Attachment J-1 DD254 Contract Security Classification_Form.pdf

CLASSIFICATION (When filled in): Unclassified

PREVIOUS EDITION IS OBSOLETE. Page 1 of 5DD 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

N5523625R3000

DUE DATE (YYYYMMDD)

20240603

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

a. ORIGINAL (Complete date in all cases.)

DATE (YYYYMMDD)

20240603

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)

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

TBD

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.)

Southwest Regional Maintenance Center 3755 Brinser St, Suite 1 San Diego, CA 92136

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.)

Naval Base Point Loma 140 Sylvester Road San Diego, CA 92106-3521

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

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

PREVIOUS EDITION IS OBSOLETE. Page 2 of 5DD FORM 254, APR 2018

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

Naval Air Station North Island 300 Alameda Blvd San Diego, CA 92135

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

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

9. GENERAL UNCLASSIFIED DESCRIPTION OF THIS PROCUREMENT

Provide a full range of maintenance, repair, and assessment execution and coordination expertise as support services throughout the SWRMC Production Department Product Families and Divisions. Additionally, the contractor shall provide facility and execution support services for the Off-Site Facility.

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

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) Public Release Authority:

SWRMC Public Affairs Officer, PH: (619) 556-8525 E-Mail: stephanie.m.higgins9.civ@us.navy.mil

13. SECURITY GUIDANCE

PREVIOUS EDITION IS OBSOLETE. Page 3 of 5DD FORM 254, APR 2018

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.)

Controlled unclassified information (CUI) (e.g., PII, distribution statement controlled) are not authorized for public release; therefore, they cannot be posted on a publicly accessible web-server or transmitted over the Internet unless appropriately encrypted. Request for public release cannot be transmitted via the Internet until the contractor receives final approval from SWRMC.

Contractor must submit a request for sharing of classified and CUI in writing to the SWRMC Contracts Office, identified in block 16 of this form.

The contractor may receive unclassified informational materials from the Government that are marked as Controlled Unclassified Information (CUI). This information is not authorized for release to the general public. Pertinent information is to be released only to contractor personnel who have a need to know for the purpose of contract execution or as directed by associated document markings or distribution statements. The contractor shall take proper safeguards to ensure that any such material received will be properly protected from unauthorized or inadvertent disclosure. If there are any questions regarding the requirements for protection or the release of CUI, the contractor shall refer those questions to the ACO.”

Item 10(j): All Controlled Unclassified Information associated with this contract must be protected per the guidance provided for Item 11(l) of this DD Form 254.

Item 11(a): Access at the actual work/performance location will not include the generation of classified information. Access to classified material will be for review only as necessary for the execution of the contract. All work will be completed at the government facility identified in Item 8.

Item 11(j): The Contractor shall protect critical information associated with this contract to prevent unauthorized disclosure. The SWRMC Critical Information List, SWRMCNOTE 5510 of August 29, 2022 will be identified under separate cover.

Item 11(j) Continued: Performance under this contract requires the contractor to adhere to OPSEC requirements. OPSEC requirements are additional to the requirements of Part 117 of Title 32, Code of Federal Regulations; National Industrial Security Program Operating Manual (NISPOM), therefore, the Contractor may not impose OPSEC requirements on its subcontractors unless SWRMC approves the OPSEC requirements. The contractor shall assign an OPSEC point of contact for this contract at no additional cost to the Government. This individual may be the Facility Security Officer (FSO).

Item 11(j) Continued: During the period of this contract, the Contractor may be exposed to, use, or produce, SWRMC Critical Information (CI) and/or observables and indicators which may lead to discovery of CI. SWRMC’s CI will not be distributed to unauthorized third parties, including foreign governments, or companies under Foreign Ownership, Control, or Influence (FOCI).

Item 11(j) Continued: Intra-office communications and electronic emails shall be encrypted and protected when containing SWRMC’s CI.

The transfer of unclassified technical data to and from the government or other associated activities must be accomplished via encrypted email or https://safe.apps.mil.

Item 11(j) Continued: Assembled large components/systems being transported to and from testing areas, other production or government facilities (whether or not on public roadways) shall be in an enclosed van trailer or covered flatbed trailer. Component/System outside storage, staging, and test areas shall be shielded/obscured from public view wherever physically possible.

Item 11(j) Continued: SWRMC’s CI shall not be publicized in corporate wide newsletters, trade magazines, displays, intranet pages or public facing websites. Media requests related to this project shall be directed to SWRMC Public Release Authority listed in Item 12 of this DD Form 254.

Item 11(j) Continued: Any attempt by unauthorized third parties to solicit, obtain, photograph, or record, or; incidents of loss/compromise of government Classified or CI, Business Sensitive, Company Proprietary information related to this or other program must be immediately reported to the Facility Security Officer and Defense Security Service and/or the Naval Criminal Investigative Service, and the SWRMC Information, Industrial, and Operations Security Division (SWRMC Code 1110). Questions concerning these requirements shall be directed to the SWRMC Information, Industrial, and Operations Security Division (SWRMC Code 1110).

Item 11(l): Legacy information from existing documents (e.g. Technical Manuals) marked CUI, that is used to create new documents/ correspondence, shall follow the minimum marking requirements of DoDI 5200.48, Section 3, paragraph 3.4.a. Nonfederal information

PREVIOUS EDITION IS OBSOLETE. Page 4 of 5DD FORM 254, APR 2018 systems storing and processing CUI shall be protected per NIST SP-800-171, or subsequent revisions. All transmissions to personal email accounts (AOL, Yahoo, Hotmail, Gmail, Comcast, etc.) and posting on social media websites (Facebook, Instagram, Twitter (Now X), LinkedIn, etc.) are prohibited. Destroy all CUI associated with this contract by any method approved for the destruction of classified information or per ISOO Notice 2019-03.

- Personnel designated as derivative classifiers shall complete derivative classification training prior to access from the contractor's Facility Security Officer (FSO). The FSO shall ensure personnel receive initial and annual training during the life of this contract. Evidence of completion, training certificates or equivalent, shall be provided per direction of the Cognizant Security Agency.

- All classified information security incidents shall be provided to the certifying official in block 17A of this DD Form 254 for classification review by the cognizant Defense Counterintelligence and Security Agency Field Office.

- All classified documents must be destroyed using a National Security Agency (NSA) approved high security crosscut shredder listed on the NSA/CSS evaluated products list(EPL) for high security crosscut paper shredders, or other approved method for destroying classified information.

- All security related issues and requests pertaining to this contract shall be presented in writing by the contractor's FSO to the individual identified in block 17A of this DD Form 254. The contractor shall abide by reporting requirements outlined in Part 117 of Title 32, Code of Federal Regulations; National Industrial Security Program Operating Manual (NISPOM).

- Forward a copy of subcontractor DD Form 254s issued under this contract to the official shown in block 17A of this DD Form 254.

- The program sponsor for this contract is: (Candice Barnes/Southwest Regional Maintenance Center/Candice.n.barnes2.civ@us.navy.mil, PH: (619) 726-5756)

- The Security POC for this contract is: (Milton Connery /Southwest Regional Maintenance Center/milton.connery.civ@us.navy.mil PH:

(619) 556-1176)

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

NAME & TITLE OF REVIEWING OFFICIAL

Milton Connery, OPSEC Program Manager

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

Southwest Regional Maintenance Center

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

N55236

c. ADDRESS (Include ZIP Code)

SOUTHWEST REGIONAL

MAINTENANCE CENTER

3755 Brinser St, Suite 1 San Diego, CA 92136

d. POC NAME

Candice Barnes

e. POC TELEPHONE (Include Area Code)

+1 (619) 726-5756

f. EMAIL ADDRESS (See Instructions) candice.n.barnes2.civ@us.navy.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)

Connery, Milton G

b. TITLE

Assistant Security Manager/Security Contracting Official

CONNERY.MILT

ON.III.1167787203

Digitally signed by

CONNERY.MILTON.III.116778

Date: 2024.06.03 09:02:14 -07'00'

PREVIOUS EDITION IS OBSOLETE. Page 5 of 5DD FORM 254, APR 2018

c. ADDRESS (Include ZIP Code)

Southwest Regional Maintenance Center 3755 Brinser St, Suite 1 San Diego, CA 92136-5205

d. AAC OF THE CONTRACTING OFFICE (See Instructions)

N55236

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

f. TELEPHONE (Include Area Code)

+1 (619) 556-1176

g. EMAIL ADDRESS (See Instructions) milton.connery.civ@us.navy.mil

h. SIGNATURE

i. DATE SIGNED (See Instructions)

20240603

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.)

CONNER

Y.MILTO

N.III.116

7787203

Digitally signed by

CONNERY.MIL

TON.III.116778

Date: 2024.06.03 09:03:40 -07'00'