Attachment 2 - DD254.pdf
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- NSWCPD Touch Labor Services Federal contract opportunity
- Solicitation number
- N6449823R4026
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DRAFT
SAMPLE
PREVIOUS EDITION IS OBSOLETE.
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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
| CurrentPage: |
| PageCount: |
| Select classification from drop-down list.: Unclassified |
| SerialNum: |
| a. Facility clearance level. Select one.: 3 |
| b. Level of safeguarding for classified information/material required at contractor facility. Select one.: 4 |
| Select for "original.": 0 |
| Select for "original.": 1 |
| Enter prime contract number.: |
| Select for "revised.": 0 |
| Select for "revised.": 0 |
| Enter subcontract number.: |
| Select for "final.": 1 |
| Select for "final.": 0 |
| Enter solicitation or other number.: N6449822R4069 |
| Enter due date in format YYYYMMDD.: 20230228 |
| Enter date in format YYYYMMDD.: 20230113 |
| Enter revision number.: |
| Enter date in format YYYYMMDD.: |
| Enter final specification.: |
| Enter date in format YYYYMMDD.: |
| Select for "no.": 0 |
| Select for "no.": 1 |
| Select for "no.": 1 |
| Select for "no.": 1 |
| Select for "yes.": 1 |
| Select for "yes.": 0 |
| Select for "yes.": 0 |
| Select for "yes.": 0 |
| Enter preceding contract number.: N6449818D0009 |
| Enter contractor's request date in format YYYYMMDD.: |
| Enter period.: |
| Enter typed name of certifying official (last, first, middle initial).: TBD |
| Enter typed name of certifying official (last, first, middle initial).: Brunson, Louise, R |
| Enter CAGE code of the prime contractor.: |
| Enter cognizant security office(s) (Name, Address, ZIP Code, Telephone required; Email Address optional).: Defense Security Service Office |
TBD
| Select to add row to locations.: |
| Select to remove last row from locations.: |
| Select to delete all signatures.: |
| Enter location(s).: NSWC Philadelphia Division |
4850 S. Broad Street Philadelphia, PA 19112
| Enter general unclassified description of this procurement.: The support shall include fabrication, installation, testing, maintenance, material procurement, industrial cleaning, and removal of shipboard machinery systems and associated components throughout various test sites located at NSWCPD. |
| Select for "a. CONTRACTOR.": 0 |
| Select for "a. CONTRACTOR.": 1 |
| Select for "a. CONTRACTOR.": 1 |
| Select for "f. OTHER AS NECESSARY.": 0 |
| Select for "f. OTHER AS NECESSARY.": 0 |
| Select for "f. OTHER AS NECESSARY.": 1 |
| Select for "b. SUBCONTRACTOR.": 0 |
| Select for "b. SUBCONTRACTOR.": 0 |
| Select for "b. SUBCONTRACTOR.": 0 |
| Select for "g. BE AUTHORIZED TO USE THE SERVICES OF DEFENSE TECHNICAL INFORMATION CENTER (DTIC) OR OTHER SECONDARY DISTRIBUTION CENTER.": 0 |
| 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.": 0 |
| Select for "c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR.": 1 |
| Select for "h. REQUIRE A COMSEC ACCOUNT.": 0 |
| 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.": 0 |
| Select for "d. U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECURITY ADMINISTRATION.": 0 |
| Select for "i. HAVE A TEMPEST REQUIREMENT.": 0 |
| 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.": Naval Nuclear Propulsion Information (NNPI) |
| Enter infomration for "other.": Code 02, Code 105, SEA 08 |
| Select for "e. ADMINISTRATIVE CONTRACTING OFFICER.": 1 |
| Select for "e. ADMINISTRATIVE CONTRACTING OFFICER.": 1 |
| Select for "l. RECEIVE, STORE, OR GENERATE CONTROLLED UNCLASSIFIED INFORMATION (CUI). .": 0 |
| Select for "m.OTHER.": 0 |
| Select for "direct.": 0 |
| Select for ": 0 |
| Enter specification for "through".: |
| Enter public release authority.: No public release is authorized. |
| Select to add signature.: |
| Select to remove last signature.: |
| text: All contractor personnel assigned to this contract and performing its required services on site as reflected in Item 8 of this DD254 shall be United States citizens and possess a personnel security clearance at the CONFIDENTIAL level. There are no safeguarding requirements required. |
Item: 10(k) 6. The contractor must maintain a current Certification of eligibility from the Defense Logistics Agency, Joint Certification Office for access to export-controlled Controlled Unclassified Information (CUI), which includes U-NNPI. DD Form 2345, Militarily Critical Technical Data Agreement, applies.
Item: 10(j). All Controlled Unclassified Information associated with this contract must be protected per the guidance provided for Item 11(l) of this DD Form 254.
Item 11 (a): Access to classified information, if applicable, will be provided by the sponsoring Program Office at the performance location reflected in Item 8.a of this DD Form 254. The contractor shall comply with all access control and visitor procedures when traveling to any location determined by the sponsoring Program Office in performance of this contract.
Item: 11(j). The Contractor shall utilize the NSWCPD Critical Information List, to help identify and protect critical information associated with this contract.
Item: 11(j). Continued: During the period of this contract, the Contractor may be exposed to, use, or produce, NSWCPD Critical Information (CI) and/or observables and indicators which may lead to discovery of CI. NSWCPD’s CI will not be distributed to unauthorized third parties, including foreign governments, or companies under Foreign Ownership, Control, or Influence (FOCI) Item: 11(j). Continued: NSWCPD’s CI shall not be publicized in corporate wide newsletters, trade magazines, displays, intranet pages or public facing websites. Media requests related to this project shall be directed to NSWCPD Public Release Authority listed in Item 12 of this DD Form 254.
Item: 11(j). Continued: Any attempt by unauthorized third parties to solicit, obtain, photograph, or record, or; incidents of loss/compromise of government Classified or CI, Business Sensitive, Company Proprietary information related to this or other program must be immediately reported to the Facility Security Officer, Defense Counterintelligence & Security Agency and/or the Naval Criminal Investigative Service, and the NSWCPD Industrial and Operations Security (Code 1051). Questions concerning these requirements shall be directed to the NSWCPD Industrial and Operations Security Division (Code 1051).
Item: 11(j). Continued: Performance under this contract requires the contractor to adhere to OPSEC requirements. OPSEC requirements are additional to the requirements of DoD 5220.22-M, National Industrial Security Program Operating Manual, therefore, the Contractor may not impose OPSEC requirements on its subcontractors unless NSWCPD approves the OPSEC requirements.
Item: 11(l).: U-NNPI CUI must be protected in accordance with OPNAVINST N9210.3 and may not be stored on Non-federal AIS without written authorization of NAVSEA 08, Naval Reactors.
Item: 11(l). All Controlled Unclassified Information (CUI) associated with this contract must be safeguarded to prevent unauthorized public disclosure. CUI such as FOUO, Security Classification Guides (SCG), and other technical information with Distribution Statements B, C, D, E or F are not authorized for public release and cannot be placed on a publicly accessible web site or web server. All emails containing such information or attachments, shall be protected per NIST SP-800-171. All transmissions to personal email accounts (AOL, Yahoo, Hotmail, Comcast, etc.) and posting on social media websites (Facebook, Instagram, Twitter, LinkedIn, etc.) are prohibited. Destroy all CUI associated with this contract by any of the following approved methods: A cross-cut shredder; a certified commercial destruction vendor; a central destruction facility; incineration; chemical decomposition; pulverizing, disintegration; or methods approved for classified destruction.
Classified or unclassified technical papers to be presented at a classified symposium must be approved by the NSWCPD Contracting Officer's Representative (COR) in concert with NSWCPD Code 1051 and PEO prior to the presentation.
The Contractor must submit a request for sharing of classified and other sensitive information between prime contracts in writing to the NSWCPD Industrial and Operations Security Division (Code 1051.). Each request must reference the contract number and identify the specific information for which approval is being sought, a justification for needing to share the information, the name of other contractor and its contract number under which the requested information will be shared.
Personnel designated as derivative classifiers shall receive derivative classification training prior to access from the contractor's Facility Security Officer (FSO). The FSO shall ensure personnel receive initial and annual refresher training during the life of this contract. Evidence of completion, training certificates or equivalent, shall be provided to the Information System Security Manager (ISSM) no later than the individual's due date.
All classified documents must be destroyed using a National Security Agency (NSA) approved high security crosscut shredder listed on the NSA/CSS evaluated products list (EPL) for high security crosscut paper shredders, or other approved method for destroying classified information.
Copies of preliminary inquiry or investigative reports of security incidents involving classified information shall be scanned and forwarded to the NSWCPD Industrial Security, code 1051.
The contractor must also provide a copy of the subcontractor DD 254s issued under this contract to NSWCPD Industrial Security office.
Contact the COR and the certify official in block 17 on this DD254 for any security questions related to this contract.
Contractor must submit a request for sharing of classified and other sensitive information between prime contracts and subcontractor in writing to the certifying official identified in Item 17 of this DD254.
This DD254 is for solicitation purposes only; therefore, it must be returned to certify official in block 17 of this form to be updated with a contract number upon contract award before the contract DD254 can be issued to the contractor.
Contracting Officer: Edward D'Imperio, Code 0241, edward.dimperio@navy.mil, (215) 897-2187.
| 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.: NSWC Philadelphia Division Code 02 |
| Enter AAC of the contracting office.: N64498 |
| Enter AAC of the contracting office.: N64498 |
| Enter address (include zip code).: NSWCPD S. Broad Street |
Building 633, Philadelphia PA 19112 Enter address (include zip code).: NSWCPD 4700 S. Broad Street, Code 1051 Building 29, 1st Flr, Philadelphia PA 19112
| Enter POC name.: Mario D'Adamo |
| Enter telephone number (include area code).: 2672512347 |
| Enter telephone number (include area code).: 2158972031 |
| Enter email address.: mario.s.dadamo.civ@us.navy.mil |
| Enter title.: Security Contracting Officer |
| Enter the datesigned in format YYYYMMDD.: |
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