Attachment 4 - PTR DD Form 254 - 30 Jul 25.pdf

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CONTROLLED UNCLASSIFIED INFORMATION (CUI) ADDENDUM

Executive Order 13526 has specified certain types of unclassified information require application of access, distribution controls, and protective measures for a variety of reasons. This information is referred to collectively as CUI.

CUI is identified as one of the following categories:

• Official Use Only (FOUO)

• Law Enforcement Sensitive (LES)

• DoD Unclassified Controlled Nuclear Information (DoD UCNI)

• Limited Distribution

• Department of State (DoS) Sensitive But Unclassified (SBU) Information

• Drug Enforcement Administration (DEA) Sensitive Information

• Foreign Government Information

• Distribution Statements On Technical Documents

For the purpose of this addendum, we will identify controls and protective measures for FOUO.

Therefore, when CUI other than FOUO is to be provided to or generated by DoD contractors, the controls and protective measures to be applied shall be described in the pertinent contract documents (e.g., contract clause and/or statement of work).

FOUO Markings and Protection. It is the responsibility of the document’s originator to determine at origination whether the information may qualify for FOUO status and to ensure markings are applied as required.

Markings:

• Documents shall be marked “FOR OFFICIAL USE ONLY” at the bottom of the outside of the front cover (if there is one), the title page, the first page, and the outside of the back cover (if there is one).

• Internal pages of the document that contain FOUO information shall be marked “FOR OFFICIAL USE ONLY” at the bottom. Optionally, for consistency with classified systems, internal pages may be marked “UNCLASSIFIED//FOR OFFICIAL USE ONLY” or “UNCLASSIFIED//FOUO”; in such case internal pages shall be marked at both the top and bottom.

• Subjects, titles, and each section, part, paragraph, or similar portion of an FOUO document shall be marked to show that they contain information requiring protection. Use the parenthetical notation “(FOUO)”

• Each part of electronically transmitted messages, including e-mail, containing FOUO information shall be marked as required by paragraph 2.c of this enclosure. Unclassified messages containing FOUO information shall be marked “FOR OFFICIAL USE ONLY”

• After working hours, FOUO information may be stored in unlocked containers, desks, or cabinets if Government or Government-contract building security is provided. If such building security is not provided or is deemed inadequate, the information shall be stored in locked desks, file cabinets, bookcases, locked rooms, etc.

• Transmittal documents that have FOUO attachments, but no classified material attached, shall be marked with the following statement or a similar one: “FOR OFFICIAL USE ONLY

ATTACHMENT.”

CONTROLLED UNCLASSIFIED INFORMATION (CUI) ADDENDUM

• Computer files and other electronic media, audiovisual media, chart, maps, films, sound recordings, etc., which contain FOUO will be

Protection of FOUO Information:

• During duty hours, contractors will take reasonable steps to minimize the risk of access by unauthorized personnel

• After working hours, FOUO information may be stored in unlocked containers, desks, or cabinets if Government or Government-contract building security is provided. If such building security is not provided or is deemed inadequate, the information shall be stored in locked desks, file cabinets, bookcases, locked rooms, etc.

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 [1] (All Files Must be Attached Prior to Signing, i.e., for any digital signature on the form) 2020 CUI Addendum.pdf

See Block 13 continuation

mark.dozier@us.af.mil (AMIC Security) 20FWIP@us.af.mil; 4fwippersonnelse@us.af.mil 366fw.ip@us.af.mil; 23WgIP@us.af.mil; 7bw.ip@us.af.mil;

28bwindustrialsec@us.af.mil;

49.fw.information.protection@us.af.mil dcsa.ncr.dcsa-isfo.mbx.hanover-field-office-1@mail.mil

Ref 10a: 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 releaseable to personnel holding only reciprocal clearances.

Ref 10j: Controlled Unclassified Information (CUI). See Attachment.

Ref Item 10k: The government will provide classified/unclassified (SIPRNET/NIPRNET) network access to include e-mail and web browser. Contractor will be held accountable for actions they initiate on the network and will conduct business IAW USAF, ACC, and local base instructions and policies. Sponsoring government agency will provide Information Assurance training prior to contractor access to network services. STE access is required for contract performance. Access will be controlled by the sponsoring agency. Contractor will follow requirements IAW AFI 33-201 V9. STE/Secure VOIP access is required for contract performance. Access will be controlled by the sponsoring agency. Contractor will follow requirements IAW AFMAN 33-283, Communications Security (COMSEC) Operations.

Ref Item 11a: 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.

The following Security Classification Guides are applicable to this contract and shall be adhered to during the performance of contract requirements:

Title Office of Origin

a. Range Threat Systems Classification Guide (SCG), OO-ALC/LHR, 9 Apr 14

b. Security Classification Guide B-1B, OC-ALC/LAB, June 2011

c. B-52 A-H Weapon System Master SCG, OC-ALC/LHMR, 1 Feb 16

d. AFTTP 3.1 (S/NF) Threat Guide, AWFC/TD, 2 Jul 10

Ref 11j: Contractor will follow base and unit Operations Security (OPSEC) guidance (SOPs, OIs, etc) for the locations identified in item 8a.

129 Andrews St Langley AFB, VA 23665 Address: ACC AMIC/PKB 129 Andrews St Langley AFB, VA 23665