Attachment 7 DD254 Solicitation Adaptive Technologies Final.pdf
PDF 311 KB Posted
- Attached to
- 1-Step Broad Agency Announcement for Adaptive Technologies for Force Readiness Federal contract opportunity
- Solicitation number
- FA8650-22-S-6279
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Attachment 2 TO 01 FA8650-22-F-6405 SOO Final.pdf | ||
| Attachment 5 TO 04 FA8650-22-F-6408 SOO Final.pdf | ||
| Attachment 6 CDRLs Adaptive Technologies.pdf | ||
| Attachment 8 Base Support Letter Adaptive Technologies.pdf | ||
| Attachment 9 SOW Supplemental.pdf | ||
| Attachment 3 TO 02 FA8650-22-F-6406 SOO Final.pdf | ||
| Attachment 10 Potential Clauses.pdf | ||
| BAA Solicitation - Adaptive Technologies for Force Readiness FINAL.pdf | ||
| Force Readiness Industry Day Announcement.pdf | ||
| Attachment 1 Basic IDIQ SOO 2021 Final.pdf | ||
| Attachment 4 TO 03 FA8650-22-F-6407 SOO Final.pdf | ||
| Attachment 7 SCI ADDENDUM TO DD FORM Force Readiness.pdf | ||
| Attachment 11 Section L.pdf | ||
| Attachment 12 Section K.pdf |
Show all 14
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CLASSIFICATION (When filled in):
PREVIOUS EDITION IS OBSOLETE. Page 1 of 5
AEM LiveCycle Designer DD FORM 254, APR 2018 PREVIOUS EDITION IS OBSOLETE. Page 1 of 5
AEM LiveCycle Designer
DD FORM 254, APR 2018
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
a. LEVEL OF FACILITY SECURITY CLEARANCE (FCL) REQUIRED
(See Instructions)
Top Secret
b. LEVEL OF SAFEGUARDING FOR CLASSIFIED INFORMATION/
MATERIAL REQUIRED AT CONTRACTOR FACILITY
None (See instructions)
2. THIS SPECIFICATION IS FOR: (X and complete as applicable.)
a. PRIME CONTRACT NUMBER (See instructions.)
b. SUBCONTRACT NUMBER
c. SOLICITATION OR OTHER NUMBER
FA8650-22-D-6400
DUE DATE (YYYYMMDD)
20210301
3. THIS SPECIFICATION IS: (X and complete as applicable.)
a. ORIGINAL (Complete date in all cases.)
DATE (YYYYMMDD)
20210223
b. REVISED (Supersedes all previous specifications.)
REVISION NO. DATE (YYYYMMDD)
c. FINAL (Complete Item 5 in all cases.) DATE (YYYYMMDD)
4. IS THIS A FOLLOW-ON CONTRACT? No Yes 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? No Yes 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
TBD
b. CAGE CODE
TBD
c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional)
TBD
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) Add Row Remove last Row Delete All Rows
a. NAME, ADDRESS, AND ZIP CODE N/A
b. CAGE CODE
N/A
c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional) N/A
8. ACTUAL PERFORMANCE (Click button to add more locations.) Add Row Remove last Row Delete All Rows
a. LOCATION(S) (For actual performance, see instructions.)
711HPW/RHW
2620 Q Street, Area B, Bldg. 852 Wright-Patterson AFB, OH 45433 (Collateral Secret, TS/SCI, Secret/SAP)
b. CAGE CODE (If applicable, see Instructions.)
N/A
c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional) See Block 15
a. LOCATION(S) (For actual performance, see instructions.)
711 HPW/RHW
2255 H Street, Area B, Building 248 Wright-Patterson AFB OH 45433-7022 (Collateral Secret, TS/SCI)
b. CAGE CODE (If applicable, see Instructions.)
N/A
c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional) See Block 15
9. GENERAL UNCLASSIFIED DESCRIPTION OF THIS PROCUREMENT
The contractor shall provide operational research and engineering capabilities for the design, conduct, evaluation, and documentation of training effectiveness and evaluation alternatives and ops in live, virtual, and constructive (LVC) training and rehearsal environments and events.
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AEM LiveCycle Designer DD FORM 254, APR 2018 PREVIOUS EDITION IS OBSOLETE. Page 2 of 5
AEM LiveCycle Designer
DD FORM 254, APR 2018
10. CONTRACTOR WILL REQUIRE ACCESS TO: (X all that apply. Provide details in Blocks 13 or 14 as set forth in the instructions.)
a. COMMUNICATIONS SECURITY (COMSEC) INFORMATION f. SPECIAL ACCESS PROGRAM (SAP) INFORMATION
b. RESTRICTED DATA g. NORTH ATLANTIC TREATY ORGANIZATION
(NATO) INFORMATION
c. CRITICAL NUCLEAR WEAPON DESIGN INFORMATION (CNWDI) (If CNWDI applies, RESTRICTED DATA must also be marked.) h. FOREIGN GOVERMENT INFORMATION
d. FORMERLY RESTRICTED DATA i. ALTERNATIVE COMPENSATORY CONTROL MEASURES
(ACCM) INFORMATION
e. NATIONAL INTELLIGENCE INFORMATION:
(1) Sensitive Compartmented Information (SCI)
(2) Non-SCI
j. CONTROLLED UNCLASSIFIED INFORMATION (CUI) (See instructions.)
k. OTHER (Specify) (See instructions.)
Access to SIPRNET
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.)
a. HAVE ACCESS TO CLASSIFIED INFORMATION ONLY AT
ANOTHER CONTRACTOR'S FACILITY OR A GOVERNMENT
ACTIVITY
(Applicable only if there is no access or storage required at contractor facility.
See instructions.)
b. RECEIVE AND STORE CLASSIFIED DOCUMENTS ONLY
c. RECEIVE, STORE, AND GENERATE CLASSIFIED
INFORMATION OR 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 A TEMPEST REQUIREMENT
j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS
k. BE AUTHORIZED TO USE DEFENSE COURIER SERVICE
l. RECEIVE, STORE, OR GENERATE CONTROLLED UNCLASSIFIED
INFORMATION (CUI).
(DoD Components: refer to DoDM 5200.01, Volume 4 only for specific CUI protection requirements. Non-DoD Components: see instructions.)
m. OTHER (Specify) (See instructions.)
Comply with AFFARS 5352.204-9000. See Item 13.
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)
DIRECT THROUGH (Specify below)
See Block 13
Public Release Authority:
See Block 13
13. SECURITY GUIDANCE Add Signature Remove last Signature Delete All Signatures
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.)
32 Code of Federal Regulations, Part 117, National Industrial Security Program Operating Manual (NISPOM), 24 February 2021, applies.
Block 12 Ref Item 12: Contractor is to submit requests through the Contracting Officer for OPSEC Program Manager review and public release authorization. The Contracting Officer will provide contractor with written approval/disapproval. Information requiring AF or DoD–level review will be reviewed by the unit’s OPSEC Program Manager or Coordinator who will in-turn forward to the entry-level public affairs
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AEM LiveCycle Designer DD FORM 254, APR 2018 PREVIOUS EDITION IS OBSOLETE. Page 3 of 5
AEM LiveCycle Designer
DD FORM 254, APR 2018
office through the AFIMSC Public Affairs Office to the Secretary of the Air Force, Office of Public Affairs, Security and Review Division (SAF/PAX), 1690 Air Force Pentagon, Washington DC 20330-1690. Transmission of public release request via e-mail is not authorized.
Ref Item 10e(1): Public release of Sensitive Compartmented Information (SCI) is not authorized.
Ref Item 10f: Public release of Special Access Program (SAP) related data is NOT authorized without prior coordination through the Air Force Office of Special Investigations (AFOSI), Office of special Projects (PJ) Security Director and subsequent approval of the Original Classification Authority (OCA) and Air Force Special Access Program Central Office (AF SAPCO). Submit all proposed public disclosures related to SAP data to the Government Program Manager (GPM) and the Air Force Office of Special Investigations (AFOSI), Office of Special Projects (PJ) Program Security Officer (PSO).
Block 13 Ref Item 10a: The contractor is not authorized to receive Government furnished cryptographic equipment. Access to classified COMSEC information requires a final U.S. Government clearance at the appropriate level. Further disclosure of COMSEC information by a contractor, to include subcontracting, requires prior approval of the GCA. Non-accountable COMSEC information, though not tracked in the COMSEC material control system, may still require a level of control within a document control system. Refer to NSA/CSS Manual 3-16, “Control of Communications Security Material,” and the Committee on National Security Systems Instruction (CNSSI) 4001, “Controlled Cryptographic Items,” for guidance.
Ref Item 10a: Contractor will comply with AFMAN 17-1302-O, Communications Security (COMSEC) Operations, 9 Apr 20.
Ref Item 10a: Contractor personnel will follow the security requirements of the host government activity.
Ref Item 10e(1): Contractor requires access to SCI materials; SCI security requirements apply, see 21 IS/INS, SSO WPAFB, SCI addendum, for details.
Ref Item 10e(2): See AFMC Non-SCI addendum.
Ref Item 10g: A formal NATO briefing is required prior to granting access to NATO Secret information. See 32 CFR, Part 117, §117.19
(g) for details.
Ref Item 10g: Access to JWICS is authorized. Users shall be briefed to NATO Secret IAW 32 CFR, Part 117, §117.19 (g) prior to access.
Ref Item 10j/11l: The contractor shall comply with DoDI 5200.48, Controlled Unclassified Information (CUI), Air Force Guidance Memorandum 2020-16-01, Air Force Guidance Memorandum for CUI, 23 Jul 20, and DoDM 5400.7-Air Force Manual 33‑302, DoD Freedom of Information Act (FOIA) Program. The contractor shall monitor CUI aggregation and compilation based on the potential to generate classified information pursuant to security classification guidance addressing the accumulation of unclassified data or information.
Ref Item 11a: The contractor will generate classified information. The contractor shall apply derivative classification and markings governed by the Air and Space Center (AOC) Weapons System (WS), AN/SUQ 163 Security Classification Declassification Guide, Functional Original date (21 July 2011); Functional OPR: ESC/HSGB, 11 Barksdale St., Hanscom AFB, MA 01731. SCDG will be provided under separate cover.
Transfer of documents to other IR&D efforts is not permitted.
The Contractor will notify the Government Contracting Activity and the Government Security Manager within 48 hours of any incident involving the actual or suspected compromise/loss of classified information to enable the Government to conduct immediate assessment of potential impact pending formal inquiry/investigation. Actual or suspected compromise of Covered Defense Information will be reported IAW DFARS Clause 252.204-7012.
Ref Item 11l: DoD Components: DoDI 5200.48, Controlled Unclassified Information, 6 Mar 20 replaced DoDM 5200.01, Volume 4. See Air Force Guidance Memorandum 2020-16-01, Air Force Guidance Memorandum for CUI, 23 Jul 20.
Ref Item 11m: Provide the information requested by the Notification of Government Security Activity and Visitor Group Security Agreements clause, Air Force Federal Acquisition Regulation Supplement (AFFARS) 5352.204-9000, to (enter the Information Protection Office’s office symbol, street address, city, state and zip code and e-mail address for each installation). The contractor shall comply with DoDM 5220.22 Vol 2_AFMAN 16-1406 Vol 2, National Industrial Security Program: Industrial Security Procedures for Government Activities, 8 May 20, by following security procedures of the installation IAW para 3.8.a.; report adverse information IAW para 4.14 (Added)(AF); and support commander self-inspections and self-assessments IAW para 14.1.f (Added)(AF).
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AEM LiveCycle Designer
DD FORM 254, APR 2018
Ref Item 18f (Distribution):
711 HPW/OMS, 2245 Monahan Way, Wright-Patterson AFB, OH 45433, 711hpw.oms.sec@us.af.mil
Program Manager: Kelly Kaleda, 711 HPW/RHW, 937-713-5505, kelly.kaleda.4@us.af.mil
Industrial Security Manager: Tina L. Henry, 711 HPW/OMSI, 937-255-0805, tina.henry@us.af.mil
711 HPW Senior Intelligence Office: 711 HPW/RHWA, 2620 Q Street, Bldg 852, WPAFB, OH 45433, Major Thomas A. Payne, thomas.payne.5@us.af.mil, 711 HPW/RHWA
WPAFB Special Security Office (SSO): 21 IS/INS, SSO WPAFB, 2450 D Street, Bldg 20, Area B, WPAFB OH 45433-7629, WPAFBSpecialSecurityOffice.Mailbox@us.af.mil
List of Attachments (All Files Must be Attached Prior to Signing, i.e., for any digital signature on the form)
Add Attachment View Selected Attachment Remove Selected Attachment
NAME & TITLE OF REVIEWING OFFICIAL
Capt Amanda Kisor, AFRL/XP2
SIO
SIGNATURE
NAME & TITLE OF REVIEWING OFFICIAL
Eric C. Brown, SSO
21 IS/INS
SIGNATURE
NAME & TITLE OF REVIEWING OFFICIAL
Anthony Jones, Branch Chief
711 HPW/OMSI
SIGNATURE
NAME & TITLE OF REVIEWING OFFICIAL
Kelly Kaleda, 711 HPW/RHW
SCI COR
SIGNATURE
14. ADDITIONAL SECURITY REQUIREMENTS
Requirements, in addition to NISPOM requirements for classified information, are established for this contract.
No Yes 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.)
Ref Item 10e(1): SCI security requirements apply, see SCI addendum for details.
Ref Item 11j: OPSEC requirements apply. See Statement of Objectives for requirements.
15. INSPECTIONS
Elements of this contract are outside the inspection responsibility of the CSO.
No Yes 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.)
Ref Items 10a/11h: 711 HPW/OMSC has oversight for COMSEC.
Ref Item 10e (1): 21 IS/INS, SSO WPAFB has exclusive security responsibility for SCI classified material released or developed under this contract and held within the contractor’s SCIF. SCI security requirements apply, see SCI addendum (para 17) for details.
Ref Item 11m: Contractor performance will occur at (reference Item 8). 711 HPW/OMS will maintain security oversight.
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AEM LiveCycle Designer
DD FORM 254, APR 2018
16. GOVERNMENT CONTRACTING ACTIVITY (GCA) AND POINT OF CONTACT (POC)
a. GCA NAME
711HPW/RHW
b. ACTIVITY ADDRESS CODE (AAC) OF THE CONTRACTING OFFICE (See Instructions)
FA8650
c. ADDRESS (Include ZIP Code)
711HPW/RHW
2255 HStreet, bldg 33 Wright-Patterson AFB 45433
d. POC NAME
Kelly Kaleda
e. POC TELEPHONE (Include Area Code)
+1 (937) 713-5505
f. EMAIL ADDRESS (See Instructions) kelly.kaleda.4@us.af.mil
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.
a. TYPED NAME OF CERTIFYING OFFICIAL (Last, First, Middle Initial) (See Instructions)
David Roux
b. TITLE
Contracting Officer
c. ADDRESS (Include ZIP Code)
AFRL/RAKH
2130 8th St Bldg 45 Wright-Patterson AFB 45433
d. AAC OF THE CONTRACTING OFFICE (See Instructions)
FA8650
e. CAGE CODE OF THE PRIME CONTRACTOR
(See Instructions.)
TBD
f. TELEPHONE (Include Area Code)
+1 (312) 713-9795
g. EMAIL ADDRESS (See Instructions) david.roux.1@us.af.mil
h. SIGNATURE
i. DATE SIGNED (See Instructions)
18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL
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. OTHER AS NECESSARY (If more room is needed, continue in Item 13 or on additional page if necessary.)
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 (All Files Must be Attached Prior to Signing, i.e., for any digital signature on the form)
| CurrentPage: |
| PageCount: |
| Classification: |
| SerialNum: |
| a. Facility clearance level. Select one.: 1 |
| b. Level of safeguarding for classified information/material required at contractor facility. Select one.: 4 |
| Choose Yes or No: 0 |
| Choose Yes or No: 1 |
| Prime: |
| Choose Yes or No: 0 |
| Choose Yes or No: 0 |
| Sub: |
| Choose Yes or No: 1 |
| Choose Yes or No: 0 |
| Soli: FA8650-22-D-6400 |
| DueDate: 2021-03-01 |
| dateA: 2021-02-23 |
| RevisionNum: |
| dateB: |
| Final: |
| dateC: |
| No: 1 |
| No: 1 |
| No: 0 |
| No: 0 |
| Yes: 0 |
| Yes: 0 |
| Yes: 1 |
| Yes: 1 |
| Enter your name here.: |
| ReqDated: |
| Enter your name here.: |
| Name: TBD |
| Name: N/A |
| Name: David Roux |
| Cage: TBD |
| Cage: N/A |
| Cage: N/A |
| Cage: N/A |
| Cage: TBD |
| CSO: TBD |
| CSO: N/A |
| CSO: See Block 15 |
| CSO: See Block 15 |
| addrow: |
| Removerow: |
| Click to delete a row: |
| Location: 711HPW/RHW |
2620 Q Street, Area B, Bldg. 852 Wright-Patterson AFB, OH 45433 (Collateral Secret, TS/SCI, Secret/SAP) Location: 711 HPW/RHW 2255 H Street, Area B, Building 248 Wright-Patterson AFB OH 45433-7022 (Collateral Secret, TS/SCI)
| Block9: The contractor shall provide operational research and engineering capabilities for the design, conduct, evaluation, and documentation of training effectiveness and evaluation alternatives and ops in live, virtual, and constructive (LVC) training and rehearsal environments and events. |
| a: 1 |
| a: 1 |
| a: 1 |
| f: 0 |
| f: 0 |
| f: 1 |
| b: 0 |
| b: 0 |
| b: 0 |
| g: 1 |
| g: 1 |
| c: 0 |
| c: 0 |
| c: 1 |
| h: 1 |
| h: 0 |
| d: 0 |
| d: 0 |
| d: 0 |
| i: 0 |
| i: 0 |
| SCI: 1 |
| NonSCI: 1 |
| j: 1 |
| j: 1 |
| k: 1 |
| k: 0 |
| Enter your name here.: Access to SIPRNET |
| Enter your name here.: |
Comply with AFFARS 5352.204-9000. See Item 13.
| e: 0 |
| e: 1 |
| l: 1 |
| m: 1 |
| direct: 0 |
| thru: 1 |
| Enter your name here.: See Block 13 |
| PublicAuthority: See Block 13 |
| AddSig: |
| RemoveSig: |
| text: 32 Code of Federal Regulations, Part 117, National Industrial Security Program Operating Manual (NISPOM), 24 February 2021, applies. |
Block 12 Ref Item 12: Contractor is to submit requests through the Contracting Officer for OPSEC Program Manager review and public release authorization. The Contracting Officer will provide contractor with written approval/disapproval. Information requiring AF or DoD–level review will be reviewed by the unit’s OPSEC Program Manager or Coordinator who will in-turn forward to the entry-level public affairs office through the AFIMSC Public Affairs Office to the Secretary of the Air Force, Office of Public Affairs, Security and Review Division (SAF/PAX), 1690 Air Force Pentagon, Washington DC 20330-1690. Transmission of public release request via e-mail is not authorized.
Ref Item 10e(1): Public release of Sensitive Compartmented Information (SCI) is not authorized.
Ref Item 10f: Public release of Special Access Program (SAP) related data is NOT authorized without prior coordination through the Air Force Office of Special Investigations (AFOSI), Office of special Projects (PJ) Security Director and subsequent approval of the Original Classification Authority (OCA) and Air Force Special Access Program Central Office (AF SAPCO). Submit all proposed public disclosures related to SAP data to the Government Program Manager (GPM) and the Air Force Office of Special Investigations (AFOSI), Office of Special Projects (PJ) Program Security Officer (PSO).
Block 13 Ref Item 10a: The contractor is not authorized to receive Government furnished cryptographic equipment. Access to classified COMSEC information requires a final U.S. Government clearance at the appropriate level. Further disclosure of COMSEC information by a contractor, to include subcontracting, requires prior approval of the GCA. Non-accountable COMSEC information, though not tracked in the COMSEC material control system, may still require a level of control within a document control system. Refer to NSA/CSS Manual 3-16, “Control of Communications Security Material,” and the Committee on National Security Systems Instruction (CNSSI) 4001, “Controlled Cryptographic Items,” for guidance.
Ref Item 10a: Contractor will comply with AFMAN 17-1302-O, Communications Security (COMSEC) Operations, 9 Apr 20.
Ref Item 10a: Contractor personnel will follow the security requirements of the host government activity.
Ref Item 10e(1): Contractor requires access to SCI materials; SCI security requirements apply, see 21 IS/INS, SSO WPAFB, SCI addendum, for details.
Ref Item 10e(2): See AFMC Non-SCI addendum.
Ref Item 10g: A formal NATO briefing is required prior to granting access to NATO Secret information. See 32 CFR, Part 117, §117.19 (g) for details.
Ref Item 10g: Access to JWICS is authorized. Users shall be briefed to NATO Secret IAW 32 CFR, Part 117, §117.19 (g) prior to access.
Ref Item 10j/11l: The contractor shall comply with DoDI 5200.48, Controlled Unclassified Information (CUI), Air Force Guidance Memorandum 2020-16-01, Air Force Guidance Memorandum for CUI, 23 Jul 20, and DoDM 5400.7-Air Force Manual 33‑302, DoD Freedom of Information Act (FOIA) Program. The contractor shall monitor CUI aggregation and compilation based on the potential to generate classified information pursuant to security classification guidance addressing the accumulation of unclassified data or information.
Ref Item 11a: The contractor will generate classified information. The contractor shall apply derivative classification and markings governed by the Air and Space Center (AOC) Weapons System (WS), AN/SUQ 163 Security Classification Declassification Guide, Functional Original date (21 July 2011); Functional OPR: ESC/HSGB, 11 Barksdale St., Hanscom AFB, MA 01731. SCDG will be provided under separate cover.
Transfer of documents to other IR&D efforts is not permitted.
The Contractor will notify the Government Contracting Activity and the Government Security Manager within 48 hours of any incident involving the actual or suspected compromise/loss of classified information to enable the Government to conduct immediate assessment of potential impact pending formal inquiry/investigation. Actual or suspected compromise of Covered Defense Information will be reported IAW DFARS Clause 252.204-7012.
Ref Item 11l: DoD Components: DoDI 5200.48, Controlled Unclassified Information, 6 Mar 20 replaced DoDM 5200.01, Volume 4. See Air Force Guidance Memorandum 2020-16-01, Air Force Guidance Memorandum for CUI, 23 Jul 20.
Ref Item 11m: Provide the information requested by the Notification of Government Security Activity and Visitor Group Security Agreements clause, Air Force Federal Acquisition Regulation Supplement (AFFARS) 5352.204-9000, to (enter the Information Protection Office’s office symbol, street address, city, state and zip code and e-mail address for each installation). The contractor shall comply with DoDM 5220.22 Vol 2_AFMAN 16-1406 Vol 2, National Industrial Security Program: Industrial Security Procedures for Government Activities, 8 May 20, by following security procedures of the installation IAW para 3.8.a.; report adverse information IAW para 4.14 (Added)(AF); and support commander self-inspections and self-assessments IAW para 14.1.f (Added)(AF).
Ref Item 18f (Distribution):
711 HPW/OMS, 2245 Monahan Way, Wright-Patterson AFB, OH 45433, 711hpw.oms.sec@us.af.mil
Program Manager: Kelly Kaleda, 711 HPW/RHW, 937-713-5505, kelly.kaleda.4@us.af.mil
Industrial Security Manager: Tina L. Henry, 711 HPW/OMSI, 937-255-0805, tina.henry@us.af.mil
711 HPW Senior Intelligence Office: 711 HPW/RHWA, 2620 Q Street, Bldg 852, WPAFB, OH 45433, Major Thomas A. Payne, thomas.payne.5@us.af.mil, 711 HPW/RHWA
WPAFB Special Security Office (SSO): 21 IS/INS, SSO WPAFB, 2450 D Street, Bldg 20, Area B, WPAFB OH 45433-7629, WPAFBSpecialSecurityOffice.Mailbox@us.af.mil
| attachmentsList: |
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| rep: Capt Amanda Kisor, AFRL/XP2 |
SIO
rep: Eric C. Brown, SSO
21 IS/INS
rep: Anthony Jones, Branch Chief
711 HPW/OMSI
rep: Kelly Kaleda, 711 HPW/RHW
SCI COR
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| Enter your name here.: Ref Item 10e(1): SCI security requirements apply, see SCI addendum for details. |
Ref Item 11j: OPSEC requirements apply. See Statement of Objectives for requirements.
Enter your name here.: Ref Items 10a/11h: 711 HPW/OMSC has oversight for COMSEC.
Ref Item 10e (1): 21 IS/INS, SSO WPAFB has exclusive security responsibility for SCI classified material released or developed under this contract and held within the contractor’s SCIF. SCI security requirements apply, see SCI addendum (para 17) for details.
Ref Item 11m: Contractor performance will occur at (reference Item 8). 711 HPW/OMS will maintain security oversight.
| GCAName: 711HPW/RHW |
| AAC: FA8650 |
| AAC: FA8650 |
| Address: 711HPW/RHW |
2255 HStreet, bldg 33 Wright-Patterson AFB 45433 Address: AFRL/RAKH 2130 8th St Bldg 45 Wright-Patterson AFB 45433
| POCName: Kelly Kaleda |
| Phone: 9377135505 |
| Phone: 3127139795 |
| Email: kelly.kaleda.4@us.af.mil |
| Email: david.roux.1@us.af.mil |
| Title: Contracting Officer |
| Enter the date using the format DD-Mon-YYYY: |
File details come from the government source that posted it. Updated .