Attachment 1 Draft DD254.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PREVIOUS EDITION IS OBSOLETE.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:

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

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

3300 Russell Road

10e.2. Contractor requires access to the SIPRNet (at government activity). Although Intelligence information is available on SIPRNet, and could be inadvertently accessed, there is no valid requirement for Intelligence information at this time; therefore, prior approval by the Government Contracting Activity (GCA) for subcontracting is not required. The contractor shall not intentionally access/download Intelligence information from the SIPRNet. In the event, Intelligence information is required, the GCA and the TECOM security office will modify this contract/DD-254. In addition, there is no valid requirement for NATO access, however inadvertent access may occur because NATO information is available on the SIPRNet. NATO Awareness Briefs will be reviewed, acknowledged, signed, and retained on file by the TECOM Security Office. Access to NATO information requires a final U.S. Government clearance and special briefings at the appropriate level.” 10g. Same NATO information above. 10h. Foreign Government Information (FGI) is information provided to the U.S. by a foreign government or any element thereof with the expectation, expressed or implied, that the information, the source of the information or both, are to be held in confidence; or produced by the U.S. pursuant to, or as a result of, a joint arrangement with a foreign government requiring that the information, the arrangement, or both are to be held in confidence. the GCA and the servicing security office. will accept request for access and provide approval prior to granting FGI access to a subcontractor. Access to classified FGI requires a final U.S. Government clearance at the appropriate level, prior to access. 10j. The contractor shall comply with the requirements of the SECNAVINST 5510.36B and DoDI 5200.48 for guidance when access to Controlled Unclassified Information (CUI) is required in performance of this contract. 10k. Secret Internet Protocol Router Network (SIPRNet) access is required. While accessing the SIPRNet, the contractor is limited to information for which there is a need-to-know, and shall not access, download or, further disseminate any special access data (e.g. Intelligence, NATO, COMSEC, etc.) outside the execution of the defined contract requirements and, or without the guidance and written permission of GCA . In the event that any special access is required, the GCA will modify the contract requirements for a revised DD-254. A final U.S. Secret clearance and Secret access is the minimum level required prior to submitting a SIPRNet package. NATO Awareness Briefings are required when NATO access is not recorded in DISS. The SIPRNet package may include, but is not limited to, the NATO Awareness brief, SIPRNet Training and Awareness brief, Derivative Classification Training certificate, annual security training certificates, DD-254 (subcontractor DD-254, if applicable), COMSEC briefs (if applicable), and a SAAR form. Facility Security Officers (FSOs) are responsible for submitting and renewing visit requests via DISS for each SIPRNet account holder/request. 11f. The contractor may be required to travel outside U.S. Territories and will have access to classified information in support of this contract. Exact locations of support are identified in section 8 (or an additional attachment). Local security clauses for International Contracts, which provides information on how to protect classified material in foreign countries may be available from the local servicing security office. 11g. The contractor may also submit DD Form 2345 “Militarily Critical Technical Data Agreement” (after registration with DTIC) to the Defense Logistics Services Center for access to unclassified, militarily critical technical data from other DoD sources. The GCA must certify the need-to-know to DTIC. 11j. OPSEC Requirements. While performing aboard NAVY/USMC sites, the contractor shall comply with the provisions of DoD Directive 5205.02E, "DoD Operations Security (OPSEC) Program," SECNAV 3070.2, Marine Corps Order 3070.2A and the locally approved Security / Instruction Manual, at all other sites the contractor shall comply with the local command and/or program OPSEC plan.

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