ATT (1) DD Form 254 ( OMB JUN 2025) (April 2018).pdf

PDF 72 KB Posted Jul 22, 2026

Attached to: U. S. NAVY 78-FOOT PATROL BOAT ORGANIZATIONAL MAINTENANCE
Solicitation number: N64710-26-0001
Issued by: Department of the Navy Strategic Systems Programs

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DRAFT

SAMPLE

PREVIOUS EDITION IS OBSOLETE.

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

RETURN COMPLETED FORM AS DIRECTED IN THE INSTRUCTIONS.

1. CLEARANCE AND SAFEGUARDING

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

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

a. ORIGINAL (Complete date in all cases.)

b. REVISED (Supersedes all previous specifications.)

4. IS THIS A FOLLOW-ON CONTRACT?

If yes, complete the following:

Classified material received or generated under

5. IS THIS A FINAL DD FORM 254?

If yes, complete the following:

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

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

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

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

e. NATIONAL INTELLIGENCE INFORMATION:

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

12. PUBLIC RELEASE

Any information (classified or unclassified) pertaining to this contract shall not be released for public dissemination except as provided by the National Industrial Security Program Operating Manual (NISPOM) or unless it has been approved for public release by appropriate U.S. Government authority. Proposed public releases shall be submitted for review and approval prior to release to the appropriate government approval authority identified here with at least office and phone contact information and if available, an e-mail address. (See instructions)

13. SECURITY GUIDANCE

The security classification guidance for classified information needed for this effort is identified below. If any difficulty is encountered in applying this guidance or if any other contributing factor indicates a need for changes in this guidance, the contractor is authorized and encouraged to provide recommended changes; to challenge the guidance or the classification assigned to any information or material furnished or generated under this contract; and to submit any questions for interpretation of this guidance to the official identified below. Pending final decision, the information involved shall be handled and protected at the highest level of classification assigned or recommended.

(Fill in as appropriate for the classified effort. Attach, or forward under separate correspondence, any documents/guides/extracts referenced herein. The field will expand as text is added. When removing any expanded text area, use delete key or backspace key, then click out of the text field for it to shrink after the text has been deleted. Also allows for up to 6 internal reviewers to digitally sign. See instructions for additional guidance or use of the fillable PDF.)

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"

CurrentPage:

PageCount:

Select classification from drop-down list.: Unclassified

Enter serial number.:

a. Facility clearance level. Select one.: 2

b. Level of safeguarding for classified information/material required at contractor facility. Select one.: 4

Select for "original.": 0

Enter prime contract number.:

Select for "revised.": 0

Enter subcontract number.:

Select for "final.": 0

Enter solicitation or other number.:

Enter due date in format YYYYMMDD.:

Enter date in format YYYYMMDD.:

Enter revision number.:

Enter date in format YYYYMMDD.:

Enter final specification.:

Enter date in format YYYYMMDD.:

Select for "no.": 0

Select for "no.": 1

Select for "yes.": 0

Enter preceding contract number.:

Enter contractor's request date in format YYYYMMDD.:

Enter period.:

Enter typed name of certifying official (last, first, middle initial).:

Enter CAGE code of the prime contractor.: NA

Enter CAGE code of the prime contractor.: N/A

Enter cognizant security office(s) (Name, Address, ZIP Code, Telephone required; Email Address optional).: Strategic Weapons Facility Pacific (SPB50M)

Attn: Security Manager Strategic Weapons Facility Pacific 6401 Skipjack Circle Silverdale, WA 98315

Select to add row to locations.:

Select to remove last row from locations.:

Select to delete all signatures.:

Enter location(s).: Strategic Weapons Facility Pacific

6401 Skipjack Circle Silverdale, WA 98315 Enter general unclassified description of this procurement.: Contractor providing vessel maintenance repair.

Estimated contract completion date: TBD

Select for "a. CONTRACTOR.": 0

Select for "a. CONTRACTOR.": 1

Select for "f. OTHER AS NECESSARY.": 0

Select for "b. SUBCONTRACTOR.": 0

Select for "g. BE AUTHORIZED TO USE THE SERVICES OF DEFENSE TECHNICAL INFORMATION CENTER (DTIC) OR OTHER SECONDARY DISTRIBUTION CENTER.": 0

Select for "c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR.": 0

Select for "c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR.": 1

Select for "h. REQUIRE A COMSEC ACCOUNT.": 0

Select for "d. U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECURITY ADMINISTRATION.": 0

Select for "i. HAVE A TEMPEST REQUIREMENT.": 0

Select for "e. NATIONAL INTELLIGENCE INFORMATION: - (1) Sensitive Compartmented Information (SCI).": 0

Select for "e. NATIONAL INTELLIGENCE INFORMATION: - (2) Non-SCI.": 0

Select for "j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS.": 1

Select for "j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS.": 0

Select for "k. BE AUTHORIZED TO USE DEFENSE COURIER SERVICE.": 0

Enter infomration for "other.":

Select for "e. ADMINISTRATIVE CONTRACTING OFFICER.": 1

Select for "l. RECEIVE, STORE, OR GENERATE CONTROLLED UNCLASSIFIED INFORMATION (CUI). .": 0

Select for "m.OTHER.": 0

Select for "direct.": 0

Select for ": 1

Enter specification for "through".: No Public Release is Authorized.

Enter public release authority.:

Select to add signature.:

Select to remove last signature.:

text: 32 CFR PART 117 - Reporting Requirements: 117. 8(d) - Reports of Loss, Compromise, or Suspected Compromise: Any loss, compromise or suspected compromise of classified information, foreign or domestic, shall be reported to the Cognizant Security Agency (CSA) within 24 hours to the SWFPAC Command Security Manager: Name at Email Address and Name at Email Address, Industrial Security.

The following Security Classification Guide(s) or subsequent revisions apply to this contract. Subsequent revisions shall be provided by the Government Contracting Activity (GCA) as Government Furnished Information (GFI) and shall be executed by the Contractor.

Security classification guidance:

a. SCG ID 05-27.9, (U) Submarine-Launched Ballistic Missile Weapon System (SLBM WS) Security Classification Guide (SCG) including Annex 001, Integrated Navy NW Security System (INWSS) SCG, and Appendix A to Annex 001, NWS Shore SCG (U)

b. DoDM 5200.01, Vols. 1-3, Information Security Program

c. DoDI 5200.48, Controlled Unclassified Information

d. 32 CFR PART 117 - National Industrial Security Program Operating Manual (NISPOM)

e. DoD 5220.22-M, Change 2, National Industrial Security Program Operating Manual (NISPOM)

f. DoDM 5220.22, Vol. 2., dtd 01 Aug 2018 g SECNAVINST 5510.36B, DON Information Security Program h.SWFLANT M-5530.2 (Series) SWFPAC Security Plan

i. OPNAVINST 2221.5D Release of Communications Security Material to U.S. Industrial Firms Under Contract to the Dept of the Navy

Personnel Clearance (PCL) is valid for access to classified information at the same or lower level of classification as the level of the clearance granted. An interim SECRET PCL is valid for access to classified information at the level of the eligibility granted, except for RD, COMSEC Information and NATO Information.

All contractor personnel performing at SWFPAC on a classified contract will require a SECRET PCL. An Interim SECRET PCL will be accepted. All Contractors must in and out brief with SWFPAC Industrial Security for access to SWFPAC facilities and areas. To in process all contractors must have a Interim Secret PCL, Visit Request in System of Record (DISS/NBIS) to SMO Code #####, be enrolled in Continuous Evaluation.

Contractor is subject to inspection for security compliance by local Industrial Security Representative at SWFPAC.

Personnel designated as derivative classifiers shall receive derivative classification training prior to access from the contractor's Facility Security Officer (FSO). The FSO shall ensure personnel receive initial and annual training during the life of this contract. Evidence of completion, training certificates or equivalent, shall be provided to the Information Assurance Manager no later than the individual's due date.

Block 10J and 11L - All documents generated under this contract which contain CUI materials must be marked in accordance to the DODI 5200.48 marking requirements. SSP CUI material, including electric transmission thereof, will be protected and handled as specified in the latest version of SSPINST 5230.11A. To facilitate implementation of the DoDI 5200.48 marking requirements, the Contractor shall be in compliance with DoDI 5200.48.

In addition to the above required markings, the government recommends use of supplemental administrative markings: Draft, Pre-decisional, and Deliberative. They should be used to indicate the non-final status of documents under development to avoid confusion and maintain the integrity of the government and contractors decision-making process. These markings are useful for determinations on information subject to the Freedom of Information Act (FOIA). If these administrative markings are utilized, they must not be incorporated into the CUI banners or duplicate any marking in the CUI Registry.

For definitions of the above CUI categories, please refer to www.archives.gov/CUI, DoDI 5200.48, and the 2019 DCRIT Determination from the USN Chief Management Officer.”

VISITOR SECURITY GROUP AGREEMENT (VGSA) - A VGSA will be executed between Company XYZ and SWFPAC.

Company XYZ will execute a VGSA to all subcontractors.

For any questions regarding this DD254, please contact the following individuals:

1) Collateral security - Name, SPB50M, at (###) ###-####, Email Address

2) SWFPAC Contracting Officer Representative (COR) and/or Technical POC:

3) Estimated Completion Date:

Click on this button to attach a file(s).:

rep:

SWFPAC Industrial Security Specialist

rep: Contracting Officer Representative

Enter signature.:

Explain and identify specific areas and government activity responsible for inspections.:

Enter GCA name.: Strategic Weapons Facility Pacific

Enter AAC of the contracting office.:

Enter address (include zip code).: 6401 Skipjack Circle

Silverdale, WA 98315 Enter address (include zip code).: 6401 Skipjack Circle Silverdale, WA 98315

Enter POC name.:

Enter telephone number (include area code).:

Enter email address.:

Enter title.: SWFPAC, Command Security Manager

Enter the datesigned in format YYYYMMDD.:

File details come from the government source that posted it. Updated Jul 22, 2026.