Attachment 2 - DD 254 (final).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PREVIOUS EDITION IS OBSOLETE.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:

May 31, 2022 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 Hide Attachment Bar

Alexandra2 Field Office (IOFCS2) 2331 Mill Road, 4th Floor Alexandria, VA 22314 571-551-7940

Multiple Locations:

SYSTEM APPLICATION AND TECHNOLOGIES, INC

BLDG 8695 Nike Ave Orogrande Base Camp Orogrande, NM 88342

TMD Defense and Space LLC 1 LTV Dr.

El Paso, TX 79928-7700 uestions concerning classification should be referred to the COR/Technical Point of Contact: Todd Barks, DSN 746-1597; COM 256-876-1597; email- todd.d.barks.civ@mail.mil, Security Manager/SSO: Terry D. Vital, 256-876-8624, email: terry.d.vital.civ@mail.mil, Facility Security Officer: Tiffany Ledbetter, 240-764-2704, email: tledbetter@sa-techinc.com

The contract effort to be performed under this contract normally will not be classified. However, in the performance of this contract, information may need to be released to or generated by the contractor and/or subcontractor which reveals the performance or specifications of a particular weapon system or target. In addition, information may need to be released to allow the contractor and/or subcontractor to fabricate, modify, install and store signature modification hardware. Classification of information in this category should be classified in accordance with the particular Security Classification Guide associated with that system.

(10a). COMSEC, access shall be IAW 5220.22-M and AR 380-40. Written concurrence of the CM/GCA is required prior to Subcontracting. Comsec material/information may not be released to DOD contractors without TSMO approval.

(10f): Discussion, storage, or processing of SAP information associated with this contract will be conducted in facilities specifically accredited by the Army SAPCO (or designee), or equivalent component-level SAPCO. SAP activities are governed by Revision 1 Department of Defense Overprint to the NISPOM and AR 380-381 Item (10j): See Attachment 1 (FOUO Instructions)

(11c): Information generated under this contract as of the effective date of this revision/new DD254 will be marked in accordance with the source documents and will be marked as follows:

DERIVED FROM: Source document, multiple sources, or security classification guide, date and POC.

DECLASSIFY ON: Date/event from source document or "source marked QADR" DATE OF SOURCE: Date of source document or Security Classification Guide

Using contractor or activity will furnish complete declassification guidance for the services to be performed. The highest level of classification for the contract is SECRET. No classified hardware will be produced for this effort.

(11j): The effort will require a OPSEC plan IAW AR530-1

Contractor and/or subcontractor must provide adequate GSA-approved container storage at their facilities for classified documents and hardware to the level of SECRET. Contractor and/or subcontractor must additionally provide Closed Areas for open storage of classified documents and large hardware items to the level of SECRET. Contractor and/or subcontractor require SIPRNET access.

When practical, the contractor and/or subcontractor shall implement security controls which are appropriate for future revision of this DD-254 to include TOP SECRET / SCI information and hardware.

The Contractor and/or subcontractor shall comply with the provision of DoD 5220.22-M National Industrial Security Program Operating Manual (NISPOM)

ATTN:SFAE-STRI-CT2-S, BLDG 4497 DIGNEY ROAD

REDSTONE ARSENAL AL 35898-7461