Attachment 12 - DRAFT LOGNET 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PREVIOUS EDITION IS OBSOLETE.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)

POW/MIA Drive, Bldg P40, Suite E1004 Scott, AFB IL 62225 *See Block 13*

HQ AMC/A4PI, Scott AFB, IL and other CONUS/OCONUS locations listed in block 13.

Integrated Support Facility (EWAISF) Network

Item 8.a., CONUS site locations are: Scott AFB, IL; Joint Base Andrews, MD; Joint Base Charleston, SC; Dover AFB, DE;

Fairchild AFB, WA; Tinker AFB, OK; Little Rock AFB, AR; MacDill AFB, FL; Joint Base Lewis-McChord, WA; McConnell AFB, KA; Joint Base McGuire-Dix-Lakehurst, NJ; Pope Army Air Field, NC; Travis AFB, CA; Dyess AFB, TX; Robins AFB, GA; other locations as determined by future requirements. OCONUS sites are: Ramstein AB, Germany; Joint Base Pearl Harbor-Hickam, HI Item 8.c, Contract security oversight is the responsibility of the host Servicing Security Office at all locations.

Item 10.a., Contractor will require access to COMSEC information at the on-base locations listed in item 8a. Contractor will not require their own COMSEC account. Access will be controlled by the sponsoring agency. Contractor will protect COMSEC material IAW directives deemed necessary by the installation COMSEC officer. Access to COMSEC material by personnel is restricted to U.S. citizens holding final U.S. Government clearances. Such information is not releasable to personnel holding only reciprocal clearances.

Item 10.j, For Official Use Only (FOUO) information provided under this contract shall be managed and safeguarded IAW DoDM 5200.01-V4, Enclosure 3, 2., FOUO Information.

Item 10.k., The Government will provide classified network access to include e-mail and web browser. Contractors will be held accountable for actions they initiate on the network and will conduct business IAW USAF, AMC, and local base instructions and policies. Sponsoring government agency will provide Information Assurance training prior to contractor access to network services.

Item 11.a., Contract performance is restricted to the locations identified in item 8a. The highest level of security clearance required for contract performance is Secret. Using activities will provide security classification guidance for performance of this contract.

The government will oversee the handling and storage of classified information in support of this contract. The Government will provide storage capability for all classified material required for this contract. All classified information shall be returned to the government upon termination of the contract.

Item 11.f., Contractor personnel will be assigned to locations listed in 8.a above, and require access to classified information. Contractor personnel deployed to overseas locations may have access to classified information under the control of U.S. Military, Host Nation Military, or Embassy personnel. The storage of classified information by contractor employees at any location abroad that is not under U.S. Government control is prohibited.

Item 11.j., Contractor will follow base and unit Operations Security guidance (SOPs, OIs, etc.) for the locations identified in item 8a. A copy of the local guidance will be provided to the contractor.

DoD 5220.22-M, Feb 06 (Change 1 Mar 2013), Section 2-211, "2-211. Interim PCLs (Personnel (Security) Clearance). Applicants for TOP SECRET, SECRET, and CONFIDENTIAL PCLs may be routinely granted interim PCLs, as appropriate, provided there is no evidence of adverse information of material significance. The interim status will cease if results are favorable following completion of full investigative requirements. Non-U.S. citizens are not eligible for access to classified information on an interim basis.

a. An interim SECRET or CONFIDENTIAL PCL is valid for access to classified information at the level of the eligibility granted, except for RD, COMSEC Information, and NATO information. An interim TOP SECRET PCL is valid for access to TOP SECRET information, RD, NATO Information, and COMSEC information at the SECRET and CONFIDENTIAL level. Access to SCI and SAP information based on an interim PCL is a determination made by the granting authority.

the Notification of Government Security Activity Clause, AFFARS 5352.204.9000, and Visitor Group Security Agreements Clause. Visitor Groups will safeguard all collateral classified information IAW DoDM 5200.01, DoD Information Security Program; AFI 16-1404, Information Security Program Management; AFI 16-1406, Industrial Security Program Management, and other directives deemed necessary by the servicing HQ AMC/IP. Prior approval of the contracting activity is required for subcontracting.

Enter your name here.: When contractors are designated as Visitor Groups on Air Force installations, Industrial Security Reviews for collateral classified information will be conducted by HQ AMC/IP. Defense Security Service retains cognizance over the cleared contractor facility.

Bldg P40, Suite E1004 Scott AFB, IL 62225-5022 Address: 763d ESS 510 POW/MIA Drive, Bldg P40, Suite E1004 Scott AFB, Illinois 62225-5022