. CERTIFICATION AND SIGNATURES - d. AAC OF THE CONTRACTING OFFICE (See Instructions): FA4610 |
| 17. CERTIFICATION AND SIGNATURES - c. ADDRESS (Include ZIP Code): 1515 Iceland Ave |
Bldg 8500 Room 150 Vandenberg AFB 93437
17. CERTIFICATION AND SIGNATURES - c. ADDRESS (Include ZIP Code): 1515 Iceland Ave.
Bldg. 8500 Room 150 Vandenberg AFB 93437
| 16. GOVERNMENT CONTRACTING ACTIVITY (GCA) AND POINT OF CONTACT (POC) - d. POC NAME: Charles C Richardson |
| 17. CERTIFICATION AND SIGNATURES - f. TELEPHONE (Include Area Code): 8056066966 |
| 17. CERTIFICATION AND SIGNATURES - f. TELEPHONE (Include Area Code): 8056066966 |
| 17. CERTIFICATION AND SIGNATURES - g. EMAIL ADDRESS (See Instructions): charles.richardson.16@spaceforce.mil |
| 17. CERTIFICATION AND SIGNATURES - g. EMAIL ADDRESS (See Instructions): charles.richardson.16@spaceforce.mil |
| 17. CERTIFICATION AND SIGNATURES - b. TITLE : Contracting Officer |
| 17. CERTIFICATION AND SIGNATURES - i. DATE SIGNED (See Instructions): |
File details come from the government source that posted it. Updated .