Attachment 1 - DD 254_DRAFT.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.

DRAFT

SAMPLE

PREVIOUS EDITION IS OBSOLETE.

Page of

DD FORM 254, MAY 2019

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:

20220531 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.)

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 whs.mc-alex.esd.mbx.formswebmaster@mail.mil

WHS

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

TBD

TBD

CSO: OPTEVFOR

7970 Diven Street, Bldg CA-10 Norfolk, VA 23505-1498

7970 Diven Street, Bldg CA-10 Norfolk, VA 23505-1498 Block9: Provide non-personal advisory and assistance services for the CIO CSS Service Support:

This performance work statement is to provide information technology support services to Operational Test and Evaluation Force (OPTEVFOR) in the areas of Customer Service, Cyber Security, and Configuration Management. This support will be required in one or more of the following forms: Information Technology (IT) software, hardware, system support, and administration.

AWARD DD254 to be provided upon award of Contract.

Mr. Shawn Corriveau

Contractor personnel shall not discuss classified material or unclassified technical sensitive information on any non-secure telephone or disclose such information to any unauthorized personnel.

The following provisions apply for the protection of Controlled Unclassified Information (CUI):

1. Foreign nationals (Non U.S. citizens) will be denied access to CUI unless expressly permitted by the OPTEVFOR Command Security Manager.

2. Compliance with OPTEVFOR Instruction 5239.7 Protection of Controlled Unclassified Information is required.

8a. Operational Test and Evaluation Force, 7970 Diven St, Norfolk VA 23505-1498.

10.e (2) Non-SCI intelligence information access is only required due to access to OTF SIPR NETWORK in the performance of this contract.

10 g. NATO information access is only required due to access to OTF SIPR NETWORK in the performance of this contract.

10 j. The "For Official Use Only" information provided under this contract shall be safeguarded as it is applied to OTF instructions.

11 j. OPSEC requirements IAW the NISPOM.

NATO BRIEFING IS ONLY REQUIRED TO BE DONE AT OTF AND HELD IN OTF SECURITY. NATO WILL NOT BE PUT INTO JPAS. CLASSIFIED MATERIAL MAY BE REMOVED FROM OTF BY CONTRACTORS WITH THE APPROVAL OF THE SSO/CSM/ACSM. ALL MATERIAL WILL BE ACCOUNTED FOR BY OTF SECURITY AND MUST BE RETURNED UPON COMPLETION OF THE CONTRACT.

For further information contact the Special Security Officer / Security Manager Sean Corriveau 757-457-6406 or, Command COR: Timothy R, Burrows; (757) 757-457-6563; Department of the Navy (DON) Personnel Security Program (PSP), SECNAVINST 5510.36A; Department of the Navy Information Security Program, SECNAV M5510.36 , National Industrial Security Program Operating Manual, DOD 5520.22M

a. All Visit requests to activities other than those not listed in the statement of work or this DD 254 shall have "Need to Know" certified by the OPTEVFOR Security Department. The Contractor Company will not submit any visit request for their contractors working on this contract. All visit requests will be done by OPTEVFOR Security Department. Contract companies are not required to submit any visit request for their employees.

b. All contractors will be required to do a full check-in regardless if they work on-site or off-site. All contractors are required to show up to OPTEVFOR with their own Work Authorization Memo (WAM) on company letterhead with an original signature by their companies approving authority. Photo copies of WAMS will not be accepted.

NORFOLK, VA 23511-3392

Address: OPTEVFOR

7970 DIVEN STREET, BLDG CA-10

NORFOLK, VA 23505-1498