Attachment D - DD Form 254.pdf
PDF 177 KB Posted
- Attached to
- USAF Prepo Vessel Time Charter Federal contract opportunity
- Solicitation number
- N32205-21-R-4172
About this file
This document is a DD Form 254, which specifies security requirements for federal contract N32205-21-R-4172. The contract is for the time charter of a prepositioned vessel to transport various cargoes, including hazardous materials, for the United States Air Force. The vessel must have a facility clearance level of SECRET and safeguarding is required for classified information at that level. Specific key crew billets designated in the contract must possess SECRET clearances to access related mission information. All personnel handling classified data must complete counterintelligence awareness training. The contractor must protect classified material according to DOD requirements and report any unauthorized disclosures. Additionally, the contractor must safeguard controlled unclassified information according to DOD standards and report any cyber incidents. The Military Sealift Command is the contracting activity responsible for inspection oversight.
View the file
Other files for this federal contract opportunity
Show all 23
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Please wait...
If this message is not eventually replaced by the proper contents of the document, your PDF viewer may not be able to display this type of document.
You can upgrade to the latest version of Adobe Reader for Windows®, Mac, or Linux® by visiting http://www.adobe.com/go/reader_download.
For more assistance with Adobe Reader visit http://www.adobe.com/go/acrreader.
Windows is either a registered trademark or a trademark of Microsoft Corporation in the United States and/or other countries. Mac is a trademark of Apple Inc., registered in the United States and other countries. Linux is the registered trademark of Linus Torvalds in the U.S. and other countries.
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PREVIOUS EDITION IS OBSOLETE.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:
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
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 |
| SerialNum: |
| 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 |
| Select for "revised.": 0 |
| Enter subcontract number.: |
| Select for "final.": 1 |
| Select for "final.": 0 |
| Enter solicitation or other number.: N322005-21-R-4172 |
| Enter due date in format YYYYMMDD.: 20211128 |
| Enter date in format YYYYMMDD.: 20210528 |
| Enter revision number.: |
| Enter date in format YYYYMMDD.: |
| Enter final specification.: |
| Enter date in format YYYYMMDD.: |
| Select for "no.": 1 |
| Select for "no.": 1 |
| Select for "no.": 1 |
| Select for "no.": 1 |
| Select for "yes.": 0 |
| Select for "yes.": 0 |
| Select for "yes.": 0 |
| Select for "yes.": 0 |
| 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).: Schotter Eric C |
| Enter CAGE code of the prime contractor.: TBD |
| Enter cognizant security office(s) (Name, Address, ZIP Code, Telephone required; Email Address optional).: |
TBD
| Enter cognizant security office(s) (Name, Address, ZIP Code, Telephone required; Email Address optional).: |
| Select to add row to locations.: |
| Select to remove last row from locations.: |
| Select to delete all signatures.: |
| Enter location(s).: |
Worldwide, as required (safeguarding will take place at the performance locations onboard the vessel).
| Enter general unclassified description of this procurement.: USAF Prepositioned Vessel - one US or foreign flag (to be re-flagged U.S.) vessel to be employed in worldwide trade for the prepositioning and/or transportation of cargo (including but not limited to hazardous cargoes, explosives, ammunition, containerized and general cargoes); and for military readiness, in accordance with the terms of this Charter. |
| 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 "f. OTHER AS NECESSARY.": 1 |
| Select for "b. SUBCONTRACTOR.": 0 |
| Select for "b. SUBCONTRACTOR.": 0 |
| 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.": 0 |
| Select for "g. BE AUTHORIZED TO USE THE SERVICES OF DEFENSE TECHNICAL INFORMATION CENTER (DTIC) OR OTHER SECONDARY DISTRIBUTION CENTER.": 0 |
| Select for "c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR.": 0 |
| Select for "c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR.": 1 |
| Select for "c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR.": 1 |
| Select for "h. REQUIRE A COMSEC ACCOUNT.": 0 |
| Select for "h. REQUIRE A COMSEC ACCOUNT.": 1 |
| Select for "d. U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECURITY ADMINISTRATION.": 0 |
| Select for "d. U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECURITY ADMINISTRATION.": 0 |
| 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.": 0 |
| Select for "e. NATIONAL INTELLIGENCE INFORMATION: - (1) Sensitive Compartmented Information (SCI).": 0 |
| Select for "e. NATIONAL INTELLIGENCE INFORMATION: - (2) Non-SCI.": 0 |
| Select for "j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS.": 0 |
| 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.": NATO ATPs |
| Enter infomration for "other.": HQ, MSC PM52 Project Officer |
| 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). .": 0 |
| Select for "m.OTHER.": 0 |
| Select for "direct.": 0 |
| Select for ": 1 |
| Enter specification for "through".: Military Sealift Command, Public Affairs Office, Code N00P |
471 E. C St.; Norfolk, VA 23511-2419
| Enter public release authority.: |
| Select to add signature.: |
| Select to remove last signature.: |
| text: |
Specific key billets as specified in the contract shall have access to SECRET information regarding mission operation. Employment must be by US citizens who possess at least a SECRET clearance. All designated personnel who maintain a security clearance and handle classified information must attend Counterintelligence Awareness and Reporting (CIAR) Training. See DoD Directive Number 5240.06 for guidance.
Information Security Requirements (InfoSec). The Contractor shall handle, store and maintain classified material in compliance with requirements set by DOD 5220.22 (series), National Industrial Security Program Operating Manual, and the DD Form 254, DOD Contracts Security Classification Specification for classified contracts. All persons who require access to classified information, sensitive information, controlled unclassified information (to include Privacy Act and Personally Identifiable Information (PII) or access to the classified information network shall comply with DoD Manual 5200.01 Vol I - IV (DoD Information Security Program), DoDM 5220.22 Volume 2&3, and DoDD 5240.06 (Counterintelligence Awareness and Reporting - CIAR). The Contractor shall implement InfoSec measures for its contractor-furnished unclassified information technology system(s) used in performance of this contract. InfoSec measures shall be compliant with DFARS 252.204-7012, Safeguarding Covered Defense Information and Cyber Incident Reporting. At a minimum, the security standards extracted from the referenced National Institute of Standards and Technology (NIST) Special Publication 800-171, Protecting Controlled Unclassified Information in Non-Federal Information Systems and Organizations or accepted equivalents, shall be incorporated into any InfoSec program the contractor establishes.
Contract performance requires that designated personnel employed onboard the ship that have access to SECRET information shall possess a completed National Agency Check and a SECRET clearance granted by DISCO. Only U.S. Citizens have access to classified material. The Contractor shall, on a semi-annual basis, provide the Contracting Officer an updated list of all crew members who are designated to have access to classified information. The Contractor shall ensure that any classified information disclosed to its employees is not further released or made available to other employees or any other person who does not have a comparable clearance and a "Need to Know."
Contractors performing duties under this contract must adhere to all service/component command/local security directives, regulations, and standard operating procedures at all contract performance locations. If subcontractors are used, this form must be modified to include subcontractor information. The contractor will ensure all subcontractors follow security guidance.
The Contractor is governed by the DoD 5220.00-S, COMSEC Supplement to Industrial Security Manual for Safeguarding Classified Information, in the control and protection of COMSEC material and information.
The Contractor must provide a VISIT AUTHORIZATION LETTER (VAL) listing all contract personnel located on installations and aboard ship that require or will have access to classified information as well as other contractors that perform contractual services in the installation or aboard ship and require or have access to sensitive unclassified information or those that require routine or frequent "entry" to the installation or aboard ship in the performance of other types of contracts, services or maintenance. During the performance period of the contract, the Contractor's Facility Security Officer shall notify MSC's Command Security Manager within 7 working days of any changes to the listing of the contract personnel.
Block 10k. The Contractor is required to access NATO ATPs in tghe performance of this contract. Access to other NATO classified or restricted information is not required.
| Click on this button to attach a file(s).: |
| rep: Gary J. Davis |
PM52 Army/Air Force Project Officer
| Enter signature.: |
| Explain and identify specific areas and government activity responsible for inspections.: |
| Enter GCA name.: N10 MSC Contracting Directorate |
| Enter AAC of the contracting office.: N32205 |
| Enter AAC of the contracting office.: N32205 |
| Enter address (include zip code).: 471 East C Street |
Norfolk, VA 23511 Enter address (include zip code).: 471 East C ST Norfolk VA 23511
| Enter POC name.: Franklin C. Orvin |
| Enter telephone number (include area code).: 7573414628 |
| Enter telephone number (include area code).: 7574432878 |
| Enter email address.: franklin.orvin@navy.mil |
| Enter email address.: eric.c.schotter@navy.mil |
| Enter title.: Security Director |
| Enter the datesigned in format YYYYMMDD.: 20210528 |
File details come from the government source that posted it. Updated .