Attachment 2 - CyOFTS III DD254 2Apr25.pdf

CLASSIFICATION (When filled in): Unclassified r ,/

SOLICITATION

DEPARTMENT OF DEFENSE 0MB No. 0704-0567

CONTRACT SECURITY CLASSIFICATION SPECIFICATION 0MB approval expires:

(The requirements of the National Industrial Security Program (NISP) apply lo all security aspects of this effort involving classified information.) June 30. 2025

The public reporting burden for this collection of information, 0704-0567, is estimated to average 36 minutes per response, including the time for reviewing instructions. searching ex,stmg data sources, gathering and maintaining lhe 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 •,-.hs mc-aiex esd mbx dd-dod-1nformat1on-co11ect1ons,g.ma11 miL Respondents should be aware lhat notwilhstandmg any other prov1s1on of law. no person shall be subiect to any penalty for fa1hng to comply with a collection of 1nformat1on if it does not display a currently valid 0MB control number.

RETURN COMPLETED FORM AS DIRECTED IN THE INSTRUCTIONS.

1. CLEARANCE AND SAFEGUARDING

a. LEVEL OF FACILITY SECURITY CLEARANCE (FCL) REQUIRED b. LEVEL OF SAFEGUARDING FOR CLASSIFIED INFORMATION/ (See Instructions) MATERIAL REQUIRED AT CONTRACTOR FACILITY

Top Secret None (Sec instnictions)

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

a. PRIME CONTRACT NUMBER (See instructions.)

DA TE (YYYYMMDD)

a. ORIGINAL (Complete date in all cases.)

b. SUBCONTRACT NUMBER b. REVISED (Supersedes all previous specifications.)

□ REVISION NO. DA TE (YYYYMMDD)

c. SOLICITATION OR OTHER NUMBER DUE DATE (YYYYMMDD)

� F1\8773-2X-D-XXXX □

c. FINAL (Complete /fem 5 in all cases.) DA TE (YYYYMMDD)

4. IS THIS A FOLLOW-ON CONTRACT? l:8J No D Yes If yes. complete the following:

Classified material received or generated under (Preceding Contract Number) is transferred to this follow-on contract.

5. IS THIS A FINAL DD FORM 254? l:8J No D 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 b. CAGE CODE c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address. ZIP Code, Telephone required; Email Address oplional)

TBD Dcli.:nsc Counterintelligence Security Agency (DCSA)

TBD

TBD

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.) b. CAGE CODE c. COGNIZANT SECURITY OFFICE(S) (CSO) 39 IOS, 208 Hartson St. (Bldg 90074). I lurlbun Field. FL: /If appl,cable. (Name, Address. ZIP Code. Telephone required: Email Address optional) 39 10 , 210 Hartson St. (Bldg 90077). I lurlbun Field, Fl.: see Instructions)

39 IOS Oct. I. 3515 S. Gencrnl McMullen (Bldg. 4). JBS/\-Lackland.

TX; and 39 IOS Oct. 2, 613 l langar Rd., Bldg. 4116, Room 208 Keesler AFB. MS 39534

9. GENERAL UNCLASSIFIED DESCRIPTION OF THIS PROCUREMENT

Dcpartmcn1 of Defense (DOD) and inter-agency Panncrs suppo,1 across a broad range of technical and engineering tasks for the design, development. and sustainment or specialized infonnation technologies (IT) as well as full system development lite-cycle suppon for global systems and network architectures. This suppon includes engineering to enhance operations, sustainment. integration. and improvcmcnlS to sysh:ms and nc.:lworks.

DD FORM 254, APR 2018 PREVIOUS EDITION IS OBSOLETE. Page 1 of 4

CLASSIFICATION (When filled in): Unclassified SOLICITATION

D 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.)

Upon notification of the presence of a visitor group, the Chief, lnfonnation Protection will provide the local Sl.'Curity policies where classified perfonnance will occur. These procedures must be in writing (e.g. email, electronic media, or paper). Prior approval of the contracting activity is required for subcontracting.

See SSO addendum for Release of SCI Intelligence/Non-Intelligence lnfonnation (Part A & B) for additional security requirements. Prior approval of the contracting activity is required for subcontracting. All DD FMs 254 prepared for a subcontract by the prime contract will be forwarded to the government contracting monitor and SSO ACT for review and concurrence prior to award of the subcontract. Access to intelligence infonnation will require special briefings and final U.S. Government Top Secret clearance with ICD 704 eligibility. See attachment for additional SAP security requirements.

15. INSPECTIONS

Elements of this contract are outside the inspection responsibility of the CSO.

D 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.)

When contractors are designated as Visitor Groups on Air Force installations, Industrial Security Reviews for collateral classified infonnation will be conducted by the Servicing Security Activity. SSO ACC (HQ ACC/ A2S) has exclusive security responsibility for all SCI classified material released to or developed under this contract and held at the government SCI facility. Defense Counterintelligence and Security Agency retains cognizance only over non-SCI material released to or developed under the contract and held within the contractor's cleared facility. See attachment for additional SAP security requirements.

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

a.GCA NAME

ACC Acquisition Management & Integration Ctr

c. ADDRESS (Include ZIP Code) Building 4012 Hilltop Rd Ste. 119

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

Tinker AFB, OK 73145

FA4890

17. CERTIFICATION AND SIGNATURES

d.POC NAME

Melissa Mitchell e.POC TELEPHONE (Include Area Code)

+I (850) 691-2441 f.EMAIL ADDRESS (See Instructions) mclissa.mitchell.7@us.af.mil

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) d. AAC OF THE CONTRACTING OFFICE h. SIGNATURE (See Instructions) (See Instructions)

TBD FA4890

b. TITLE

Contracting Officer

c. ADDRESS (Include ZIP Code) ACC AMIC Del 2 Building 4012 Hilltop Rd Ste. 119 Tinker AFB, OK 73145

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

f. TELEPHONE {Include Area Code)

g. EMAIL ADDRESS (See Instructions)

i. DATE SIGNED (See Instructions)

18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL

� a. CONTRACTOR "71 f. OTHER AS NECESSARY (If more room is needed, continue in Item 13 or on

□ b. SUBCONTRACTOR

"71 c. COGNIZANT SECURITY OFFICE FOR PRIME AND

� SUBCONTRACTOR

□ d. U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECURITY

ADMINISTRATION

[81 e. ADMINISTRATIVE CONTRACTING OFFICER

� additional page if necessary.)

mark.dozier@us.af.mil jadis.rhodin. l@us.af.mil rodney.rush. l@us.af.mil michael.white.7@us.af.mil

DCSA:TBD

DD FORM 254, APR 2018 PREVIOUS EDITION IS OBSOLETE.