Attachment F - DD254.pdf

PDF 108 KB Posted Apr 26, 2023

Attached to: NS NETWORK SYSTEMS Federal contract opportunity
Solicitation number: W912JB23Q0117
Issued by: Department of the Army Michigan Army National Guard

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Other files for this federal contract opportunity

Other files attached to NS NETWORK SYSTEMS, newest first.
File	Type	Posted
Attachment E - Kalamazoo County.pdf	PDF	Apr 26, 2023
Attachment G - PSIP Request.pdf	PDF	Apr 26, 2023
Attachment B - Solicitation Provisions and Clauses.pdf	PDF	Apr 26, 2023
Attachment D - Eaton and Ingham Counties.pdf	PDF	Apr 26, 2023
Attachment A - PWS.pdf	PDF	Apr 26, 2023
Attachment C - Alpena and Crawford Counties.pdf	PDF	Apr 26, 2023

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CLASSIFICATION (When filled in): Unclassified

PREVIOUS EDITION IS OBSOLETE. Page 1 of 3DD 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:

June 30, 2025

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)

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

W912JB-22-xxxx

DUE DATE (YYYYMMDD)

20221231

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

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 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.) Add Row Remove Last Row Delete All Rows

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

W8AC MIARNG ELEMENT, JF HQ

3411 N MARTIN LUTHER KING BLVD

LANSING MI 48906-2934

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

W90T83

c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional) CW2 Mary Allen (PSM)

3411 N MARTIN LUTHER KING BLVD

LANSING MI 48906-2934

517-481-8345 mary.e.allen138.mil@army.mil

9. GENERAL UNCLASSIFIED DESCRIPTION OF THIS PROCUREMENT

Contractor will facilitate and coordinate communication of classified information over channels classified as SECRET. The information transmitted will primarily involve military unit readiness. In order to obtain access to these systems, the contractor must possess a SECRET security clearance. Additionally, contractor will require access to secure facilities and the secure systems which store and transmit SECRET information, contractor will require access and possess knowledge of SECRET communications security (COMSEC) information.

PREVIOUS EDITION IS OBSOLETE. Page 2 of 3DD 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 DoDI 5200.48, only for specific CUI protection requirements. Non-DoD Components: see instructions.)

m. OTHER (Specify) (See instructions.)

12. PUBLIC RELEASE

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)

CW2 Mary Allen (MIARNG, PSM), 517-481-8345, mary.e.allen138.mil@army.mil

Public Release Authority:

LTC Anthony Baker (NGB J2, Chief IO DIV) 703-607-2511, anthony.w.baker7.mil@army.mil

13. SECURITY GUIDANCE Add Signature Remove Last Signature Delete All Signatures

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.)

Access to classified information is not required during pre-contract phases. When the contract is awarded a new DD Form 254 will be generated by the Requiring Activity and issued with the contract number in item 2a. or 2b.

FM 6-02

1-146. Signal Soldiers and units support all warfighting functions by installing, operating, and securing the DODIN-A to provide connectivity to critical Defense Information Systems Network (DISN) services. These services include the Defense Switched Network, Defense Red Switched Network, Organizational Messaging Service, video teleconferencing, telemedicine services, SECRET Internet Protocol Router Network (SIPRNET), Non-Classified Internet Protocol Router Network (NIPRNET), Joint Worldwide Intelligence Communications System, and mission partner environment.

AR 380-40

c. COMSEC account personnel operating within the EKMS, using the COMSEC local management device (LMD)

PREVIOUS EDITION IS OBSOLETE. Page 3 of 3DD FORM 254, APR 2018 and/or key processor (KP) must have a minimum secret security clearance.

d. In addition, those individuals whose official duties require continuing access to unencrypted secret crypto or top secret crypto keying material are subject to the requirements of the DACAP described in chapter 7 of this regulation.

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

NAME & TITLE OF REVIEWING OFFICIAL

LTC John M Keelean, MING J7

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.)

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.)

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

a. GCA NAME

MIARNG

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

W912JB

c. ADDRESS (Include ZIP Code) 3423 N Martin Luther King Jr Blvd Lansing, MI 48906

d. POC NAME

Eva Lauchie

e. POC TELEPHONE (Include Area Code)

+1 (517) 481-7846

f. EMAIL ADDRESS (See Instructions) eva.p.lauchie.civ@army.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)

b. TITLE

c. ADDRESS (Include ZIP Code)

d. AAC OF THE CONTRACTING OFFICE (See Instructions)

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.)

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:

June 30, 2025 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.

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

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

Enter serial number.:

a. Facility clearance level. Select one.: 2

b. Level of safeguarding for classified information/material required at contractor facility. Select one.: 4

Select for "original.": 0

Enter prime contract number.:

Select for "revised.": 0

Enter subcontract number.:

Select for "final.": 1

Select for "final.": 0

Enter solicitation or other number.: W912JB-22-xxxx

Enter due date in format YYYYMMDD.: 20221231

Enter date in format YYYYMMDD.:

Enter revision number.:

Enter date in format YYYYMMDD.:

Enter final specification.:

Enter date in format YYYYMMDD.:

Select for "no.": 1

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).:

Enter CAGE code of the prime contractor.: W90T83

Enter cognizant security office(s) (Name, Address, ZIP Code, Telephone required; Email Address optional).: CW2 Mary Allen (PSM)

3411 N MARTIN LUTHER KING BLVD

LANSING MI 48906-2934

517-481-8345 mary.e.allen138.mil@army.mil

Select to add row to locations.:

Select to remove last row from locations.:

Select to delete all signatures.:

Enter location(s).: W8AC MIARNG ELEMENT, JF HQ

3411 N MARTIN LUTHER KING BLVD

LANSING MI 48906-2934

Enter general unclassified description of this procurement.: Contractor will facilitate and coordinate communication of classified information over channels classified as SECRET. The information transmitted will primarily involve military unit readiness. In order to obtain access to these systems, the contractor must possess a SECRET security clearance. Additionally, contractor will require access to secure facilities and the secure systems which store and transmit SECRET information, contractor will require access and possess knowledge of SECRET communications security (COMSEC) information.

Select for "a. CONTRACTOR.": 1

Select for "a. CONTRACTOR.": 0

Select for "f. OTHER AS NECESSARY.": 0

Select for "b. SUBCONTRACTOR.": 1

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 "c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR.": 0

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 "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 "k. BE AUTHORIZED TO USE DEFENSE COURIER SERVICE.": 0

Enter infomration for "other.":

Select for "e. ADMINISTRATIVE CONTRACTING OFFICER.": 0

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".: CW2 Mary Allen (MIARNG, PSM), 517-481-8345, mary.e.allen138.mil@army.mil

Enter public release authority.: LTC Anthony Baker (NGB J2, Chief IO DIV)

703-607-2511, anthony.w.baker7.mil@army.mil

Select to add signature.:

Select to remove last signature.:

text: Access to classified information is not required during pre-contract phases. When the contract is awarded a new DD Form 254 will be generated by the Requiring Activity and issued with the contract number in item 2a. or 2b.

FM 6-02

AR 380-40

c. COMSEC account personnel operating within the EKMS, using the COMSEC local management device (LMD) and/or key processor (KP) must have a minimum secret security clearance.

Click on this button to attach a file(s).:

rep: LTC John M Keelean, MING J7

Enter signature.:

Explain and identify specific areas and government activity responsible for inspections.:

Enter GCA name.: MIARNG

Enter AAC of the contracting office.: W912JB

Enter address (include zip code).: 3423 N Martin Luther King Jr Blvd

Lansing, MI 48906

Enter POC name.: Eva Lauchie

Enter telephone number (include area code).: 5174817846

Enter email address.: eva.p.lauchie.civ@army.mil

Enter title.:

Enter the datesigned in format YYYYMMDD.:

File details come from the government source that posted it. Updated Apr 26, 2023.