Attachment 4 - Security Classification Specification.pdf

PDF 383 KB Posted

Attached to
MC-CBRN Medical Emergency Manager Federal contract opportunity
Solicitation number
FA301626Q7062
Issued by
Department of the Air Force Air Education and Training Command

About this file

This is a Department of Defense (DoD) Contract Security Classification Specification Form (DD Form 254), which serves as a template for establishing security requirements for classified contract efforts.

The form establishes facility clearance requirements at the SECRET level and specifies the level of safeguarding required for contract performance. It identifies the prime contractor, subcontractor(s), and actual performance location, along with their Commercial and Government Entity (CAGE) codes and cognizant security offices. The form requires contractors to indicate what types of classified information they will access, including communications security (COMSEC) information, restricted data, critical nuclear weapon design information, intelligence information (both sensitive compartmented and non-SCI), special access information, NATO information, foreign government information, and other protected materials. Contractors must also specify their performance activities, such as receiving classified documents only, receiving and generating classified material, fabricating or storing classified hardware, or performing services only. The form includes sections for security classification guidance, additional security requirements beyond Industrial Security Manual (ISM) standards, inspection responsibilities, and public release procedures. It requires certification by an authorized official and mandates distribution to the contractor, subcontractor, cognizant security office, administrative contracting officer, and other relevant activities. All contractor personnel must comply with 32 CFR Part 117 and the National Industrial Security Program Operating Manual (NISPOM), including DoDI 5220.22 and AFMAN 16-1406 requirements. The form notes that classified material must be returned or destroyed within 30 days of contract completion, with destruction reports submitted to the unit security assistant.

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DEPARTMENT OF DEFENSE

CONTRACT SECURITY CLASSIFICATION SPECIFICATION

(The requirements of the DoD Industrial Security Manual apply to all security aspects of this effort.)

1. CLEARANCE AND SAFEGUARDING

a. FACILITY CLEARANCE REQUIRED

b. LEVEL OF SAFEGUARDING REQUIRED

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

a. PRIME CONTRACT NUMBER

b. SUBCONTRACT NUMBER

c. SOLICITATION OR OTHER NUMBER DUE DATE (YYYYMMDD)

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

a. ORIGINAL (Complete date in all cases)

REVISION NO.

c. FINAL (Complete Item 5 in all cases)

DATE (YYYYMMDD)

b. REVISED (Supersedes all previous specs)

DATE (YYYYMMDD)

DATE (YYYYMMDD)

4. IS THIS A FOLLOW-ON CONTRACT? YES NO. 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? YES NO. 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 (Name, Address, and Zip Code)

7. SUBCONTRACTOR

a. NAME, ADDRESS, AND ZIP CODE b. CAGE CODE c. COGNIZANT SECURITY OFFICE (Name, Address, and Zip Code)

8. ACTUAL PERFORMANCE

a. LOCATION b. CAGE CODE c. COGNIZANT SECURITY OFFICE (Name, Address, and Zip Code)

9. GENERAL IDENTIFICATION OF THIS PROCUREMENT

10. CONTRACTOR WILL REQUIRE ACCESS TO: 11. IN PERFORMING THIS CONTRACT, THE CONTRACTOR WILL:YES NO YES NO

a. COMMUNICATIONS SECURITY (COMSEC) INFORMATION

b. RESTRICTED DATA

c. CRITICAL NUCLEAR WEAPON DESIGN INFORMATION

d. FORMERLY RESTRICTED DATA

e. INTELLIGENCE INFORMATION

(1) Sensitive Compartmented Information (SCI)

(2) Non-SCI

f. SPECIAL ACCESS INFORMATION

g. NATO INFORMATION

h. FOREIGN GOVERNMENT INFORMATION

i. LIMITED DISSEMINATION INFORMATION

j. FOR OFFICIAL USE ONLY INFORMATION

k. OTHER (Specify)

a. HAVE ACCESS TO CLASSIFIED INFORMATION ONLY AT ANOTHER

CONTRACTOR'S FACILITY OR A GOVERNMENT ACTIVITY

b. RECEIVE CLASSIFIED DOCUMENTS ONLY

c. RECEIVE AND GENERATE CLASSIFIED MATERIAL

d. FABRICATE, MODIFY, OR STORE CLASSIFIED HARDWARE

e. PERFORM SERVICES ONLY

f. HAVE ACCESS TO U.S. CLASSIFIED INFORMATION OUTSIDE THE U.S., PUERTO RICO, U.S. POSSESSIONS AND TRUST TERRITORIES

g. BE AUTHORIZED TO USE THE SERVICES OF DEFENSE TECHNICAL INFORMATION

CENTER (DTIC) OR OTHER SECONDARY DISTRIBUTION CENTER

h. REQUIRE A COMSEC ACCOUNT

i. HAVE TEMPEST REQUIREMENTS

j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS

k. BE AUTHORIZED TO USE THE DEFENSE COURIER SERVICE

l. OTHER (Specify)

DD FORM 254, DEC 1999 PREVIOUS EDITION IS OBSOLETE. Adobe Professional X

12. PUBLIC RELEASE. Any information (classified or unclassified) pertaining to this contract shall not be released for public dissemination except as provided by the Industrial Security Manual or unless it has been approved for public release by appropriate U.S. Government authority. Proposed public releases shall be submitted for approval prior to release

a. TYPED NAME OF CERTIFYING OFFICIAL

Direct Through (Specify)

d. ADDRESS (Include Zip Code)

Yes No to the Directorate for Freedom of Information and Security Review, Office of the Assistant Secretary of Defense (Public Affairs)* for review.

*In the case of non-DoD User Agencies, requests for disclosure shall be submitted to that agency.

13. SECURITY GUIDANCE. The security classification guidance needed for this classified 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. Add additional pages as needed to provide complete guidance.)

14. ADDITIONAL SECURITY REQUIREMENTS. Requirements, in addition to ISM requirements, 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 cognizant security office. Use Item 13 if additional space is needed.)

Yes No15. INSPECTIONS. Elements of this contract are outside the inspection responsibility of the cognizant security office.

(If Yes, explain and identify specific areas or elements carved out and the activity responsible for inspections. Use Item 13 if additional space is needed.)

16. CERTIFICATION AND SIGNATURE. 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.

b. TITLE c. TELEPHONE (Include Area Code)

e. SIGNATURE

17. REQUIRED DISTRIBUTION

a. CONTRACTOR

b. SUBCONTRACTOR

c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR

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

e. ADMINISTRATIVE CONTRACTING OFFICER

f. OTHERS AS NECESSARY

DD FORM 254 (BACK), DEC 1999

fac_clear: SECRET
safe_level: SECRET
prime_no:
xprime: Off
sub_no:
xsub: Off
xsolic: Off
solic_no:
due_date:
xspec3: Off
orig_date:
rev_no:
rev_date:
final_date:
xfollowon: Off
prec_no:
xfinal: Yes
req_dated:
period:
ctr_name:
ctr_cage:
ctr_ofc:
sub_name:
sub_cage:
sub_ofc:
perf_loc:
perf_cage:
perf_ofc:
gen_id: Contractor may be required to attend classified briefings, review classified documents and provide analysis of classified material.
x10a: Yes
x10b: Yes
x10c: No
x10d: Yes
x10e1: No
x10e2: No
x10f: No
x10g: Yes
x10h: No
x10i: Yes
x10j: Yes
x10k: Yes
other10k: SIPRNET, NIPRNET
x11a: Yes
x11b: Off
x11c: Off
x11d: Off
x11e: Off
x11f: Off
x11g: Yes
x11h: Off
x11i: Off
x11j: Off
x11k: Off
x11l: Yes
other11l: Receive, store, or generate controlled unclassified information (CUI)
xrelease: No
release_thru: All classified material received, generated, fabricated or modified by this contract will be returned within 30 days after completion of contract or destroyed with destruction report being submitted to UNIT Security Assistant. Prior to any destruction of classified information a full listing of documents will be provided to the UNIT Security Assistant for review and approval.
guidance: All contractor personnel shall comply with the provisions of 32 CFR Part 117, December 10, 2021 National Industrial Security Program Operating Manual (NISPOM); DoDI 5220.22, National Industrial Security Program, Incorporating Change 1, Effective May 2018; DoDM 5220.22, Vol. 2, AFMAN 16-1406 Vol. 2, National Industrial Security Program: Industrial Security Procedures for Government Activities, 8 May 2020
xaddlsec: Yes
addl_sec: OPSEC requirements
xinsp: No
inspections:
cert_name:
cert_title:
cert_phone:
cert_addr:
x17a: Off
x17b: Off
x17c: Off
x17d: Off
x17e: Off
x17f: Off
other_dist:

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