Attachment 5 - Draft DD 254.pdf

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Appendix A

CUI/FOUO DD FORM 254 ATTACHMENT

Contract Number:

PROTECTING “CONTROLLED UNCLASSIFIED INFORMATION (CUI)/FOR OFFICIAL USE ONLY INFORMATION

1. GENERAL:

a. The "For Official Use Only" (FOUO) marking is assigned to information at the time of its creation in a DoD User Agency. It is not authorized as a substitute for a security classification marking but is used on official government information that may be withheld from the public under exemptions 2 through 9 of the Freedom of Information Act (FOIA).

b. Other non-security markings, such as "Limited Official Use" and "Official Use Only" are used by non-DoD User Agencies for the same type of information and should be safeguarded and handled in accordance with instruction received from such agencies.

c. Use of the above markings does not mean that the information cannot be released to the public under FOIA, only that the Government must review the information prior to its release to determine whether a significant and legitimate government purpose is served by withholding the information or portions thereof.

2. MARKINGS:

a. An unclassified document containing FOUO information will be marked "For Official Use Only" at the bottom of the front cover (if any), on the first page, on each page containing FOUO information, on the back page, and on the outside of the back cover (if any).

b. Within a classified document, an individual page that contains both FOUO and classified information will be marked at the top and bottom with the highest security classification of information appearing on the page. If an individual portion contains FOUO information but no classified information, the portion will be marked, "FOUO."

c. Any "'For Official Use Only" information released to a contractor by a DoD User Agency is required to be marked with the following statement prior to transfer.

“This document contains information EXEMPT FROM MANDATORY DISCLOSURE UNDER THE FOIA. Exemptions apply.”

d. Removal of the "For Official Use Only" marking can only be accomplished by the originator or other competent authority. When the "For Official Use Only" status is terminated, all known holders will be notified to the extent practical.

3. DISSEMINATION: Contractors may disseminate "For Official Use Only" information to their employees and subcontractors who have a need for the information in connection with a classified contract. Contractors must ensure employees and subcontractors are aware of the special handling instructions detailed below.

4. STORAGE: During working hours, "For Official Use Only" information shall be placed in an out-of-sight location if the work area is accessible to persons who do not have a need for the information. During nonworking hours, the information shall be stored to preclude unauthorized access. Filing such material with other unclassified records in unlocked files or desks, is adequate when internal building security is provided during nonworking hours. When such internal security control is not exercised, locked buildings or rooms will provide adequate after- hours protection or the material can be stored in locked receptacles such as file cabinets, desks, or bookcases.

5. TRANSMISSION: "For Official Use Only" information may be sent via first-class mail or parcel post. Bulky shipments may be sent by fourth-class mail. DoD components, officials of DoD components, and authorized DoD contractors, consultants, and grantees send FOUO information to each other to conduct official DoD business. Tell recipients the status of such information, and send the material in a way that prevents unauthorized public disclosure. Make sure documents that transmit FOUO material call attention to any FOUO attachments. Normally, you may send FOUO records over facsimile equipment. To prevent unauthorized disclosure, consider attaching special cover sheets, the location of sending and receiving machines, and whether authorized personnel are around to receive FOUO information. FOUO information may be passed to officials in other departments and agencies of the executive and judicial branches to fulfill a government function. Mark the records "For Official Use Only" and tell the recipient the information is exempt from public disclosure under the FOIA and requires special handling.

6. DISPOSITION: When no longer needed, FOUO information must be shredded.

7. UNAUTHORIZED DISCLOSURE: Unauthorized disclosure of "For Official Use Only" information does not constitute a security violation but the releasing agency should be informed of any unauthorized disclosure. The unauthorized disclosure of FOUO information protected by the Privacy Act may result in criminal sanctions and disciplinary action may be taken against those responsible.

Appendix B

CONTRACT # TBD

SOLICITATION #

NVESD # 000657

US ARMY SCI ADDENDUM TO DD FORM 254, (20200519)

XXX (1) This contract requires access to Sensitive Compartmented Information (SCI). The Commander, US Army Intelligence and Security Command (INSCOM), acting on behalf of the DA Deputy Chief of Staff (DCS), G-2 as the Cognizant Security Authority (CSA) for the US Army, has exclusive security responsibility for all SCI released to the contractor or developed under the contract and held within the Contractor's SCI Facility (SCIF) or Co-utilization Agreement (CUA) SCIF. The Defense Intelligence Agency (DIA) has security inspection responsibility for SCI and the Defense Security Service (DSS) retains responsibility for all collateral information released or developed under the contract and held within the DoD Contractor's SCIF. The manuals, regulations and directives checked below provide the necessary guidance for physical, personnel, and information security for safeguarding SCI, and are part of the security classification specification for this contract:

XXX DoD 5105.21-M-1, SCI Security Manual, Administrative Security

XXX Signals Intelligence Security Regulations (SISR) (Available from the CM)

XXX Imagery Policy Series (Available from the CM)

XXX DCID 6/3, Protecting Sensitive Compartmented Information within Information Systems

___ DCID 6/9, Physical Security Standards for Sensitive Compartmented Information Facilities

XXX AR 25-2, Information Assurance

XXX AR 380-28, DA Special Security System

___ AR 380-381, Special Access Programs (SAPS).

XXX Army Handbook for SCI Contracts.

XXX Other

XXX (2) Contract estimated completion date: 5 Years from Date of Award (NOTE: Section “F” of the contract normally provides the Period of Performance. Option years are not to be included, as an option is not valid until exercised by the government.)

XXX (3) The name, telephone number, email address and mailing address of the Contract Monitor (CM) for the SCI portion of this contract is:

CM: Ken Heyse, 703-704-2400, Security Specialist, FCDD-ISN-SB, U.S. Army Futures Command, CCDC, C5ISR Center NVESD, 10221 Burbeck Road, Fort Belvoir, Virginia 22060-5806, kenneth.p.heyse.civ@mail.mil

SCTY POC: TBD

XXX (4) All DD Forms 254 prepared for subcontracts involving access to SCI under this contract must be forwarded to the CM for approval and then to HQ INSCOM, ACofS Security, G2, Contractor Support Element (CSE) for review and concurrence prior to award of the subcontract.

XXX (5) The contractor will submit the request for SCI visit certifications through the CM for approval of the visit. The certification request must arrive at the Contractor Support Element at least ten (10) working days prior to the visit. Visit certification requests will be processed through ACAVS.

XXX (6) The contractor will not reproduce any SCI related material without prior written permission of the CM.

XXX (7) Security Classification Guides or extracts are attached or will be provided under separate cover.

___ (8) Electronic processing of SCI requires accreditation of the equipment in accordance with DCID 6/3 and AR 25-2

___ (9) This contract requires a contractor SCIF.

XXX (10) This contract requires XX (SI) XX (TK) XX (G) XX (HCS) (Add others as required)

XXX (11) The contractor will perform SCI work under this contract at the following locations: US Army Futures Command, CCDC, C5ISR Center Night Vision & Electronic Sensors Directorate, 10251 Burbeck Road, Fort Belvoir, VA 22060-5806, and at other Government and cleared contractor locations as deemed necessary by the Government Task Leader.

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 [2] (All Files Must be Attached Prior to Signing, i.e., for any digital signature on the form) Appendix A Handling FOUO Information.docx 000657-Appendix B.docx

See BLOCK 13.

Fort Belvoir, VA 22060-5806

BLOCK 10e1: SCI Access required. No public release of information authorized, public disclosure or confirmation of any subject related to the support contract is not authorized without first obtaining written approval from the CM.

BLOCK 10e2: Non-SCI Information is not releasable to contractor employees who have not received a clearance at the appropriate security level. Written concurrence of the CM is required prior to subcontracting. Access to Intelligence information required for performance.

BLOCK 10j: Controlled Unclassified Information (CUI) generated and/or provided under this contract shall be safeguarded and marked as specified in DoD 5200.01, Volume 4.

BLOCK 11c: The contractor requires access to classified source data up to and including Top Secret in support of the work effort. Any extracts or use of such data requires the contractor to apply derivative classifications and markings consistent with the source documents. Use of “Multiple Sources” on the “Derived From” line necessitates compliance with the NISPOM, paragraph 4-208a, and the use of a bibliography.

BLOCK 11f: Access to classified information in OCONUS locations shall be at the discretion/requirements of the designated military commander.

BLOCK 11j: The Prime contractor shall coordinate with the Government OPSEC Officer, comply with the government’s OPSEC Plan and provide new contractor employees Level 1 OPSEC Awareness training. The contractor shall coordinate OPSEC training requirements with the Government OPSEC Officer. All contractor employees must complete annual OPSEC awareness training in accordance with HQDA guidance. This training will be provided by the government at Fort Belvoir for all on-site contract employees at least annually. Contractors working OCONUS under NVESD contracts will receive Level 1 OPSEC Awareness training as directed or at the discretion of the appropriate military commander in theater.

BLOCK 11l: Contractor will refer to DoDM 5200.01, Volume 4 (provided under separate cover) for the protection and handling of Controlled Unclassified Information.

BLOCK 13a: A Threat Awareness and Reporting Program (TARP) briefing is required for contractor personnel working under a contract for NVESD. NVESD will provide TARP training to the contractor on Fort Belvoir as required by Army regulations. Contractors working OCONUS under NVESD contracts will receive TARP training as directed or at the discretion of the appropriate military commander in theater. Persons employed by Army contractors will be aware of and report threat related incidents, behavioral indicators, and other matters of Counterintelligence (CI) interest as specified in Army Regulation (AR) 381-12, Threat Awareness and Reporting Program, Chapter 3. Incidents will be reported to Defense Security Service (DSS), NVESD Security Office or nearest military CI counterintelligence office.

BLOCK 13b: Critical Program Information (CPI) is defined as information/technologies resident in a particular system or program which if divulged to unauthorized persons, would likely result in the reduction of a critical U.S. military technological advantage. In as much, CPI may be identified by the Government during a contracted effort and if identified must be protected by the contractor in accordance with guidance outlined in an Interim Program Protection Plan (IPPP) or Program Protection Plan (PPP), written in collaboration with the contractor. The aforementioned IPPP or PPP will establish policy and procedures for the protection of CPI.

BLOCK 13c: ANTITERRORISM: All contractor employees, to include subcontractor employees, requiring access to government installations, facilities and controlled access areas shall complete AT Level l awareness training within 30 calendar days after contract start date or effective date of incorporation of this requirement into the contract, whichever is applicable. The contractor shall submit certificates of completion for each affected contractor employee and subcontractor employee, to the NVESD Security Office ATTN: AT Officer within 30 calendar days after completion of training by all employees and subcontractor personnel. AT Level 1 training is an annual requirement for contractor and subcontractor employees. AT Level I awareness training is available at the following website: https://jkodirect.jten.mil BLOCK 13d: INFORMATION SECURITY: Contractor and all associated sub-contractors employees shall comply with applicable installation, facility and area commander installation/facility access and local security policies and procedures (provided by government representative). The contractor shall also provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshal Office, Director of Emergency Services or Security Office. Contractor workforce must comply with all personal identity verification requirements as directed by DOD, HQDA and/or local policy. In addition to the changes otherwise authorized by the changes clause of this contract, should the Force Protection Condition (FPCON) at any individual facility or installation change, the Government may require changes in contractor security matters or processes. Contractor shall comply with FAR 52.204-2, Security Requirements. This involves access to information classified "Confidential," "Secret," or "Top Secret" and requires contractors to comply with- (1) The Security Agreement (DD Form 441), including the National Industrial Security Program Operating Manual (DoD 5220.22-M); any revisions to DOD 5220.22-M, notice of which has been furnished to the contractor.

BLOCK 13e: INFORMATION TECHNOLOGY/CYBER AWARENESS: Contractor Employees Who Require Access to Government Information Systems (IS). All contractor employees that require access to government IS must successfully complete the DoD Cyber Security prior to access to the IS and then annually thereafter, per DoD Instruction 8500.01, Cyber Security. Contractor employees that act as privileged users, are in IT/Cyber Security specialty position and/or act as IT/Cyber Security managers must be registered in the ATCTS (Army Training Certification Tracing System) at commencement of services. All contractor employees and associated sub-contractor employees must complete the DoD Cyber Security training before issuance of network access and annually thereafter. All contractor employees working IT functions must comply with DoD and Army training requirements in DoDD 8570.01, DoD 8570.01-M and AR 25-2 within six months of employment. Per DoD 8570.01-M, DFARS 252.239.7001 and AR 25-2, the contractor employees supporting IT functions shall be appropriately certified upon contract award. The baseline certification as stipulated in DoD 8570.01-M must be completed upon contract award.

BLOCK 13f. Army regulations available at www.apd.army.mil BLOCK 13g: Applicable Security Classification Guides (SCGs) will be provided under separate cover as required.

Government Task Leader rep: Ken Heyse, SSR SCI Contract Monitor

10221 Burbeck Road Fort Belvoir, VA 22060-5806