Atch 7 DD Form 254.pdf

CLASSIFICATION (When filled in): Unclassified

PREVIOUS EDITION IS OBSOLETE. Page 1 of 4DD FORM 254, APR 2018

DEPARTMENT OF DEFENSE

CONTRACT SECURITY CLASSIFICATION SPECIFICATION

(The requirements of the National Industrial Security Program (NISP) apply to all security aspects of this effort involving classified information.)

OMB No. 0704-0567 OMB approval expires:

June 30, 2025

The public reporting burden for this collection of information, 0704-0567, is estimated to average 70 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Washington Headquarters Services, at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

RETURN COMPLETED FORM AS DIRECTED IN THE INSTRUCTIONS.

1. CLEARANCE AND SAFEGUARDING

a. LEVEL OF FACILITY SECURITY CLEARANCE (FCL) REQUIRED (See Instructions)

Top Secret

b. LEVEL OF SAFEGUARDING FOR CLASSIFIED INFORMATION/

MATERIAL REQUIRED AT CONTRACTOR FACILITY

None (See instructions)

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

a. PRIME CONTRACT NUMBER (See instructions.)

b. SUBCONTRACT NUMBER

c. SOLICITATION OR OTHER NUMBER

FA2391-23-S-2403

DUE DATE (YYYYMMDD)

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

a. ORIGINAL (Complete date in all cases.)

DATE (YYYYMMDD)

20230206

b. REVISED (Supersedes all previous specifications.)

REVISION NO. DATE (YYYYMMDD)

c. FINAL (Complete Item 5 in all cases.) DATE (YYYYMMDD)

4. IS THIS A FOLLOW-ON CONTRACT? No Yes If yes, complete the following:

Classified material received or generated under (Preceding Contract Number) is transferred to this follow-on contract.

5. IS THIS A FINAL DD FORM 254? No Yes If yes, complete the following:

In response to the contractor's request dated , retention of the classified material is authorized for the period of:

6. CONTRACTOR (Include Commercial and Government Entity (CAGE) Code)

a. NAME, ADDRESS, AND ZIP CODE

TBD

b. CAGE CODE

TBD

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

7. SUBCONTRACTOR(S) (Click button if you choose to add or list the subcontractors -- but will still require a separate DD Form 254 issued by a prime contractor to each subcontractor)

a. NAME, ADDRESS, AND ZIP CODE

N/A

N/A

N/A

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

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

(If applicable, see Instructions.)

TBD

9. GENERAL UNCLASSIFIED DESCRIPTION OF THIS PROCUREMENT

This hybrid BAA permits the study efforts on novel concepts as well as R&D contracts to mature specific technologies to appropriate TRLs depending on end use. R&D efforts under this program include but are not limited to: fundamental science, advanced technology demonstration, critical experiments, and ground and flight tests. Research sites will be limited to each task order and located at various research centers. The BAA will allow for the submittal of white papers.

PREVIOUS EDITION IS OBSOLETE. Page 2 of 4DD FORM 254, APR 2018

10. CONTRACTOR WILL REQUIRE ACCESS TO: (X all that apply. Provide details in Blocks 13 or 14 as set forth in the instructions.)

a. COMMUNICATIONS SECURITY (COMSEC) INFORMATION f. SPECIAL ACCESS PROGRAM (SAP) INFORMATION

b. RESTRICTED DATA

g. NORTH ATLANTIC TREATY ORGANIZATION

(NATO) INFORMATION

c. CRITICAL NUCLEAR WEAPON DESIGN INFORMATION (CNWDI) (If CNWDI applies, RESTRICTED DATA must also be marked.)

h. FOREIGN GOVERMENT INFORMATION

d. FORMERLY RESTRICTED DATA

i. ALTERNATIVE COMPENSATORY CONTROL MEASURES

(ACCM) INFORMATION

e. NATIONAL INTELLIGENCE INFORMATION:

(1) Sensitive Compartmented Information (SCI)

(2) Non-SCI

j. CONTROLLED UNCLASSIFIED INFORMATION (CUI) (See instructions.)

k. OTHER (Specify) (See instructions.)

JWICS access authorized.

11. IN PERFORMING THIS CONTRACT, THE CONTRACTOR WILL: (X all that apply. See instructions. Provide details in Blocks 13 or 14 as set forth in the instructions.)

a. HAVE ACCESS TO CLASSIFIED INFORMATION ONLY AT

ANOTHER CONTRACTOR'S FACILITY OR A GOVERNMENT

ACTIVITY

(Applicable only if there is no access or storage required at contractor facility.

See instructions.)

b. RECEIVE AND STORE CLASSIFIED DOCUMENTS ONLY

c. RECEIVE, STORE, AND GENERATE CLASSIFIED

INFORMATION OR MATERIAL

d. FABRICATE, MODIFY, OR STORE CLASSIFIED HARDWARE

e. PERFORM SERVICES ONLY

f. HAVE ACCESS TO U.S. CLASSIFIED INFORMATION OUTSIDE

THE U.S.,PUERTO RICO, U.S. POSSESSIONS AND TRUST

TERRITORIES

g. BE AUTHORIZED TO USE THE SERVICES OF DEFENSE

TECHNICAL INFORMATION CENTER (DTIC) OR OTHER

SECONDARY DISTRIBUTION CENTER

h. REQUIRE A COMSEC ACCOUNT

i. HAVE A TEMPEST REQUIREMENT

j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS

k. BE AUTHORIZED TO USE DEFENSE COURIER SERVICE

l. RECEIVE, STORE, OR GENERATE CONTROLLED UNCLASSIFIED

INFORMATION (CUI).

(DoD Components: refer to DoDI 5200.48, only for specific CUI protection requirements. Non-DoD Components: see instructions.)

m. OTHER (Specify) (See instructions.)

AFFARS 5352.204-9000 applies. See block 13.

12. PUBLIC RELEASE

Any information (classified or unclassified) pertaining to this contract shall not be released for public dissemination except as provided by the National Industrial Security Program Operating Manual (NISPOM) or unless it has been approved for public release by appropriate U.S. Government authority.

Proposed public releases shall be submitted for review and approval prior to release to the appropriate government approval authority identified here with at least office and phone contact information and if available, an e-mail address. (See instructions)

DIRECT THROUGH (Specify below)

AFRL/RQ for non-SAR material. Transmission of public release request via e-mail is not authorized. Allow 23 days for processing.

Public Release Authority:

AFRL/RQ

2130 8th Street, WPAFB OH 45433

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.)

32 Code of Federal Regulations, Part 117, National Industrial Security Program Operating Manual (NISPOM), 24 February 2021, applies.

SECURITY GUIDANCE:

The Contractor will notify the Government Contracting Activity and the Government Security Manager within 48 hours of any incident involving the actual or suspected compromise/loss of classified information to enable the Government to conduct immediate assessment of potential impact pending formal inquiry/investigation. Actual or suspected compromise of Covered Defense Information will be reported IAW DFARS Clause 252.204-7012.

Access to classified information may be required during pre-contract phases, and will be dependent upon each individual task order.

Ref Blk 10e(1), Block12: Public release of Sensitive Compartmented Information (SCI) is NOT authorized.

PREVIOUS EDITION IS OBSOLETE. Page 3 of 4DD FORM 254, APR 2018

Ref Blks 10e(1): Contractor requires access to SCI materials; SCI security requirements apply, see 21 IS/INS, SSO WPAFB, SCI Addendum, for details. Access to Joint Worldwide Intelligence Communications System (JWICS) is authorized. Users shall be briefed to NATO Secret IAW the NISPOM, Para 10-706, prior to access.

Ref Blks 10j/11l: The contractor shall comply with DoDI 5200.48, Controlled Unclassified Information; AFMAN 16-1404, volume 1, Operations Support, Information Security Program: Overview, Classification, and Declassification; Air Force Guidance Memorandum 2020-16-01, Air Force Guidance Memorandum for CUI, 23 July 2020; and DoDM 5400.7-Air Force Manual 33 302, DoD Freedom of Information Act (FOIA) Program. The contractor shall monitor CUI aggregation and compilation based on the potential to generate classified information pursuant to security classification guidance addressing the accumulation of unclassified data or information.

Ref Blk 11c: Contractor will reference the appropriate security classification guidance when generating or deriving classified or unclassified information or hardware that is generated or used in the performance of this contract. The contractor shall protect such items and apply derivative classification and markings consistent with the source document. At the termination or expiration of this contract, the AFRL/RQ security (AFRL/RQOS) will be contacted for disposition instructions. Information or hardware generated or received under this contract is not authorized to be used or transferred to any other contractor or effort without the written approval from AFRL/RQ security.

SCG will be provided under separate cover.

Ref Blk 11d: The contractor is required to provide adequate and approved storage for classified hardware or material to the level of TOP SECRET which because of size or quantity cannot be safeguarded in an approved storage container.

Ref Blk 11m: Provide the information requested by the Notification for Government Security Activity and Visitor Group Security Agreements clause, Air Force Federal Acquisition Regulation Supplement (AFFARS) 5352.204-9000, to AFRL/RQOS the Servicing Security Activity (SSA), AFRL/RQOS, 2130 8th St, WPAFB, OH 45433.

* AFRL/RQ Security (RQOS) office must approve further disclosure of information covered under this effort, to include subcontracting.

* Upon the end of this effort, the contractor shall contact the AFRL/RQOS for disposition instructions of classified access or material generated or received during this effort.

* This information covered under this effort cannot be transferred or used for another effort to include IRAD, unless express written approval is received from AFRL/RQ PM or AFRL/RQOS.

*Contractor personnel shall utilize US Government or official company email for transmitting official US Government business/ information. US Government information shall NOT be transmitted via personal, private or commercial email or social media accounts (e.g. Hotmail, Gmail, Yahoo, Tik Tok, Facebook etc.). The use of DOD Safe is authorized for unclassified and Controlled Unclassified Information only.

*Contractor personnel are strictly prohibited from referencing this contract, classification, clearances, accesses (SAP/SAR, SCI), in advertisements, websites, capability fliers, promotional efforts or even in retirement notifications of employees.

Program Manager: Jonathan Wyatt, 1st Lt, AFRL/RQHP, (937) 255-1196, jonathan.wyatt.4@us.af.mil

Administrative Contracting Officer: TBD

Security Manager: Lucinda Coleman, AFRL/RQOS, (937) 904-8609, lucinda.coleman@us.af.mil; David Hanson, AFRL/RQOS, (937) 938-4921, david.hanson.17@us.af.mil

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

RQOS- Security Coordination

NAME & TITLE OF REVIEWING OFFICIAL

Dennis Reed Chief of Security, AFRL/RQOS

SIGNATURE

Ref 10e(1) Intelligence Coordination

NAME & TITLE OF REVIEWING OFFICIAL

David Hanson Intelligence Officer, AFRL/RQOS

SIGNATURE

14. ADDITIONAL SECURITY REQUIREMENTS

Requirements, in addition to NISPOM requirements for classified information, are established for this contract.

No Yes If Yes, identify the pertinent contractual clauses in the contract document itself, or provide an appropriate statement which identifies the additional requirements. Provide a copy of the requirements to the CSO. The field will expand as text is added or you can also use item 13. When removing any expanded text area, use delete key or backspace key, then click out of the text field for it to shrink after the text has been deleted.

(See instructions for additional guidance or use of the fillable PDF.)

REED.DENNIS

.G.1032466385

Digitally signed by

REED.DENNIS.G.1032466385

Date: 2022.10.31 15:12:00 -04'00'

HANSON.DAVID.L

ELAND.1244703905

Digitally signed by

HANSON.DAVID.LELAND.124

4703905 Date: 2022.10.31 14:54:24 -04'00'

PREVIOUS EDITION IS OBSOLETE. Page 4 of 4DD FORM 254, APR 2018

Ref Blk 11j: OPSEC requirements apply. See Statement of Work (SOW) for requirements.

Ref Blk 10e(1): SCI security requirements apply, see SCI addendum for details.

15. INSPECTIONS

Elements of this contract are outside the inspection responsibility of the CSO.

No Yes If Yes, explain and identify specific areas and government activity responsible for inspections. The field will expand as text is added or you can also use item

13. When removing any expanded text area, use delete key or backspace key, then click out of the text field for it to shrink after the text has been deleted.

(See instructions for additional guidance or use of the fillable PDF.)

Ref Blk 11m: Contractor performance will occur at WPAFB. DCSA is relieved of all inspection responsibilities for contractor performance on the installation. AFRL/RQOS will maintain security oversight.

Ref Blk 10e(1): SCI security requirements apply, see SCI addendum (para 13) for details.

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

a. GCA NAME

AFRL/RQKPB

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

FA2391

c. ADDRESS (Include ZIP Code)

AFRL/RQKPB

2130 8th Street Wright-Patterson AFB, OH 45433

d. POC NAME

Peter Seiley

e. POC TELEPHONE (Include Area Code)

+1 (312) 713-9943

f. EMAIL ADDRESS (See Instructions) peter.seiley@us.af.mil

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)

Seiley, Peter F

b. TITLE

Contracting Officer

c. ADDRESS (Include ZIP Code)

AFRL/RQKPB

2130 8th Street Wright-Patterson AFB, Ohio 45433

d. AAC OF THE CONTRACTING OFFICE (See Instructions)

FA2391

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

f. TELEPHONE (Include Area Code)

+1 (312) 713-9943

g. EMAIL ADDRESS (See Instructions) peter.seiley@us.af.mil

h. SIGNATURE

i. DATE SIGNED (See Instructions)

20230511

18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL

a. CONTRACTOR

b. SUBCONTRACTOR

c. COGNIZANT SECURITY OFFICE FOR PRIME AND

SUBCONTRACTOR

d. U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECURITY

ADMINISTRATION

e. ADMINISTRATIVE CONTRACTING OFFICER

f. OTHER AS NECESSARY (If more room is needed, continue in Item 13 or on additional page if necessary.)

AFRL/RQOS, 2130 Eighth St, Wright-Patterson AFB OH 45433-7542, Wright-PattersonAFRL/RQOS_All@us.af.mil

Blk 18f: AFRL/RQOS, 2130 8th Street, WPAFB OH 45433, lucinda.coleman@us.af.mil; david.hanson.17@us.af.mil

SEILEY.

PETER.F

.1407640

Digitally signed by

SEILEY.PETER

.F.1407640256 Date: 2023.05.11 17:04:45 -04'00'