Atch 2 - AFMS3 3.0 DD254.pdf

Please wait...

If this message is not eventually replaced by the proper contents of the document, your PDF viewer may not be able to display this type of document.

You can upgrade to the latest version of Adobe Reader for Windows®, Mac, or Linux® by visiting http://www.adobe.com/go/reader_download.

For more assistance with Adobe Reader visit http://www.adobe.com/go/acrreader.

Windows is either a registered trademark or a trademark of Microsoft Corporation in the United States and/or other countries. Mac is a trademark of Apple Inc., registered in the United States and other countries. Linux is the registered trademark of Linus Torvalds in the U.S. and other countries.

PREVIOUS EDITION IS OBSOLETE.

Page of

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:

June 30, 2025 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 254, "DoD Contract Security Classification Specification"

(See Instructions) - Select from drop-down list: 1

1330 AF Pentagon Washington, DC 20330 703-614-2932

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): SLD 45/IP Mr. Mike Chambers michael.chambers.25@us.af.mil ; 321-494-7685 1201 Edward H. White II Street Patrick SFB, FL 32925-2221

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): 11 WG/IP 1330 AF Pentagon Washington, DC 20330 703-614-2932

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): 11 WG/IP 1330 AF Pentagon Washington, DC 20330 703-614-2932

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): 11 WG/IP 1330 AF Pentagon Washington, DC 20330 703-614-2932

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): HQ ACC A5/8Z Mr. Wayne Smith 757-764-4237 113 Plum Street Langley, VA 23665

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): Mr. Ted Pilihos theodore.pilihos.1@us.af.mil 210-652-1592 520 I Street East, Bldg. 743, Rm. 147 JBSA-Randolph AFB, TX 78150

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): TSgt Jonathon Greathouse Jonathon.greathouse@us.af.mil; DSN: 315-784-7613

7 AF/A8A9 (PASC)

Unit 2047

APO AP 96278

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): Mr. Timothy P. Wagner (CIV) timothy.p.wagner@usmc.mil

(703) 432-3954 2200 Lester Street Quantico, Virginia 22134

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): Navy International Programs Office 202-433-6006 1250 10th Street SE, Building 200 Washington Navy Yard, DC, 20374

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): 505 CCW/IP, 128 Harston St., Hurlburt Field, FL 32544-5231, 850-884-1664 or (850) 844-9367; 505CCW.IP@us.af.mil

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): AFLCMC/WNE-IP ; 937-713-2781 AFLCMC.WNOS.Workflow@US.AF.mil Agile Combat Support (ACS) Security Division 1981 Monahan Way Area B, Building 12 Wright-Patterson AFB, OH 45433-7424

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): 149 FW Information Protection Joel.lobisser.2@us.af.mil / 149.FW.FW.IP.Org@us.af.mil 210-925-7605 107 Hensley St., Ste-1 JBSA-Lackland, TX 78236-0103

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): 161 ARW/IPO MSgt Bryan Angst ; 602-302-9405

USAF.AZ.161-ARW.MBX.IP@MAIL.MIL

3200 E. Old Tower Road, Bldg 10-226 Phoenix, AZ

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): 162 FW/IP TSgt Kristopher Goins ; kristopher.goins.2@us.af.mil 520-295-6417 1475 East El Tigre Way Tucson, AZ 85706

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): 140 WG/MTC edwin.guadalupe@us.af.mil / steven.whitener.2@us.af.mil 720-847-5056 / 720-847-5353 19210 E. Breckenridge Buckley AFB, CO 80011

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): 148 FW/CCZ MSgt Sam Lasky ; samuel.lasky@us.af.mil Maj Sean Churchill; sean.churchill@us.af.mil 4611 Phantom Drive, Bldg 211 Duluth, MN 5581

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): 180 FW/CCZ SMSgt Brett Lohman brett.lohman@us.af.mil 2660 S Eber Rd, Bldg 118 – Ops Vault Swanton, OH 43558

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): 86 AW/IPD 86aw.informationprotectionoffice@us.af.mil

DSN: 314-480-2107

Unit 3300 Ramstein AB, Germany 09094

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): 611 ACOMS jacob.edwards.13@us.af.mil / Joseph.wilburn@us.af.mil 907-552-7716 / 905-552-2707 9480 Pease Ave, Ste 212 Joint Base Elmendorf Richardson, AK 99506

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): 30 SW/IP DSN 276-1281 or comm. 805-606-1281; 805-605-0766 2ROPS.Security_Managers@us.af.mil Bldg 11777 Vandenberg, CA 93437

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): Chief, Wing IP Mr. Robert Connolly 120 Burrell Loop, Room 227 Langley, AFM 23665

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): AFLCMC/XA Security Chaun Leigh Edwards 2240 B Street, Building 11

WPAFB, OH 45433

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): 88 ABW/IPD 1801 Tenth Street, Building 8

WPAFB, OH 45433

937-255-4892 or 937-255-2878

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): 132 WG/IP 3100 McKinley Avenue Des Moines, IA 50321 515-261-8800 or 515-261-8275 usaf.ia.132-wg.mbx.information-protection@mail.mil

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): 11 WG/IP 1330 AF Pentagon Washington, DC 20330 703-614-2932

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): 711 HPW AFRL/RHW RENDAL R. BASS, JR., DO-3, Chief of SecurityDSN: 986-7644, Comm: 937-656-5366; Rendal.bass@us.af.mil

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): AFLCMC/WN-IP Security Manager Kelli Frazier 937-938-4784

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): ACC/A3 SSO POC Info:

Clorinda.ortega-parker.1@us.af.mil DSN 574-2076, Comm 757-764-2076 HQ ACC/A3 Security Manager Joint Base Langley-Eustis VA 23665

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): 377 ABW/IP 505-846-3973 4500 Biggs Ave SE Kirtland AFB, NM 87116

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): SSO MR. Robert C Learnard 702-652-2058 *According to SSO, for DD254 address put: “All DoD accredited SCIFs at Nellis”

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): michael.reeves.10@us.af.mil (A3DJ)

DSN 312.779.0471; COMM: 618.229.0471

jonathan.andrew.2@us.af.mil (A3TM)

DSN 312.779.8594; COMM: 618.229.8594402

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): 96 TW/IP 101 West D Ave Eglin AFB 32542 850-882-4850

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): AFCENT SSO Mark Bingham 803-717-6343 524 Shaw Dr. Building 1130, Suite 175 Shaw AFB, SC 29150

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): AFLCMC/WAC Security Lauren Mills 2960 Loop Road West Bldg 556

WPAFB, OH 45433

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): AFLCMC/WAC Security Lauren Mills 2960 Loop Road West Bldg 556

WPAFB, OH 45433

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): Michael G. Campbell 492 SOTRSS Chief, Facility/Security Operations Hurlburt Field, Florida 32544-5407 Comm (850) 881-2367 DSN 641-2367 Cell (850) 217-1400

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): 72 ABW/IP (AFMC) 4385 South Air Depot Boulevard Tinker AFB, OK 73145-8606 Phone: 405-582-1823; Email: 72ABW.IP.IndustrialSecurity@us.af.mil

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): Melissa A Simpson

AETC 479 OSS/USM

Keesler, AFB Biloxi, MS 39534 melissa.simpson.8@us.af.mil

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): SSO MR. Robert C Learnard 702-652-2058 *According to SSO, for DD254 address put: “All DoD accredited SCIFs at Nellis”

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): SSO MR. Robert C Learnard 702-652-2058 *According to SSO, for DD254 address put: “All DoD accredited SCIFs at Nellis”

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): 611 ACOMS jacob.edwards.13@us.af.mil / Joseph.wilburn@us.af.mil 907-552-7716 / 905-552-2707 9480 Pease Ave, Ste 212 Joint Base Elmendorf Richardson, AK 99506

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): SSO MR. Robert C Learnard 702-652-2058 *According to SSO, for DD254 address put: “All DoD accredited SCIFs at Nellis”

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): SSO Edwards AFB CA Security/ Policy Review- 661-277-8707

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): 1 WG/IP 1330 AF Pentagon Washington, DC 20330 703-614-2932

JB Lackland San Antonio TX

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): PACAF/SSO Joint Base Pearl Harbor Hickam Honolulu HI

8. ACTUAL PERFORMANCE - c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional): INSCOM SSO Ft Belvoir VA 22065

1480 Air Force Pentagon Room 5D756 Washington DC 20330

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): AF Agency for Modeling and Simulation 3051 Technology Parkway Orlando FL 32826

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): SAF/SAAM Department of the Air Force Chief Modeling & Simulation Office 1 Liberty Center Arlington, VA 22203

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): SAF/IAPD 1080, Air Force Pentagon, Room is 4C253, Wash DC 20330-1080

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): HAF/A3W 1490 Air Force Pentagon Washington DC 20330-1490

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): NGB -- 138FW 4210 N Corsair Avenue, Building 814, Tulsa, Oklahoma 74115

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): 558th Flying Training Squadron 520 I Street East, Bldg. 743 JBSA-Randolph AFB, TX 78150

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): FB5294 (7 AF/A9K) Osan AB Bldg 946 Sin Jang Dong Pyeongtaek City, 17759, Korea, South

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): Marine Corps Systems Command (MARCORSYSCOM) 2200 Lester Street Quantico, Virginia 22134

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): Navy International Programs Office 1250 10th Street SE, Building 200 Washington Navy Yard, DC, 20374

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): 505 CTS 138 Hartson Street Building 90005 Hurlburt Field, FL, 32544

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): AFLCMC/WNS Agile Combat Support (ACS) Simulators Division 2300 D Street, Bldg 32

WPAFB, OH 45433-7249

937-255-7408

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): NGB -- 149 FW 107 Hensley St JBSA-Lackland, TX 78236-0103

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): NGB -- 161 ARW Goldwater Air National Guard Base 3200 E. Old Tower Road Phoenix, AZ 85034

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): NGB -- 162 FW 1500 East Valencia Road Tuscon, AZ 85706

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): NGB -- 140 WG/NTC 19210 E. Breckenridge, Building 909 Buckley AFB, CO 80011

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): NGB -- 148 FW F-16/MTC, Bldg 211 4611 Phantom Drive Duluth, MN 55811

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): NGB – 180 FW 2660 S Eber Rd Swanton, OH 43558

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): USAFE/WC Kaiserstrasse 84, GEB 708, Kaiserslautern 67661 also known as UAWC Einsiedlerhof Air Station (AS) in Germany

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): 611 ACOMS 9480 Pease Ave, Ste 212 Joint Base Elmendorf Richardson, AK 99506

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): 2 ROPS/DOP 806 13th Street, Bldg 7015 Vandenberg, CA 93437

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): Headquarters Air Combat Command Langley AFB, VA 23665

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): AFLCMC/XA 2303 Eighth Street, Building 802

WPAFB, OH 45433

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): AFLCMC/XA 2240 B Street, Building 11

WPAFB, OH 45433

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): Distributed Training Operations Center 3100 McKinley Ave Bldg 180 Des Moines IA 50321

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): Joint Base Anacostia Bolling 112 Luke Ave Carpenter Bldg, 5683 JBAB, Washington, DC 20032

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): 711 HPW AFRL/RHW Airman Systems Directorate Warfighter Interactions and Readiness Division 2620 Q Street, Bldg 852

WPAFB, OH 45433

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): AFLCMC/WN-IP

WPAFB, OH 45433

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): HAF/A3TI LNO to ACC 130 Andrews Street Bldg 703, Room 301 Langley AFB, VA 23665 SMO code: LE1CFS9Y6

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): 705 CTS 4500 Aberdeen Dr. SE, Bldg 942 Kirtland AFB, NM 87116

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): USAFWC 4370 N. Washington Blvd., Rm. 214 Nellis AFB, NV 89191

SMO code: SSO Nellis

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): AMC/A3T 402 Scott Dr., Unit 3A1, Bldg. 1600 Scott AFB, IL 62225

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): 96TW 101 West D. Ave., Ste. 26 Eglin AFB, FL 32542

SMO code: SSO Eglin

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): AFCENT A3/A3AO 524 Shaw Dr., Bldg. 1130, Ste. 181 Shaw AFB, SC 29150

SMO Code: SSO Shaw

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): AFLCMC/WAC 2960 Loop Road West Bldg 556

WPAFB, OH 45433

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): (CUI) AFLCMC/WAC 2685 Hibiscus Way Beavercreek, OH 45431

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): 492 SOTRSS 589 Independence Road Hurlburt Field FL 32544

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): 76 SWEG, 559 SWES/MXDPFB Tinker AFB, OK 73145

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): 555th Software Engineering Squadron 860 San Carlos Rd Bld 4149 Rm 108 NAS Pensacola, FL 32508 SMO Code: TX0JFB479

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): Joint Synthetic Environment JSE -N Nellis AFB NV

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): Joint Integrated Test and Training Center JIITC-N Nellis AFB NV

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): Joint Integrated Test and Training Center JITTC-E JB Elmendorf Alaska

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): Digital Test and Training Range DTTR-N Nellis AFB NV

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): Digital Test and Training Range DTTR -E Edwards AFB CA93524

AF/A4LM

Pentagon Washington D.C.

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): 19th AF/AETC/DOUR JB Randolph AFB TX 78150

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): 16TH AF/DO JB Lackland San Antonio TX

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): Pacific AF (PACAF) A3/6 Cyber Joint Base Pearl Harbor Hickam Honolulu HI 96818

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): United States Army Modeling and Simulation Office (AMSO) 5801 Hurley Road Building 805 Fort Belvoir, VA 22060

8. ACTUAL PERFORMANCE - a. LOCATION(S) (For actual performance, see instructions.): Naval Information Warfare Training Group (NIWTG)

NIWTG/N85

Norfolk VA

NIPRNET, SIPRNET, JWICS

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.): - all Security Assistants for work performance locations

- Contractor Team Lead

- SSOs for all work performance locations

-AFOSI/PSO

(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.): All contractor personnel shall comply with the provisions of 32 CFR Part 117, National Industrial Security Program Operating Manual (NISPOM); DoDI 5220.22, National Industrial Security Program, Incorporating Change 1, Effective May 2018; DoDM 5220.22, Vol. 2_AFMAN 16-1406 Vol. 2, National Industrial Security Program: Industrial Security Procedures for Government Activities, May 2020.

While performing duties within USG owned and operated facilities, the contractor must adhere to all service/component command/local security directives, regulations, and standard operating procedures at contract performance locations.

All Government Badges issued under this contract will be returned immediately upon termination of the contract, or individual terminations. When an individual Visitor Group is terminated, for any reason, it is the responsibility of the Facility Security Officer to immediately notify the appropriate Security Assistant. Failure to comply could result in the suspension of all Visitor Group accounts.

Contract performance: Base period is one year from Day Month Year - Day Month year, with 4 Option years.

There will be an annual review of the DD254 and PWS, any known changes will dictate a revised DD254 at that time.

Security classification guidance on information, hardware, and equipment will be furnished to the contractor at the time access to classified is granted or when classification changes occur. This will include any special projects.

All classified visit requests by Visitor Groups shall be forwarded to the COR for approval and need-to-know certification before being sent to the facility to be visited. The COR must be notified and approve the receipt and/or generation of classified information under this contract. All classified information received and/or generated under this contract is the property of the U.S. Government regardless of proprietary claims. Upon completion or termination of this contract, the U.S, Government will be contacted for destruction or disposition instructions.

In addition to the reporting requirements directed by the NISPOM, the Visitor Group will provide a concurrent report of loss or compromise of classified information to the appropriate Security Assistant (e.g. HAF/A3 Security Assistant). Visit requests to activities other than those not listed in the statement of work on this DD254 shall have a “Need to Know” certified by the unit/organization's Security Assistant. All requests shall contain the information required by the NISPOM and shall not exceed a 12-month period.

All classified material received, generated, fabricated or modified by this contract will be returned within 30 days after completion of contract or destroyed with destruction report being submitted to the appropriate Security Assistant. Prior to any destruction of classified information a full listing of documents will be provided to the Security Assistant for review and approval. If additional contracting requirements exist where retention of classified information by the Visitor Group facility is required, a written request to retain material for a period but not to exceed 2 years is required.

Provide the information requested by the Notification of Government Security Activity Clause, AFFARS 5352.204-9000 and Visitor Group Security Agreement Clause, AFFARS5352.204.90001, to the Cognizant Security Office (CSO) address in Block 18.f of this form. Refer to the contract document for these clauses.

Non-Disclosure Agreement: The Visitor Group may be required to have access to highly sensitive and confidential plans and data for the performance of this delivery order. The Visitor Group will not divulge any information about activities or functions, or other knowledge gained, to anyone who is not authorized to have access to such information. It will be the Visitor Group’s responsibility to ensure that persons have the proper authority and “need to know” prior to any discussions. The Visitor Group will observe and comply with any security provisions.

The use of cellular phones, hand-held radios, beepers/pagers, cordless telephones, cordless microphones, and all wireless electronic devices shall be addressed in the Standard Operating Procedures (SOP) of the Information Security (IS) procedures for each computer facility where classified processing is accomplished.

Ref 8. ACTUAL PERFORMANCE Intentions for the original DD254 was to include all known work performance locations; however, additional work locations may need to be added based on mission needs. To not delay mission requirements, contractors may begin work at a new work location prior to a revised DD254 being executed, as long as it's on a U.S. government installation, a Visit Request has been issued for the work performance location, and the appropriate CSO has approved/acknowledged the visit prior to contractor arrival. A revised DD254 will still need to be executed to add the additional work location, if it's deemed the work performance location will be visited more than the one time visit.

If the company deems it necessary to work with classified material at another own facility within the company; then the company must possess the appropriate FCL for that work place location. CAGE code will need to be verified as accordingly in NISS. And DD254 will need a revision prior to contractors beginning work with classified material at the new company location.

Named CSO POCs may change while this contract is in effect; however, the appropriate Information Protection office and/or Defense Counterintelligence and Security Agency (DCSA) will still maintain CSO oversight for the designated work performance location.

Ref 10. CONTRACTOR WILL REQUIRE ACCESS TO:

Ref. 10.a.: Communications Security (COMSEC) Information:

1. COMSEC material/information may not be released to DOD contractors without Air Force Cryptological Support Center (AFCSC) approval.

2. Contractor must forward requests for COMSEC material/information to the COMSEC officer through the program office.

3. The contractor is governed by the following 32 CFR part 117 (NISPOM) Section 4. Communications Security (COMSEC) in the control and protection of COMSEC material/information.

4. Access to COMSEC material by personnel is restricted to U.S. citizens holding final U.S. Government clearances. Such information is not releasable to personnel holding only reciprocal clearances.

5. The contractor is governed by AFMAN 17-1302-O. Access to COMSEC material or information is restricted to US citizens holding final U.S.Government clearances and is not releasable to personnel holding only a reciprocal clearance.

6. Personnel requiring Personnel requiring COMSEC access shall be briefed in accordance with AFMAN 17-1302-O NOTE: The COMSEC briefing applies only to the use and control of cryptographic equipment and specialized COMSEC publications.

Additionally,cryptographic information/equipment shall be retained in a contractor facility user COMSEC account in accordance with current guidelines..

7. The Air Force program/project manager shall designate the number of personnel requiring COMSEC access. The number will be limited to the minimum necessary and will be on a strict need-to-know basis.

8. When COMSEC support, including STE, is provided by an AF COMSEC Account, the contractor must comply with AFI 33-211 andAFI 33-209.

9. COMSEC information includes accountable or non-accountable COMSEC information and controlled cryptographic items (CCI). If accountable COMSEC material is involved, the Visitor Group must have a COMSEC account. NOTE: COMSEC custodians are DAF civilians or military members. Visitor Groups are considered hand receipt holders.

10. Classified COMSEC material is not releasable to Visitor Group employees who have not received a FINAL clearance at the appropriate security level. COMSEC access shall be IAW 32 CFR part 117. When access is required at Government facilities, Visitor Group personnel will adhere to COMSEC rules and regulations as mandated by Command policy and procedures. Prior written approval from the CO is required in order for a prime Visitor Group to grant COMSEC access to a subcontracting Visitor Group.

11. The contractor will establish a COMSEC Account with the APPLICABLE COMM SQ

Ref. 10.b.: Restricted Data (RD) Information:

Policy: DoDM 5200.01, Vol 1-3 Information Security Program; DoDI 5210.02, Access To and Dissemination of Restricted Data and Formerly Restricted Data

1) Contractor is permitted access to Restricted Data (RD) in performance of this contract. CONFIDENTIAL security clearance eligibility is not valid for access to Restricted Data. Contractors must comply with all instructions and guidance provided by the servicing AF Activity Security Manager. Prior approval of the contracting activity is required for subcontracting.

2) Definitions:

a) Restricted Data (RD). Information which is classified and controlled under the Atomic Energy Act of 1954. It is all data (information) concerning design, manufacture, or utilization of atomic weapons; the production of special nuclear material; or the use of special nuclear material in production of energy. The term does not include data declassified or removed from the Restricted Data category pursuant to section 142 of the Atomic Energy Act of 1954, as amended (reference (b)). (Also see “Formerly Restricted Data.”)

b) Access. Within and between DoD Components, to include contractor activities, access to Restricted Data (RD) information will be governed by the same procedures and criteria required for access to other classified information:

i) Require access in performance of official duties.

ii) Have a final US Government security clearance at a level commensurate with the information concerned.

iii) Access requires in-brief by the servicing AF Activity Security Assistant, documentation of AF Form…