Attachment 5. DD 254 Draft.pdf

PDF 70 KB Posted Dec 18, 2023

Attached to: Space Environment Technologies and Science (SETS) Call 001
Solicitation number: FA9453-23-R-X001_Call-001
Issued by: Department of the Air Force Materiel Command Research Laboratory

About this file

Written by GovTribe AI · Dec 21, 2023

This document is a DD Form 254, which is a Department of Defense Contract Security Classification Specification. It specifies that the contractor will require access to controlled unclassified information and non-SCI national intelligence. The contractor facility clearance level must be Secret and safeguarding is required at the Secret level. The general unclassified description of the procurement is for the interdisciplinary development and integration of separate discipline scientific and engineering products and products of the greater research community leading to innovative new space environment awareness, mitigation and exploitation capabilities for the joint warfighter. The contracting government agency is the Air Force Research Laboratory and the point of contact is Jessica Perez, with a response due date of November 30, 2022.

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Other files

File	Type	Posted
Attachment 1 SETS BAA Call 001 Statement of Objectives.pdf	PDF	Dec 18, 2023
Attachment 7 - Security Program Questionnaire FINAL.pdf	PDF	Dec 18, 2023
Attachment 6 - Standard Form 424 (Research and Related SeniorKey Person Profile).pdf	PDF	Dec 18, 2023
Attachment 2 - Draft DD Form 1423-1 CDRL.pdf	PDF	Dec 18, 2023
SETS BAA Call 001 Final.pdf	PDF	Dec 18, 2023
Attachment 4- Proposal Adequacy Checklist 2023.pdf	PDF	Dec 18, 2023
Attachment 3. Data Assertions Table DFARS 252.227-7017.pdf	PDF	Dec 18, 2023
DD254 Continuation Sheet for On-base Only Secret_NIPR-SIPR.pdf	PDF	Dec 18, 2023

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DRAFT

SAMPLE

PREVIOUS EDITION IS OBSOLETE.

Page of

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:

June 30, 2025 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"

CurrentPage:

PageCount:

Select classification from drop-down list.: Unclassified

Enter serial number.: FA945X23C1234

a. Facility clearance level. Select one.: 2

b. Level of safeguarding for classified information/material required at contractor facility. Select one.: 2

Select for "original.": 0

Select for "original.": 1

Enter prime contract number.:

Select for "revised.": 0

Enter subcontract number.:

Select for "final.": 1

Select for "final.": 0

Enter solicitation or other number.: FA9453-23-R-X001 Call 001

Enter due date in format YYYYMMDD.: 20221130

Enter date in format YYYYMMDD.: 20230922

Enter revision number.:

Enter date in format YYYYMMDD.:

Enter final specification.:

Enter date in format YYYYMMDD.:

Select for "no.": 1

Select for "no.": 0

Select for "yes.": 0

Select for "yes.": 1

Enter preceding contract number.:

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).: N/A

Enter typed name of certifying official (last, first, middle initial).: Perez, Jessica

Enter CAGE code of the prime contractor.: TBD

Enter CAGE code of the prime contractor.: N/A

Enter CAGE code of the prime contractor.: TBD

Enter CAGE code of the prime contractor.: N/A

Enter cognizant security office(s) (Name, Address, ZIP Code, Telephone required; Email Address optional).: TBD *Example format*

Defense Counterintelligence & Security Agency (DCSA) Detroit Field Office (734) 853-8410 17177 N. Laurel Park Drive, Suite 42, Livonia, MI 48152 dcsa.dcsa-northern.dcsa-isfo.mbx@mail.mil

Enter cognizant security office(s) (Name, Address, ZIP Code, Telephone required; Email Address optional).: N/A

Enter cognizant security office(s) (Name, Address, ZIP Code, Telephone required; Email Address optional).: **Gov't facilities only- CSO info is not required**

AFRL/RDOSC

3550 Aberdeen Ave SE Kirtland AFB, NM 87117

(505) 846-0536 Enter cognizant security office(s) (Name, Address, ZIP Code, Telephone required; Email Address optional).: TBD *Example format* Defense Counterintelligence & Security Agency (DCSA) Detroit Field Office (734) 853-8410 17177 N. Laurel Park Drive, Suite 42, Livonia, MI 48152 dcsa.dcsa-northern.dcsa-isfo.mbx@mail.mil

Select to add row to locations.:

Select to remove last row from locations.:

Select to delete all signatures.:

Enter location(s).: AFRL/RV Facilities

3550 Aberdeen Ave SE Kirtland AFB, NM 87117

Enter location(s).: TBD

Enter general unclassified description of this procurement.: The objectives of this effort are the interdisciplinary development and integration of separate discipline scientific and engineering products and products of the greater research community leading to innovative new space environment awareness, mitigation and exploitation capabilities for the joint warfighter.

Select for "a. CONTRACTOR.": 1

Select for "a. CONTRACTOR.": 0

Select for "a. CONTRACTOR.": 1

Select for "f. OTHER AS NECESSARY.": 0

Select for "f. OTHER AS NECESSARY.": 1

Select for "b. SUBCONTRACTOR.": 1

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.": 1

Select for "c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR.": 1

Select for "h. REQUIRE A COMSEC ACCOUNT.": 1

Select for "d. U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECURITY ADMINISTRATION.": 1

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.": 1

Select for "e. NATIONAL INTELLIGENCE INFORMATION: - (1) Sensitive Compartmented Information (SCI).": 0

Select for "e. NATIONAL INTELLIGENCE INFORMATION: - (2) Non-SCI.": 1

Select for "j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS.": 1

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.": Use of SIPRNet

Enter infomration for "other.": Use of KAFB AIS and Use of Classified AIS at contractor facility

Enter infomration for "other.": AFRL/PRS Security

AFRL/RDOI/SSO

Select for "e. ADMINISTRATIVE CONTRACTING OFFICER.": 0

Select for "e. ADMINISTRATIVE CONTRACTING OFFICER.": 1

Select for "l. RECEIVE, STORE, OR GENERATE CONTROLLED UNCLASSIFIED INFORMATION (CUI). .": 1

Select for "m.OTHER.": 1

Select for "direct.": 0

Select for ": 1

Enter specification for "through".: SEE CONTINUATION SHEET

Enter public release authority.: SEE CONTINUATION SHEET

Select to add signature.:

Select to remove last signature.:

text:

SEE CONTINUATION SHEET

text:

SEE CONTINUATION SHEET

Click on this button to attach a file(s).:

rep:

Enter signature.:

Explain and identify specific areas and government activity responsible for inspections.: SEE CONTINUATION SHEET

Enter GCA name.: AFRL/RVKB

Enter AAC of the contracting office.: FA9453

Enter address (include zip code).: 3550 Aberdeen Ave SE

Kirtland AFB NM 87117 Enter address (include zip code).: 3550 Aberdeen Ave SE Kirtland AFB NM 87117

Enter POC name.: Perez, Jessica

Enter telephone number (include area code).: 5058460938

Enter email address.: jessica.perez.23@us.af.mil

Enter title.: Contracting Officer

Enter the datesigned in format YYYYMMDD.:

File details come from the government source that posted it. Updated Dec 18, 2023.