Attachment 8 DD Form 254.pdf

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DRAFT

SAMPLE

PREVIOUS EDITION IS OBSOLETE.

Page of

DD FORM 254, MAY 2019

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:

20220531 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 whs.mc-alex.esd.mbx.formswebmaster@mail.mil

WHS

List of Attachments (All Files Must be Attached Prior to Signing, i.e., for any digital signature on the form)

COMPLETION OF THIS BLOCK IS NOT APPROVED FOR SOLICITATIONS

Name:

COMPLETION OF THIS BLOCK IS NOT APPROVED FOR SOLICITATIONS

COMPLETION OF THIS BLOCK IS NOT APPROVED FOR SOLICITATIONS

CSO:

COMPLETION OF THIS BLOCK IS NOT APPROVED FOR SOLICITATIONS

TBD

Continental United States Block9:

GHS provides heavyweight delivery services for international and domestic shipments. Services shall be provided for the DoD, other civilian federal agencies, and applicable government contractors. Provides door-to-door, time definite, pick-up and delivery, transportation, timely and accurate shipment tracking, government Third Party Payment System participation, customs clearance processing (if applicable) and shipment data reporting. All shipments must include an air segment.

Tracking No: USTRANSCOM- TCCS-062-21

b. Controlled Unclassified Information (CUI) may be accessed. Contractors will comply with the requirements stated in DoD Instruction 5200.48 with emphasis on section 5.3. No CUI information will be discarded in trash or recycle bins. The contractor will monitor CUI for compilation and will contact USTRANSCOM contracting team when such compilations are believed to reach the specified level stated in a Security Classification Guide or need to be provided to a USTRANSCOM Original Classification Authority (OCA) for a classification by compilation decision (also see block 14).

c. Contractor employees may derivatively classify information only if they have been annually trained on derivative classification. USTRANSCOM can provide this training.

d. Contractors will comply with the following Instructions:

1. OPSEC requirements in USTRANSCOM instruction 31-12 that includes the Critical Information List .

2. DISA 300.115.3 Circular: (SIPRNet Security Classification Guide)

3. USTRANSCOM INSTRUCTION 31-02 (USTRANSCOM Classification Guide)

4. DoDM 5200.01, Vol. 2, (Marking of Classified Information)

5. DoD 4500.9-R, Part II, Appendix E, Defense Transportation Regulation’s (movements) – DTR

e. No DoD classified information will be disseminated to anyone in the contractor company that is not performing on this contract.

f. Contractor employees will comply with all USTRANSCOM security practices and policies.

g. Upon receipt of a contract, the designated contractor shall, within 60 days, provide the Cognizant Security Office listed in block 6c, a copy of the award DD-254 with any continuation pages, attachments or enclosures and the contract PWS.

h. USTRANSCOM will conduct a NATO indoctrination for all on-site contractor employees and load that access in DISS. FSO’s may conduct annual refresher training for their personnel but are also responsible for updating DISS.

i. Notes: Contractors will be made aware that the term "NOFORN" is identified as classified INTELLIGENCE information that may not be released to foreigners, without permission of the originator. AUTHORIZED FOR RELEASE (REL TO) identifies classified information that an originator has predetermined to be releasable, to the foreign county(ries) indicated.

j. Note-taking and recordings are not authorized during classified sessions at USTRANSCOM.

k IAW DISA Security Technical Implementation Guide (STIG) V-32342 (12 Jul 2013) for the Department of Defense, contractors performing work in privileged IS roles must undergo successful Federal Investigative Standards Tier 5 (SSBI) investigations with 6-year reviews. Privileged users must undergo a Tier 5 (SSBI) investigation regardless of the security clearance level required for contract performance (e.g., even if no clearance or only Confidential or Secret is required). Foreign Nationals or Local Nationals employed by the DoD ARE NOT AUTHORIZED to have (IT-I) privileged access to US Information Systems.

l. Note (1) FSO's: Without approval of the USTRANSCOM Protection and ResponseOffice, only cleared personnel from the CAGE code listed in block 6b, are approved for access to classified on this contract; upon its award.

m. Note (2): Employees of Companies without a Facility clearance (FCL) are not cleared for access to USTRANSCOM facilities and information. If such employees would visit USTRANSCOM, they must display an UNCLEARED visitors badge and be escorted at all times. They will not have access to USTRANSCOM Information systems. Uncleared visitors must obtain their Visitor Badges from the Protection Service Center (PSC) for each period of their visit.

n. Note (3): FSO's: Prime contractor personnel assigned to these locations (cited in block 8a), will be required to produce a copy of their award DD-254 to the Protection Service Center, that matches the visit notice in DISS and includes the POC, telephone number, assigned position and contract number. Sub-contractors must submit Visit Notifications to USTRANSCOM with the same notations that states their personnel are assigned to the (name the prime contractor and the primes contract number, (listed in the Visits' additional information block).

o. Note (4): FSO’s: Contractor employees with out-of-scope background investigations and are not enrolled in continuous evaluation (CE), are not authorized to work in USTRANSCOM secure room areas until a new open investigation is on their DISS/DISS record or they have been enrolled in CE.

p. Note (5): FSO’s are required, at a minimum, to familiarize themselves with the Security section of the contract PWS.

q (Note 6): Prime contractors will provide the CAGE code and name of all subcontracted companies that will require classified access to the USTRANSCOM contracting team.

r. Note (7): The FSO will provide a copy of the Contract DD-254 (Page 1) to each employee, for their initial visit/assignment for work in UTRANSCOM (USTC) facilities. They will present the document (including 2 forms of picture identification) to the USTC Protection Services Center (PSC), for assignment verification, against the Company Visit Notice in DISS.

1. Operations Security (OPSEC): Information furnished to the Contractor is sensitive and may be legacy FOR OFFICIAL USE ONLY (FOUO) or Controlled Unclassified Information (CUI). The Contractor is required to be aware of USTRANSCOM OPSEC requirements. Information determined as legacy FOUO or CUI included as part of the OPSEC Critical Information List (CIL) is not to be released to the public.

2. Security Regulation Compliance: The Contractor shall be required to comply with all security regulations and directives as identified herein, and other security requirements in this contract. The Contractor shall not divulge any financial, planning, programming, or budgeting information without the express consent of the Government as outlined in Operational Security (OPSEC) and Information Security regulations

508 Scott Drive Scott AFB, IL 62225-5004 Address: USTRANSCOM, ATTN: TCCS-PR 508 Scott Drive Scott AFB, IL 62225-5004