Attachment 8 - Draft DD254_No POC Info_02.10.23.pdf

CLASSIFICATION (When filled in): Unclassified

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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:

May 31, 2022

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

Top Secret

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

a. PRIME CONTRACT NUMBER (See instructions.)

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.)

DATE (YYYYMMDD)

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 c. COGNIZANT SECURITY OFFICE(S) (CSO)

(Name, Address, ZIP Code, Telephone required; Email Address optional)

Corresponding DCSA Field Office Address

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)

a. NAME, ADDRESS, AND ZIP CODE b. CAGE CODE c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional)

8. ACTUAL PERFORMANCE (Click button to add more locations.)

a. LOCATION(S) (For actual performance, see instructions.)

TBD

b. CAGE CODE

(If applicable, see Instructions.)

c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional)

a. LOCATION(S) (For actual performance, see instructions.)

Defense Advanced Research Projects Agency (DARPA) 675 N. Randolph Street Arlington, VA 22203

b. CAGE CODE (If applicable, see Instructions.)

N/A

c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional)

N/A

9. GENERAL UNCLASSIFIED DESCRIPTION OF THIS PROCUREMENT

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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.)

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.)

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)

Refer to block 13

Public Release Authority:

Meagan Snyder, Deputy Director, SAPCO

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.)

(U) 10a: The performer will protect classified COMSEC information and material in accordance with 32 Code of Federal Regulation (CFR) Part 117, NISPOM. Access to classified COMSEC information requires a final U.S. Government clearance at the appropriate level.

(U) The DARPA Contracting Officer for Security Matters must approve further disclosure of COMSEC information by a contractor, to include subcontracting.

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AEM LiveCycle Designer

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(U) 10e(1): SCI Access required. The Director, DIA and Director, DARPA, have exclusive security responsibility for SCI released to the performer or developed under this contract. Before releasing or providing SCI to performers, the PSO will ensure they are appropriately cleared in accordance with Security Executive Agent Directive (SEAD) 4, dated June 8, 2017, or successor documents, and the performer must agree to follow controls and procedures for SCI protection, handling, and accountability.

(U) Performer will conduct all activities involving SCI (including discussions) in Sensitive Compartmented Information Facilities (SCIFs).

Adhere to physical security standards for SCIFs as described in ICD/ICS 705.

(U) 10e(2): Access to non-SCI Intelligence information is required for performance. The Cognizant Security Office (CSO), has exclusive security responsibility for Non-SCI released to the performer or developed under this contract.

(U) 10j: The Performer will protect CUI in accordance with DoD Instruction 5200.48, which cancels Volume 4 of the DoDM 5200.01, and any additional publications (e.g., Implementing DoD Manual(s) to the Instruction)

(U) 11c: The performer requires access to classified data and information up to and including (Top Secret, Secret, Confidential – insert one) in support of this program. Classified material generated in support of this contract will be in accordance with the source material or DARPA security classification guidance in Block 14. DCSA must approve information systems and networks prior to processing classified information. All classified information the performer receives or generates under this contract is the property of the U.S. Government. At the termination or expiration of this contract, the performer will contact DARPA for proper disposition instructions.

(U) The performer requires access to existing Secret Internet Protocol Router Network (SIPRNet) terminals, and is authorized to generate collateral SECRET information on SIPRNet in support of this program.

(U) 11g: The performer must prepare and forward DD Forms 1540 and 2345 to the COR for authorization before the services may be requested. All such requests will be coordinated through the DARPA PM and PSO. The forms are available at https://www.esd.whs.mil/ Directives/forms/dd1500_1999/.

(U) 11h: The performer will establish COMSEC accounts in accordance with 32 Code of Federal Regulation (CFR) Part 117, NISPOM.

(U) 11j: If working at DARPA, the performer will adhere to the DARPA Security Guide, as well as, the DARPA Baseline Agency OPSEC Plan available on the DARPA Portal.

(U) 11j: Off-Site performers are required to create an OPSEC Plan or incorporate program specific OPSEC guidance into an existing OPSEC Plan. In either case, the performer will forward those OPSEC plans to the PSO for approval.

(U) 11l: The Performer will protect CUI in accordance with DoD Instruction 5200.48, which cancels Volume 4 of the DoDM 5200.01, and any additional publications (e.g., Implementing DoD Manual(s) to the Instruction).

(U) 12: Public Release Through: The contractor will not release any information (Classified or Unclassified) without prior written approval of the public release authority, except as provided in applicable U.S. Statutes.

(U) Prime contractors must submit all Subcontractor DD Form 254s to DARPA. DARPA must preapprove all Subcontractor DD Form 254s with proscribed information and non-SCI in accordance with 32 Code of Federal Regulation (CFR) Part 117, NISPOM. The performer will provide DARPA with a courtesy copy of their Subcontractor(s) DD Form 254s that do not contain proscribed information;

these DD Form 254s do not require a preapproval. 32 CFR Part 117, NISPOM is available at https://www.ecfr.gov/current/title-32/subtitle- A/chapter-I/subchapter-D/part-117.

(U) All Performers on this contract will abide by all current and applicable successor governmental guidance. Please contact your FSO, CPSO, PSO or PSR if any questions arise pertaining to the availability of these guidance documents.

(U) The security point of contact (POC) will immediately report to the PSO, but no later than 24 hours from discovery, all security incidents. A security incident may be an infraction or violation. The security POC will forward all final incident reports to the PSO for concurrence; this is in addition to the NISPOM reporting requirements to DCSA, when applicable.

(U) All security requirements contained within this DD Form 254, where applicable, will be applicable to any subcontractors and consultants supporting this contract.

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

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AEM LiveCycle Designer

DD FORM 254, APR 2018

NAME & TITLE OF REVIEWING OFFICIAL

Meagan Snyder Deputy Director, SAPCO

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.)

(U) All performers on this contract will abide by the requirements in Volumes 1 through 3 of DoD Manual 5200.01, available at http:// www.esd.whs.mil/Directives/issuances/dodm/, in addition to the requirements in the 32 Code of Federal Regulation (CFR) Part 117, NISPOM.

(U) All performers on this contract will abide by the requirements in Intelligence Community Directive (ICD) 701, or its successor document, for any suspected or actual unauthorized disclosures in addition to the requirements in the 32 Code of Federal Regulation (CFR) Part 117, NISPOM. The ICD 701 is available at https://www.dni.gov/index.php/what-we-do/ic-related-menus/ic-related-links/intelligence-community-directives.

(U) All performers on this contract will abide by the requirements in DoD Instruction 5200.48 available at https://www.esd.whs.mil/ Directives/issuances/dodi/.

(U) All performers on this contract will abide by the requirements in Volumes 1 through 3 of DoD Manual 5105.21, or successor documents, to include ICDs the PSO requires in addition to the requirements in 32 Code of Federal Regulation (CFR) Part 117, NISPOM. The DoD Manual 5105.21 Volumes are available at http://www.esd.whs.mil/Directives/issuances/dodm/.

(U) Program information will be protected in accordance with various DARPA and other agency security classification guides.

(U) Off Site Performers: Any DARPA program conducting testing with classified technology, systems, subsystems, or components (at any classification level) must have a security test plan. The PSO must approve all test plans at least 30 days prior to the scheduled test date.

(U) Off Site Performers: The PSO must approve all transportation plans at least 30 days prior to classified movement. Transportation plans are specific to classified movement for testing and the performer may incorporate this plan as part of the test plan. The PSO may require transportation plans for moving classified material in a manner not outlined in Volume 3 of DoD Manual 5200.01, DoD 5220.22-M, or for large shipments of classified information and material.

(U) Off Site Performers: Any test, experiment, demonstration, or measurement conducted at a lower classification level (including unclassified) than the highest classification level identified in the security classification guide(s) (SCGs) for this effort requires a concept of operation (CONOP) submitted to the DARPA PM & PSO at least 45 days prior to the event. This CONOP must outline the technical goals of the event, the hardware involved, information systems involved, targets involved, data inputs, and data outputs. The CONOP will cite applicable sections of the relevant SCGs for this program as well as SCGs for any systems or subsystems involved in the event; it will describe how the event will be conducted at the lower classification level without compromising classified elements of the program and will identify OPSEC risks along with proposed mitigations.

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.)

(U) SCI: DIA has exclusive security responsibility for inspection of all SCI materials released or developed under this contract.

(U) TSCM Survey: The DARPA Technical Security Section will conduct Technical Surveillance Countermeasures (TSCM) Surveys for DARPA sponsored SCIFs and DARPA SAPFs in accordance with DoD Instruction 5240.05. TSCM Surveys may occur prior to SCIF or SAPF accreditation and any time after accreditation while the SCIF or SAPF is in an active status. The Instruction is available at https:// www.esd.whs.mil/Directives/issuances/dodi/.

16. GOVERNMENT CONTRACTING ACTIVITY (GCA) AND POINT OF CONTACT (POC)

a. GCA NAME

DARPA CMO

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b. ACTIVITY ADDRESS CODE (AAC) OF THE CONTRACTING OFFICE (See Instructions)

HR0011

c. ADDRESS (Include ZIP Code)

675 N. Randolph Street Arlington, VA 22203-2114

d. POC NAME

Mary Beth Colvavito

e. POC TELEPHONE (Include Area Code)

f. EMAIL ADDRESS (See Instructions)

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)

Corbin, Christopher M.

b. TITLE

Chief, Information, Industrial, and International Security

c. ADDRESS (Include ZIP Code)

Defense Advanced Research Projects Agency (DARPA) 675 North Randolph Street Arlington, VA 22203-2114

d. AAC OF THE CONTRACTING OFFICE (See Instructions)

HR0011

e. CAGE CODE OF THE PRIME CONTRACTOR (See Instructions.)

f. TELEPHONE (Include Area Code)

g. EMAIL ADDRESS (See Instructions)

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.)