Att 3 - DD254 ATEC ITSS.pdf

CLASSIFICATION (When filled in):

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DD FORM 254, APR 2018 PREVIOUS EDITION IS OBSOLETE. Page 1 of 3 AEM LiveCycle Designer

DD 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:

October 31, 2020

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

W91CRB-21-R-0017

DUE DATE (YYYYMMDD)

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

a. ORIGINAL (Complete date in all cases.)

DATE (YYYYMMDD)

20210114

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.W91CRB16F0009

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

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

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

USA TEST & EVALUATION COMMAND - APG, MD,

2202 Aberdeen Blvd, APG, MD, 21005

b. CAGE CODE (If applicable, see Instructions.)

W3Q2AA

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

USA TEST & EVALUATION COMMAND - APG, MD

- 2202 Aberdeen Blvd, APG, MD, 21005

9. GENERAL UNCLASSIFIED DESCRIPTION OF THIS PROCUREMENT

PROVIDE INFORMATON TECHNOLOGY SUPPORT TO INCLUDE COMPUTER OPERATIONS, DATA COMMUNICATIONS, NETWORK ADMINISTRATION, SYSTEM ALALYSIS/PROGRAMMING, CUSTOMER SUPPORT TO INCLUDE PROBLEM RESOLUTION, INFORMATION ASSISTANCE, SOFTWARE DEVELOPMENT, COMSEC SUPPORT, UPGRADES AND MAINTENANCE, MAINTENANCE FOR UNCLASSIFIED AND CLASSIFIED SECURE SYSTEMS AND DISASTER RECOVERY.

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DD 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.)

see below

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 DoDM 5200.01, Volume 4 only for specific CUI protection requirements. Non-DoD Components: see instructions.)

m. OTHER (Specify) (See instructions.)

see below

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)

PUBLIC RELEASE OF SCI IS NOT AUTHORIZED Public Release Authority: Gerald Taulbee, Contracting Officer, ACC-AP

Public Release Authority:

PUBLIC RELEASE OF SCI IS NOT AUTHORIZED

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.)

SEE SECTION 13 CONTINUATION SECTION AT THE BOTTOM OF THIS FORM

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

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DD FORM 254, APR 2018

NAME & TITLE OF REVIEWING OFFICIAL 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.)

See SCI addendum, See Base Contract/PWS paragraph C.1.12.8 and SAP Addendum.

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.)

See SCI addendum, OCONUS and SAP activity will be under the security cognizance of HQ ATEC G-2, 6617 Aberdeen Blvd, Building 2202, Aberdeen Proving Ground, MD 21005-5001. Additional security oversight may be provided OCONUS by Combatant Command organizations.

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

a. GCA NAME

Army Contracting Command

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

W91CRB

c. ADDRESS (Include ZIP Code)

6515 Integrity Court

APG, MD 21005-3013

d. POC NAME

Tara Casey

e. POC TELEPHONE (Include Area Code)

+1 (410) 278-0863

f. EMAIL ADDRESS (See Instructions) tara.l.casey.civ@mail.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)

Rush, Andrew

b. TITLE

Industrial Security Specialist

c. ADDRESS (Include ZIP Code)

2202 Aberdeen Blvd, APG, MD 21005

d. AAC OF THE CONTRACTING OFFICE (See Instructions)

W91CRB

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

f. TELEPHONE (Include Area Code)

+1 (443) 861-9278

g. EMAIL ADDRESS (See Instructions) andrew.w.rush.civ@mail.mil

h. SIGNATURE

i. DATE SIGNED (See Instructions)

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.)

GATCH.KRISTEN.

MARIE.1297930610

Digitally signed by

GATCH.KRISTEN.MARIE.1297

930610 Date: 2021.02.03 15:11:08 -05'00'

Classified COMSEC material is not releasable to contractor employees who have not received a FINAL clearance at the appropriate security level. COMSEC access shall be IAW DoD 5220.22-M and AR 380-40. When access is required at Government facilities, contractor personnel will adhere to COMSEC rules and regulations as mandated by Command policy and procedures. Written concurrence of the CM is required prior to subcontracting.

10b: Restricted Data Information is not releasable to contractor employees who have not received a FINAL clearance at the appropriate security level. Written concurrence of the KO is required prior to subcontracting.

10c: CNWDI Information is not releasable to contractor employees who have not received a FINAL clearance at the appropriate security level. Written concurrence of the KO is required prior to subcontracting.

10d: The contractor is permitted access to Formerly Restricted Data (FRD) in the performance of this contract. Access to FRD requires a final U.S. Government clearance at the appropriate level. Written concurrence of the KO is required prior to subcontracting.

10e1: SCI Access required. No public release of information authorized, public disclosure or confirmation of any subject related to the support contract is not authorized without first obtaining written approval from the CM.

10e2: Non-SCI Information is not releasable to contractor employees who have not received a clearance at the appropriate security level. Written concurrence of the CM is required prior to subcontracting. Access to Intelligence information required for performance.

10f: Discussion, storage, or processing of SAP information associated with this contract will be conducted in facilities specifically accredited by the Army SAPCO (or designee), or equivalent component-level SAPCO. Contact the appropriate servicing SAPCO for approved SAP facilities locations. SAP activities are governed by Revision 1 Department of Defense Overprint to the National Industrial Security Program Operating Manual Supplement, 1 APR 04, and applicable program security classification and procedures guides. Component-managed SAPFs and SAP Temporary Secure Working Areas (TSWA) are governed by JAFAN 6/9.

Access to SAP information requires employees undergo additional personnel security screening and meet the SAP access standards delineated in the applicable DoD directives and policies. SAP inspections and security oversight while in component facilities are under the cognizance of the SAPCO, as appropriate. Additional SAP security requirements may apply at alternate locations/facilities based on service/component Command requirements. The KO for these locations/facilities will provide specific guidance as required. SAP inspections conducted at contractor facilities are under the security oversight of the Defense Security Service (DSS) unless officially relieved of their oversight responsibilities. ATC Security and Intelligence Division will conduct SAP briefings and debriefings as required for the contractor personnel, refer to Army Regulation 380-381, Special Access Programs and Sensitive Activities.

10g: Personnel not assigned to a NATO staff position, but requiring access to NATO classified information, NATO COSMIC, NATO Secret or access to the NATO accredited SIPRNET terminals, must possess the equivalent FINAL or Interim U.S. Security Clearance based upon the appropriate personnel security investigation required. Personnel with access to NATO ATOMAL information must have the appropriate level FINAL U.S. Security Clearance. The government program/project manager is the designated representative that will ensure the contractor security manager and concerned employees are NATO briefed prior to access being granted. The contractor will maintain strict compliance in regards to NATO information IAW NISPOM Ch 10, Section 7.

Prior approval from the CM is required for subcontracting.

10h: Foreign Government Information (FGI) is not releasable to contractor employees who have not received a FINAL clearance at the appropriate security level. Written concurrence of the CM is required prior to subcontracting.

10j: For Official Use Only (FOUO) Information generated and/or provided under this contract shall be safeguarded and marked as specified in DoD 5200.1-R.

10k: IF PROVIDED THIS TEXT SHOULD PROVIDE A COMPLETE DESCRIPTION FOR (OTHER) Additional notes: Secret Internet Protocol Network (SIPRNET) access required. The contractor shall not access, download or further disseminate any special access data (i.e. intelligence, NATO, COMSEC, etc.) outside the execution of the defined contract requirements and without the guidance and written permission of the KO. In the event that any special access is required, the KO must modify the requirements for the DD Form 254. Note: Once the KO has modified the requirements for the DD Form 254, the Contractor must complete the SIPRNET Access Request Form, along with the modified DD Form 254, and forward to the KO prior to receiving access. A NATO awareness brief will also be required for all Contractors prior to access to the SIPRNET.

11a: Contractor performance is restricted. Government agency or activity will provide security classification guidance for performance of this contract. Visit request to the CM and/or Security Management Office for need-to-know verification is done through JCAVS IAW Oct 2005 memo.

11f: Contractor employees may be required to perform contract duties OCONUS in support of specific test and evaluation events.

Specific locations of such events will be provided to the contractor when the events arise. HQ ATEC will provide security oversight for OCONUS activity.

11j: The contract requires planning for and application of OPSEC in accordance with Army Regulation 530-1, Operations Security (OPSEC) and the contract clauses and statement of work. The ATEC Security Manager will advise the contractor of ATEC's Critical Information (CI), why it needs to be protected, where it is located, who is responsible for it and how to protect it. OPSEC guidance will also be provided as applicable for each unique project or program affected by this support. Individual security classification guides and test plans will be provided by the COR to the contractor for performance of this contract.

11m: IF PROVIDED THIS TEXT SHOULD PROVIDE A COMPLETE DESCRIPTION FOR (OTHER) Additional notes: The contractor is required to handle and safeguard CUI in accordance with DoDM 5200.01, Volume 4, "DoD Information Security Program: Controlled unclassified Information

(CUI)", dated 24 Feb 12 and successive editions. Additional information and instruction may be provided by HQ ATEC G-2 or its subordinate command activity security personnel. Contract performance will be at government facilities associated with HQ Army Test and Evaluation

Command (ATEC), Army Evaluation Center (AEC), Aberdeen Test Center (ATC) Aberdeen Proving Ground, Maryland, and the Operational Test

Command (OTC), Ft. Hood, Texas and Ft. Huachuca, Arizona.

UNCLASSIFIED//FOR OFFICIAL USE ONLY

US ARMY SCI ADDENDUM TO DD FORM 254

X (1)-This contract requires access to Sensitive Compartmented Information (SCI). The Commander, US Army Intelligence and Security Command (INSCOM), acting on behalf of the DA Deputy

Chief of Staff (DCS), G-2 is the Cognizant Security Authority (CSA) for the US Army, has exclusive security responsibility for all SCI released to the contractor or developed under the contract and held within the Contractor's SCI Facility (SCIF) or Co-utilization Agreement (CUA).

X (2)-The Defense Intelligence Agency (DIA) has security inspection responsibility for SCI and the

Defense Security Service (DSS) retains responsibility for all collateral information released or developed under the contract and held within the DoD Contractor's SCIF. All DD Forms 254 prepared for contracts involving access to SCI under this contract must be processed through

ACCS to the CM and Industrial Security Specialist for approval.

X (3)-The manuals, regulations, and directives checked below provide the necessary guidance for physical, personnel, and information security for safeguarding SCI, and are part of the security classification specification for this contract:

X (a)-ICD 503, Intelligence Community Information Technology Systems Security Risk

Management, Certification and Accreditation

X (b)-ICD 704 Personnel Security Standards and Procedures Governing Eligibility for Access to Sensitive Compartmented Information and Other Controlled Access Program Information

X (c)-IC Tech Spec-for ICD/ICS 705, Technical Specifications for Construction and

Management of Sensitive Compartmented Information Facilities

X (d)-Signals Intelligence Security Regulations (SISR) (Available from the CM) X (e)-Imagery Policy Series (Available from the CM) X (f)-DoDM 5105 Vol 1 – 3 SCI Administrative Security Manual.

X (g)-AR 380-28, DA Special Security System X (h)-AR 25-2, Information Assurance X (i)-AR 380-381, Special Access Programs X (j)-Army Handbook for SCI Contracts.

(k)-Other X (4)-Contract estimated completion date (PERIOD OF PERFORMANCE ONLY): 20211108

(NOTE: Option years are not to be included, as an option is not valid until exercised by the government.)

X (5)-The name, telephone number, and email and mailing address of the Contract Monitor (CM) and alternate for the SCI portion of this contract are: Kristen Gatch, Address: 2202 Aberdeen Blvd, APG, MD, 21005, Phone: 443-861-9782, Email: kristen.m.gatch.civ@mail.mil - thomas loisel, Address:

2202 Aberdeen Blvd, APG, MD, 21005, Phone: 2542881373, Email: thomas.j.loisel2.civ@mail.mil

(Additionally, identify the Security POC, phone number, and email address at the contractor’s/subcontractor’s location): Michael Carr (The CM and the contractor security officer must be registered in the Army Centralized Contracts and Security Portal (ACCS) at the level of contract, in order to process SCI actions)

UNCLASSIFIED//FOR OFFICIAL USE ONLY

X (6)-All DD Forms 254 prepared for contracts involving access to SCI under this contract must be processed through ACCS to the CM and Industrial Security Specialist for approval and to

Contractor Support Element, USAINSCOM, ACofS Security, G2 for review and concurrence of the awarded contract.

X (7)-Visit certification to DoD locations is not required, as need to know and accesses is verified at the visiting facility. Non DoD locations the contractor must process request for SCI visit certification(s) through ACCS to the CM for approval and to Contractor Support Element (CSE) for review and processing. Visit certification request must be submitted at least ten (10) working days prior to the visit.

X (8)-Debriefings: All FSO’s/CSSO’s must properly debrief all contractors from SCI through ACCS.

FSO/CSSO’s must submit the debrief request NLT 7 days and NET 10 days before actual departure. FSO’s/CSSO’s will separate all contractors from JCAVS after completion of debriefing.

X (9)-The contractor will not reproduce any SCI related material without prior written permission of the CM.

X (10)-Security Classification Guides or extracts are attached or will be provided under separate cover.

X (11)-Electronic processing of SCI requires accreditation of the equipment in accordance with ICD

503 and AR 25-2. (Note: NATO security awareness briefing is required for access to JWICS indicated in blocks 10k or 11l of DD 254.).

(12)-This contract requires a contractor Controlled Space or CUA X (13)-Request for Indoctrination/Debrief Authority X (14)-This contract requires (SI) (TK) (G) (HCS) (Add others as required) X (15)-The contractor will perform SCI work under this contract at the following location (Name of government or contractor activity, SCI SMO or CAGE Code):

Agencies: W04YAA - US Electronic Proving Ground, AZ, W469AA - US ARMY OPERATIONAL TEST

COMMAND(USAOTC),

(16)-The contractor identified in Block 6 is a Multiple Facility Organization (MFO) and is authorized to submit DD254 and SCI Addendum for the following SCI locations (Facility Name and CAGE Code).

(17)- SCI Courier Requirement