Attachment 12 DD Form 254 (1).pdf

PDF 72 KB Posted Dec 16, 2025

Attached to: HC108426R0004 Enterprise Storage Solutions IV Managed Storage Service Draft Request for Proposal
Solicitation number: HC108426R0004
Issued by: Defense Information Systems Agency

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Attachment 1 Sample Task Orders (1).docx	DOCX document	Dec 16, 2025
Attachment 7 Small Business Participation Plan Template (1).docx	DOCX document	Dec 16, 2025
Attachment 9 SOFA Contract Clauses (1).docx	DOCX document	Dec 16, 2025
Appendix 12 - PWS Technical Requirements (1).xlsx	XLSX spreadsheet	Dec 16, 2025
HC108426R0004 Draft Solicitation.docx	DOCX document	Dec 16, 2025
Attachment 3 ESS IV Sample Cert Ltr (1).docx	DOCX document	Dec 16, 2025
Attachment 4 ESS IV Offeror Technical Specifications (1).xlsx	XLSX spreadsheet	Dec 16, 2025
Attachment 6 Quality Assurance Surveillance Plan (1).docx	DOCX document	Dec 16, 2025
Attachment 11 Mission-Essential Contractor Services ESS IV (1).pdf	PDF	Dec 16, 2025
Appendix 9 - EPL Worksheet (1).xlsx	XLSX spreadsheet	Dec 16, 2025
Attachment 2 ESS IV Self-Certification Checklist (1).xlsx	XLSX spreadsheet	Dec 16, 2025
Attachment 5 ESS IV Price Model (1).xlsx	XLSX spreadsheet	Dec 16, 2025
Attachment 8 Performance Work Statement (1).docx	DOCX document	Dec 16, 2025
Attachment 10 DISA Subcontracting Plan Checklist (1).docx	DOCX document	Dec 16, 2025
Appendix 8 - DISA NDA (1).docx	DOCX document	Dec 16, 2025

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PREVIOUS EDITION IS OBSOLETE.

Page of

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

SerialNum:

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

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Enter solicitation or other number.: 842468794

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Enter preceding contract number.: HC108420D0009

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Enter CAGE code of the prime contractor.: TBD

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Enter cognizant security office(s) (Name, Address, ZIP Code, Telephone required; Email Address optional).: TBD

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Enter location(s).: See block 13

Enter general unclassified description of this procurement.: The purpose of this contract is to obtain reliable, responsive, cost-effective managed services and on-demand storage capabilities for Government-approved locations located in the continental United States (CONUS) and outside of the continental United States (OCONUS). The Government’s goal is to obtain a scalable storage capability using an on-demand service approach that will readily adjust to changes in storage and throughput requirements, both increases and decreases, and is priced on a utility (as used) basis for the total lifecycle of the contract. This utility concept requires that the Contractor provide all assets needed for the storage managed service. These assets will include hardware, software, software maintenance and licensing, and all associated design capabilities, logistical services, field maintenance, and systems engineering.

Select for "a. CONTRACTOR.": 0

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

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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 "d. U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECURITY ADMINISTRATION.": 1

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.": 1

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

Enter infomration for "other.": SIPRNET ACCESS

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

Select for "l. RECEIVE, STORE, OR GENERATE CONTROLLED UNCLASSIFIED INFORMATION (CUI). .": 1

Select for "m.OTHER.": 0

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Enter specification for "through".:

Enter public release authority.: Public Release of information is not authorized

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text: General Information:

No access to classified information is required during pre-contract phases.

All classified visit requests by contractors shall be forwarded to the Agreements Officer Representative (AOR) for approval and need -to-know certification before being sent to the facility to be visited.

All visit access requests (VARs) by contractors shall be sent via the Defense Information System for Security (DISS) to the DISA VAR Center (DISS SMO: DKABAA10) or appropriate SMO for the effort. The COR/ACOR must approve the VAR prior to sending the request to the facility being visited. Contractors must also provide a copy of the VAR to the SM.

The COR/ACOR must be notified and approve the receipt and/or generation of classified information under this contract.

All classified information received and/or generated under this contract is the property of the U.S. Government regardless of proprietary claims. Upon completion or termination of this contract, the U.S. Government will be contacted for destruction or disposition instructions.

Foreign Nationals will not perform on any area of the contract (classified or unclassified).

Prime Contractor FSO will provide the Government a copy of the subcontractor DD Form 254 and subcontract memo for all their subcontracts meeting review criteria via a SM to submit for approval.

Period of performance: Period of performance for this contract is five (5) years with five (5), one year renewal options for a total life cycle of ten (10) years.

Base period is from to XX XXX XXXX to XX XXX XXXX OY1 is from XX XXX XXXX to XX XXX XXXX OY2 is from XX XXX XXXX to XX XXX XXXX OY3 is from XX XXX XXXX to XX XXX XXXX OY4 is from XX XXX XXXX to XX XXX XXXX OY5 is from XX XXX XXXX to XX XXX XXXX One six-month extension, if exercised per FAR 52.217-8 dates: from XX XXX XXXX to XX XXX XXXX

Reference Block 8a:

Place of performance, any DoD Installations worldwide

CONUS Locations:

• Chambersburg, DISA, Operations Center Logistics, 1 Overcash Ave., Bldg. 3 South, Letterkenny Army Depot, Chambersburg, PA 17201-4186

• Columbus, DISA Columbus, 3990 East Broad St., Bldg. 23, Columbus, OH 43213

• Denver, DISA Operations Center-Denver, 6162 S Willow Dr, Suite 200, Greenwood Village, Co 80111-3209

• Fort Meade, DISA Operations Center 6906 Cooper Avenue, Fort Meade, MD 20755

• Pensacola, DISA Chief Financial Executive, Cfeh91, 45 Industrial Blvd, Suite C, Pensacola, FL 32503

• Mechanicsburg, DISA Mechanicsburg, Bldg. 308 North End, 5450 Carlisle Pike, Mechanicsburg, PA 17050-0975

• Montgomery, DISA Montgomery, 401 East Moore Drive, Bldg. 857, Maxwell AFB/Gunter Annex, Montgomery, AL 36114-3001

• Ogden, DISA Ogden, 7879 Wardleigh Road, Bldg. 891, Hill AFB, UT 84056-5996

• Oklahoma City, DISA Oklahoma City, Gate 33, Se59 and Air Depot Rd, 8705 Industrial Blvd., Bldg. 3900, Tinker AFB, Oklahoma City, OK 73145-3064

• Raven Rock Mountain Complex, PA (shipping address: 114th Sig Battalion, 9200 Amber Drive Fort Detrick, MD 21702-9229)

• San Antonio, DISA San Antonio, 3326 General Hudnell Dr, San Antonio, TX 78226-2023

OCONUS Locations:

• Schofield Data Center, Bldg. 1500 Rm 103 Trimble Rd, Schofield Barracks, HI 96857

• DISA Ford Island, 477 Essex Street, Bldg. 77, Suite 183, Pearl Harbor, HI 96860

• Joint Base Pearl Harbor-Hickam Air Base, 477 Essex Street, Bldg. 77, STE 183, JBPHH, HI, 96860

• USINDOPACOM, Pacific Warfighting Center, 150 Lexington Blvd, Bldg. 510, Honolulu HI 96818

• Fort Wainwright, 507th Signal Company, Bldg. 1060, Gaffney Road, Fort Wainwright, AK 99703

• Patch Barracks, Vaihingen, Germany, DISA Europe - Stuttgart SITE A & B, Room 157, Bldg. 2340, Patch Barracks, Stuttgart, GE 70569

• Data Center Europe Wiesbaden, Flugplatz Erbenheim, Geb. 1000, Rm. T3, Wiesbaden, GE 65205

• Bahrain, DISA TECC-CR, NSA Bahrain, PSC 451 Box 200, Kingdom Of Bahrain

• South Korea, 1st Signal BDE, 41st Signal BN. 169th Signal Company ATTN: C4IS Camp Walker - Building # 205 Bong duk-dong Nam gu, Dae-gu Si 705-025

• Yokota Air Base, 374th Communications Squadron/ SCXP, Bldg. 653, Yokota Air Base, Fussa, Tokyo 197-0001, Japan

Reference Block 10j: Contractor will be provided with and will abide by DoDM 5400.07, DoD Freedom of Information Act Program, and DoDI 5200.48 Controlled Unclassified Information (CUI), Section 3.4. Guidance provided under separate cover.

Reference Block 10k: SIPRNet Access is required at the Government facility. A NATO Secret briefing is required for SIPRNet access.

Reference Block 11a: Contract performance is restricted to Government or contractor locations. See Block 8. The using contractor or Government facility will provide security classification guidance for the performance of this contract.

Reference Block 11e: Contract is for equipment maintenance services on equipment which processes classified information. Actual knowledge of, generation, or production of classified information is not required for performance of the contract. Cleared personnel are required to perform this service because access to classified information cannot be precluded by escorting personnel.

Reference Block 11f: Contractors when performing or traveling outside the United States under this contract will: a. All personnel will obtain an AOR specific foreign travel brief within 90 days of travel and will provide proof of training to the COR/ACOR. b. All personnel will receive the Antiterrorism Level I Awareness training within one year prior to travel.

Reference Block 11l: 1. DoD Components: Refer to DODI 5200.48 Controlled Unclassified Information (CUI), Section 3.4 when considering specific requirements to be imposed on the contractor for the protection of CUI. 2. Non-DoD Components must consult with your Component-specific information security policy office to determine if you have any existing authority by law.

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

rep:

Enter signature.:

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

Enter GCA name.: DISA/DITCO/PS8411

Enter AAC of the contracting office.: HC1084

Enter AAC of the contracting office.: H98272

Enter address (include zip code).: DISA/DITCO/PS8411

Bldg. 3600 2300 East Drive Scott Air Force Base, IL 62225-5406 Enter address (include zip code).: 1 Overcash Avenue, Bldg 3 Chambersburg, PA 17201

Enter POC name.: Tricia Singler

Enter telephone number (include area code).: 6678916097

Enter email address.: tricia.l.singler.civ@mail.mil

Enter title.: Contracting Officer's Representative

Enter the date signed in format YYYYMMDD.:

File details come from the government source that posted it. Updated Dec 16, 2025.