Att 3 DD 254 H-1 LOT 7_8.pdf

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DRAFT

SAMPLE

PREVIOUS EDITION IS OBSOLETE.

Page of AEM LiveCycle Designer

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:

May 31, 2022 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

****REQUEST FOR PROPOSAL****

****NOT VALID FOR PERFORMANCE****

*****MULTIPLE LOCATIONS*****

***SEE BLOCK 13***

Block9: Enter a Brief Description of this contract

Technical Point of Contact (TPOC): Program Manager(PM):

Nelish Patel Stephen Coln NAWCTSD, Orlando NAWCTSD, Orlando Tel: 407-380-4370 (DSN 960) Tel: 407-380-8159 (DSN 960) Email: nelish.b.patel.civ@us.navy.mil Email: stephen.c.coln.civ@us.navy.mil

**********************************************CONTINUES*********************************************************

DD 254 dated yearmoda - Solicitation #N61340-22-R-0030 -Planning Document-Not Valid For Performance

Block 7.a: The Prime contractor is responsible for issuing required DD 254 to each subcontractors.

Block 8.a: Actual Performance Location:

1) Enter Location Name 2) Enter Location Name City, State City, State

**********************************************CONTINUES******************************************************

CONTINUATION ITEM 13-DD 254 dated yearmoda - Solicitation #N61340-22-R-0030 -Planning Document-Not Valid For Performance

*** Enter guidance for each box selected in Blocks 10 & 11

Block 10.a:

Block 11.a:

Block 11.m: Additional Information.

-Supply Chain Risk Management (SCRM) For National Security Systems - The Contractor shall mitigate supply chain risk in the provision of supplies and services to the Government per FAR 252.239-7018, Supply Chain Risk, and CNSSD -505, Supply Chain Risk Management (SCRM). The contractor shall, implement a process for managing supply chain risk by identifying susceptibilities, vulnerabilities, and threats throughout the supply chain and developing mitigation strategies to combat those threats whether presented by the supplier, the supplied product and its subcomponents, or the supply chain (e.g., initial production, packaging, handling, storage, transport, mission operation, and disposal.

-International Traffic and Arms Regulation - The contractor shall ensure that foreign persons, as defined under section 120.16 of the International Traffic and Arms Regulation (ITAR) (22 CFR, Parts 120 – 130), are not given access to U.S. Government controlled unclassified information, sensitive information, defense articles, defense services, or technical data, as defined in the ITAR, Part 120, without proper issuance of an export license from the U.S. Government authority.

-Government-Issued Personal Identification Credentials - The contractor and subcontractor(s) (when applicable) shall:

Account for all forms of U.S Government-provided identification credentials (CACs and/or U.S. Government-issued badges) issued to the contractor or their employees in connection with contract performance.

Have in place an established and enforced “out-processing” policy for employees that leave the company, including suspension of account access, CAC/ID Badges turn in.

Ensure that out-processed employees receive debriefings on the need to maintain confidentiality of U.S. Government Controlled Unclassified Information.

-Personnel Security - The Contractor shall report to the NAWCTSD Security Office adverse or derogatory information pertaining to on-site CSS personnel (when applicable) or contractor personnel in direct support of this contract. Examples:

Domestic Violence, Other Violent or Sexual Crime arrest or self-report Contractor personnel receive revocation of an Interim or denial for the issuance of a CAC until final adjudication Denial or suspension of clearance occurs for a contractor employee Contractor employee receives a final denial of eligibility for a security clearance

-Technical papers, briefings, presentations, either classified or unclassified to be presented at classified symposia must be submitted to government sponsor for approval prior to presentation. Unclassified material submitted for public release (that is not to be presented at classified symposia) shall be forwarded for review prior to release as stated in item 12 above.

-Contractors shall comply with security procedure and all additional OPSEC security plans and requirements in effect at all Government sites visited and where work to take place as listed in Block 8.

-All instances of loss, compromise and electronic spillage of classified or controlled unclassified information shall be reported to the COR, TPOC, and Government Security Office within 24 hours of the incident occurring.

-Determination of need-to-know in connection with a classified visit is the responsibility of the individual/host who will disclose the classified information.

**********************************************CONTINUES******************************************************

CONTINUATION ITEM 13-DD 254 dated yearmoda - Solicitation #N61340-22-R-???? -Planning Document-Not Valid For Performance

Cont. Block 11.m: Additional Information.

-The contractor shall not release any classified information to a "Non U.S. Citizen" or persons holding “Reciprocal Clearances" without written authorization from this activity.

-Visit request shall have "need-to-know" certified by the POC listed in Block 9. All visit requests to Military Installations for classified or unclassified visits from subcontractors will be sent via the prime contractor who will certify the need-to-know.

-All contractor personnel shall comply with DoD Security Agreement (DD Form 441), as well as 32 CFR Part 117 (NISPOM rule).

-Contractors shall perform work in accordance with Statement of Work.

Block 12: Transmissions by non-secure facsimile or E-mail is NOT authorized by Prime or subcontractor(s).

****************************************NO FURTHER ENTRIES************************************************** text:

Block is used when STILO review is required

12211 Science Drive Orlando, FL 32826-3275 Address: Naval Air Warfare Center Training Systems Division (NAWCTSD) 12211 Science Drive Orlando, FL 32826-3275