Attachment 4 - DD254- Signed.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PREVIOUS EDITION IS OBSOLETE.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

Item: 10(j). All Controlled Unclassified Information (CUI) associated with this contract must be protected per the guidance provided for Item 11(l) of this DD Form 254.

Item: 11(c). The contractor requires access to classified source data up to and including the level of Secret. Classified material generated in support of this contract shall be classified in per its source material or SCG. Automated Information Systems (AIS) must be certified and accredited by the Cognizant Security Agency (CSA) prior to processing classified information associated with this contract.

Item: 11(d). All classified data and hardware will be protected IAW DoD 5220.22-M, National Industrial Security Program Operating Manual (NISPOM).

Item: 11(g). DD Form 1540 “Registration for Scientific and Technical Information Services” must be completed for registration with DTIC. The contractor may also submit DD Form 2345 “Militarily Critical Technical Data Agreement” (after registration with DTIC) to the Defense Technical Information Center for access to unclassified, militarily critical technical data from other DoD sources.

Item: 11(j). The Contractor shall use the NAVSEA Critical Information and Indicators List, Ser 00P-293/111 of 24 March 2020 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, NAVSEA Critical Information (CI) and/or observables and indicators which may lead to discovery of CI. NAVSEA’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: Assembled large components/systems being transported to and from testing areas, other production or government facilities (whether or not on public roadways) shall be in an enclosed van trailer or covered flatbed trailer. Component/System outside storage, staging, and test areas shall be shielded/obscured from public view wherever physically possible.

Item: 11(j). Continued: NAVSEA’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 NAVSEA 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 and Company Proprietary information related to this contract or other programs must be immediately reported to the Facility Security Officer, DCSA and/or the Naval Criminal Investigative Service, and SEA 00P3. Questions concerning these requirements shall be directed to SEA 00P3.

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 NAVSEA approves the OPSEC requirements.

Item: 11(l). All CUI associated with this contract must be safeguarded to prevent unauthorized public disclosure. CUI such as FOUO, 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 NAVSEA HQ Contracting Officer's Representative (COR) in concert with SEA 00P3 and PEO USC prior to the presentation.

The Contractor must submit a request for sharing of classified and other sensitive information between prime contracts in writing to SEA 00P3 at NAVSEAHQ_INDUSEC.fct@navy.mil. Each request must reference contract number N00024-20-R-6405 to 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 Industrial Security mailbox: NAVSEAHQ_INDUSEC.fct@navy.mil

The contractor must scan and forward the subcontractor’s DD 254s issued under this contract to the Industrial Security mailbox: NAVSEAHQ_INDUSEC.fct@navy.mil

SEA 00P3 POC: Keith G. Stevens at 202.781.3105 text:

Supply chain risk provisions are applicable to this contract.

text: Operation Security (OPSEC) requirements for this contract is reflected in item 13 of the DD Form 254 under item: 11(j).

Deputy Technology Protection rep: James T. Williams (00P3) OPSEC Program Manager

Washington Navy Yard, DC 20376 Address: Naval Sea Systems Command 1333 Isaac Hull Avenue SE Stop 9917 Washington Navy Yard, DC 20376