Attachment J.02_DD_Form_254.pdf

CLASSIFICATION (When filled in): Unclassified

PREVIOUS EDITION IS OBSOLETE. Page 1 of 7DD 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

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

N63394-25-R-0007

DUE DATE (YYYYMMDD)

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

a. ORIGINAL (Complete date in all cases.)

DATE (YYYYMMDD)

20250429

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.14D7987/18F3000

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

DD254 IS PREPARED FOR SOLICITATION

PURPOSES ONLY (NO CONTRACT NUMBER HAS

BEEN ISSUED):

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 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.)

Refer to Block 13

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

This requirement is to provide lifecycle support for equipment and systems, including routine maintenance, upgrades, and depot-level repairs.

It covers all phases from deployment to retirement, ensuring systems meet performance standards, adapt to changing needs, and are efficiently maintained.

PREVIOUS EDITION IS OBSOLETE. Page 2 of 7DD 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.)

Refer to Block 13

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)

Naval Surface Warfare Center (NSWC), Port Hueneme Division (PHD), 103, 4363 Missile Way, Port Hueneme, CA 93043-4307

Public Release Authority:

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.)

-No security classification guides currently exist for this contract. Classified information generated in support of this contract must be marked in accordance with the source material provided.

Item 4: Task Order No. N00178-14-D-7987 will be replaced by this procurement. Material generated or received under Task Order No.

N63394-18-F-3000 will be transferred to the contract listed in Block 2.

Item 8: Performance locations will include San Diego, CA; Norfolk, VA; Mayport, FL; Everett, WA; Bremerton, WA; Seattle, WA; Pearl Harbor, HI; Pascagoula, MS; Charleston, SC and other government or military activities as specified in the SOW or other contract authorizations.

Item 10j,11L: All Controlled Unclassified Information (CUI) associated with this contract must be safeguarded to prevent unauthorized public disclosure. CUI such as Privacy, PROPIN, SCG, EXPT, and other controlled technical information (CTI) with Distribution Statements B, C, D, E or F are not authorized for public release and cannot be placed on a publicly accessible web site or web server. You

PREVIOUS EDITION IS OBSOLETE. Page 3 of 7DD FORM 254, APR 2018 can find a full list of CUI categories on the National Archives web site at https://www.archives.gov/cui. All emails containing such information or attachments, shall be protected per NIST SP-800-171, or subsequent revisions. All transmissions to personal email accounts (AOL, Yahoo, Hotmail, Comcast, etc.) and posting on social media websites (Facebook, Instagram, Twitter, LinkedIn, etc.) are prohibited.

Destroy all CUI associated with this contract by any of the following approved methods: A cross-cut shredder; a certified commercial destruction vendor; a central destruction facility; incineration; chemical decomposition; pulverizing; or disintegration.

Protect CUI in accordance with DoDI 5200.48 Controlled Unclassified Information dated March 6, 2020 (which canceled and replaced DoD M-5200.01 Volume 4, DoD Information Security Program: Controlled Unclassified Information dated 2/24/2012.) It is emphasized that CUI information may not be transmitted via unprotected systems, e.g., the internet, unless fully encrypted to current DoD standards.

Contractor employees who do not require access to classified information in performance of this contract but are assigned to sensitive national security duties, require access to sensitive information, or those that for other reasons require a fitness or trustworthiness determination shall be processed for the appropriate background investigation through the Naval Surface Warfare Center Port Hueneme Division (NSWC PHD) Personnel Security Office for a Non- NISP investigation. Point of contact is the Personnel Security Specialist,

(805) 228-7468.

Item 11c: The contractor requires access to classified source data up to and including the level identified in item 1a of this DD254.

Classified material generated in support of this contract shall be classified in accordance with the source material of the Navy Security Classification Guidance, which will be provided by the GCA. Automated Information Systems (AIS) must be certified and accredited by the Cognizant Security Agency (CSA) prior to processing classified information from NSWC PHD.

Item 11f: Access to U.S. classified information may be required in (Sasebo, Japan; Yokosuka, Japan; Rota, Spain; Bahrain; Gaeta, Italy;

Genoa, Italy). DoD components are responsible for providing the day-to-day oversight and management of contractors collocated with and supporting government customers. Security officers on-board the designated ships and installations will maintain control of the classified information and conduct security inspections if required. Additional locations may be required, as identified per SOW, TI, TO, TDL or other contractual authorization. Contractors in a foreign country and working FMS programs must complete NAVSEA foreign disclosure training on TWMS. Course Name: NAVSEA FOREIGN DISCLOSURE TRAINING course number: 689777; course ID: TWMS-689777 or equivalent.

Item 11j(1): The Contractor shall follow and protect critical information associated with this contract to prevent unauthorized disclosure.

The NSWC PHD Critical Information and Indicators List (CIIL) is located in the OPSEC Instruction, NSWCPHDINST 3070.1.

Item 11j(2): Performance under this contract requires the contractor to adhere to OPSEC requirements. OPSEC requirements are additional to the requirements of 32 CFR Part 117, NISPOM, therefore, the Contractor may not impose OPSEC requirements on its subcontractors unless NSWC PHD 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 11j(3): During the period of this contract, the Contractor may be exposed to, use, or produce, NSWC PHD Critical Information (CI) and/or observables and indicators which may lead to discovery of CI. NSWC PHD CI will not be distributed to unauthorized third parties, including foreign governments, or companies under Foreign Ownership, Control, or Influence (FOCI).

Item 11j(4): 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 11j(5): NSWC PHD 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 NSWC PHD Public Release Authority listed in Item 12 of this DD Form 254.

Item 11j(6): 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 programs must be immediately reported to the Facility Security Officer and Defense Counterintelligence and Security Agency and/or the Naval Criminal Investigative Service, and the NSWC PHD Industrial Security Department.

Item 11j(7): For specific OPSEC requirements, Critical Information and Indicators Lists (CIILs) and assistance contact the respective OPSEC Program Officer or COR.

Item 11j(8): Employee completion of initial and annual OPSEC fundamentals training or company (e.g., FSO) providing an OPSEC Orientation training brief. (Mandatory if contractors will be accessing government IT systems/networks)

Item 11m. OTHER:

PREVIOUS EDITION IS OBSOLETE. Page 4 of 7DD FORM 254, APR 2018

• Per NISPOM update 117.13(d)(5), Return of Classified Materials effective 24 February 2021 contractors must return all classified material to the government at the end of the contract. Contractors must coordinate the return of materials with their designated COR.

• Contractor performance shall be in accordance with the NISPOM, 32 CFR Part 117 and DFARS 252.204-7012 - Safeguarding Covered Defense Information and Cyber Incident Reporting, 48 CFR 52.204-2 - Security Requirements and NIST Special Publication 800-171. The contractor shall limit requests for Personnel (Security) Clearances (PCL) to the minimal number of personnel for operational efficiency, consistent with contractual obligations and other requirements of the NISPOM.

• This DD254 and the 32 CFR Part 117, National Security Program Operating Manual (NISPOM) are part of the contract. The contractor agrees to provide and maintain a system of security controls within its own organization according to the NISPOM. All contractor personnel will obtain and maintain the appropriate level of security clearance eligibility or access as required to perform on the level of tasking assigned. Access to classified information will be limited by the access level showing in Defense Information Security System (DISS) or subsequent system of record and need to know. All classified information shall be handled in accordance with approved security practices and procedures. Contractor personnel in contact with classified documentation, information and/or equipment shall have the proper level of access showing in DISS or the subsequent system of record and have a need to know.

• Per the DFARS clause 252.204-7000:

a) The Contractor shall not release to anyone outside the Contractor's organization any unclassified information, regardless of medium (e.g., film, tape, document), pertaining to any part of this contract or any program related to this contract, unless—

(1) The Contracting Officer has given prior written approval;

(2) The information is otherwise in the public domain before the date of release; or

(3) The information results from or arises during the performance of a project that involves no covered defense information (as defined in the clause at DFARS 252.204-7012) and has been scoped and negotiated by the contracting activity with the contractor and research performer and determined in writing by the contracting officer to be fundamental research (which by definition cannot involve any covered defense information), in accordance with National Security Decision Directive 189, National Policy on the Transfer of Scientific, Technical and Engineering Information, in effect on the date of contract award and the Under Secretary of Defense (Acquisition, Technology, and Logistics) memoranda on Fundamental Research, dated May 24, 2010, and on Contracted Fundamental Research, dated June 26, 2008 (available at DFARS PGI 204.4 (DFARS/PGI view)).

b) Requests for approval under paragraph (a)(1) shall identify the specific information to be released, the medium to be used, and the purpose for the release. The Contractor shall submit its request to the Contracting Officer at least 10 business days before the proposed date for release.

c) The Contractor agrees to include a similar requirement, including this paragraph (c), in each subcontract under this contract.

Subcontractors shall submit requests for authorization to release through the prime contractor to the Contracting Officer.

This clause shall also be made available to Subcontractors.

• Contractors must adhere to all training outlined in the security manual to include CUI training etc.

• All classified information received is the property of the US Government. Any classified information generated in the performance of this contract shall be classified according to the markings shown on the source material as well as the applicable security classification guide (SCG). In the event of a discrepancy between source material and the SCG, the SCG shall prevail. Classified information shall be processed for appropriate disposition per 32 CFR Part 117, NISPOM, 117.15(i).

• If additional contracting requirements exist where retention of classified information by the contractor facility is required, a written request to retain material for a period but not to exceed 2 years is required to the individuals listed in Blocks 16 and 17.

• Upon completion or termination of the classified contract, or sooner when the purpose of the release has been served, the contractor will return all classified information to the source from which received unless retention or other disposition instructions are authorized by

NSWC PHD.

• FAR CLAUSE - 52.204-2 -- Security Requirements

(a) This clause applies to the extent that this contract involves access to information classified “Confidential,” “Secret,” or “Top Secret.”

(b) The Contractor shall comply with --

(1) The Security Agreement (DD Form 441), including the National Industrial Security Program Operating Manual (32 CFR Part 117);

and

(2) Any revisions to that manual, notice of which has been furnished to the Contractor.

(c) If, subsequent to the date of this contract, the security classification or security requirements under this contract are changed by the Government and if the changes cause an increase or decrease in security costs or otherwise affect any other term or condition of this contract, the contract shall be subject to an equitable adjustment as if the changes were directed under the Changes clause of this contract.

PREVIOUS EDITION IS OBSOLETE. Page 5 of 7DD FORM 254, APR 2018

(d) The Contractor agrees to insert terms that conform substantially to the language of this clause, including this paragraph.

• The Security Classification Guide listed in Block 13 or subsequent revisions apply to this contract. Subsequent revisions shall be provided by the Government Contracting Activity as Government Furnished Information and shall be executed by the Contractor at no additional cost to the government.

• Contract Couriers: Facility Security Officer (FSO) will provide required courier briefings to employees authorized to courier classified information for this contract. FSO will provide NSWC PHD security office a list of personnel authorized and briefed to courier classified material. This list will be reconciled and forwarded to the security office as changes occur.

• Personnel designated as derivative classifiers shall receive 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 to the Information Assurance Manager no later than the individual's due date.

• Contractors are not authorized to unilaterally declassify or downgrade material marked for automatic downgrading or declassification.

Contractors must receive written authorization from NSWC PHD before taking actions to declassify or downgrade material.

• Contractors responsible for unauthorized disclosure of PII may be held accountable for any costs associated with breach mitigation, including those incurred as a result of having to notify personnel.

• Classified or unclassified technical papers to be presented at a classified symposium must be approved by the NSWC PHD Contracting Officer’s Representative prior to the presentation in conjunction with the sponsoring program office (information owner).

• Security classification guides (OPNAVINST 5513 series) and controlled unclassified information (CUI) (e.g., FOUO, 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 NSWC PHD Public Affairs (block 12).

• Contractor must submit a request for sharing of classified and other sensitive information between prime contractors in writing to the certifying official identified in Block 17(a) of this form for approval.

• All security related issues, incidents, or requests pertaining to this contract shall be presented in writing by the contractor's Facility Security Officer (FSO) to the individual identified in block 17(a) of this DD254. The contractor shall abide by other reporting requirements outlined in Part 117 of Title 32, Code of Federal Regulations which replaces DoD 5220.22-M (NISPOM).

• All reports of contractor security violations associated with this contract shall be mailed by the Cognizant DSS field office directly to the certifying official in Block 17 of this DD Form 254.

• All classified information involved in security incidents shall be retained and provided to the certifying official in Block 17(a) of this DD Form 254 for classification review.

• All classified paper documents destroyed by shredding must be done using a National Security Agency (NSA) approved high security crosscut shredder listed on the NSA/CSS evaluated products list for high security crosscut paper shredders. Destruction may also be accomplished by other approved methods for destruction of classified information.

• In addition to the reporting requirements directed by per 32 CFR Part 117, NISPOM, the contactor will provide a concurrent report if loss or compromise of classified information to the certifying official in Block 17 of this form and the Site Director, (Attn: Security Manager).

• Forward a copy of subcontractor DD Form 254s issued under this contract to NSWC PHD Security at the address in Block 17(a) of this DD Form 254.

• When submitting visit request to NSWC PHD, use its Security Management Office (SMO) code: PHD SMO code: 633946; VA Beach SMO code: 63394VA6-200; WS SMO Code 63394NM6; Mayport SMO code: 63394MPT-200

• NSWC PHD seated contractors are authorized to be escorts into NSWC PHD spaces. Contractors cannot escort foreign visitors.

• All security aspects of this contract fall under the cognizance of NSWC PHD. Security POCs: Christine Hansen, Deputy Security Manager, Code 105, (805)228-0234; Lillian Dent, Security Specialist, Code 1051, 805-415-6981, Lillian.j.dent.civ@us.navy.mil at the address in Block 17.

PREVIOUS EDITION IS OBSOLETE. Page 6 of 7DD FORM 254, APR 2018

On-Site Contractors:

1. Contractor employees must check out with NSWC PHD Security when departing NSWC PHD at the end of employment with their company or firm, end of procurement, when transferred to a different procurement, or upon being denied access to Government materials or information. The contractor shall return the items listed below to the custody of PHD NSWC Security Office, Bldg. 1380 or the local site security manager listed below.

• Common Access Cards (CACs), except issued to retired military personnel and retired civil servants on that basis.

• Pass/passes, except those issued to retired military personnel and retired civil servants on that basis.

2. Contractor personnel shall comply with all DoD, DoN, NAVSEA, NSWC PHD local Navy installation, and PHD NSWC security instructions, policies, procedures and guidance as they apply to the contractor. This includes all training requirements outlined in the NSWC PHD Security Manual. Contractor is required to return all government furnished equipment and government furnished material to the government at the end of this contract.

NSWC PHD site Security Managers:

NSWC PHD ARDEL Facility: Lei Lynn Hirata; leilynn.n.hirata.civ@us.navy.mil; (808) 335-4230 NSWC PHD Detachment White Sands: Janna Koenig; janna.koenig.civ@us.navy.mil; (575) 678-6050 NSWC PHD Mayport; Leon Jordan; leon.jordan2.civ@us.navy.mil; (904) 270-5534 X 10 NSWC PHD San Diego; Millie Ann Watson; millie.watson.civ@us.navy.mil; (619) 556 -9194 NSWC PHD Virginia; Marvin Abuan; marvin.g.abuan.civ@us.navy.mil; (757) 492-5064

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

Access to OPSEC has been reviewed NAME & TITLE OF REVIEWING OFFICIAL

Jacob Valentino, Alternate OPSEC Program Officer

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.)

OPSEC requirements are imposed on this task. Refer to Item: 13 of this DD Form 254 for applicable guidance. These OPSEC requirements cannot be imposed on subcontractors without written consent from the NSWC PHD OPSEC Program Officer. A written request by the Prime Contractor to the GCA Contracting Officer is required for the flow down of information to a subcontractor for OPSEC. These requirements shall not be imposed at an additional cost to the government. If the contractor is working aboard NSWC PHD, they will utilize NSWCPHDINST 3070.1 Operations Security.

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

Naval Surface Warfare Center Port Hueneme

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

N63394

c. ADDRESS (Include ZIP Code)

COMMANDING OFFICER, NSWC PHD

4363 MISSILE WAY PORT HUENEME,

CA 93043

d. POC NAME

Antoinette Ceglia

e. POC TELEPHONE (Include Area Code)

+1 (805) 228-6987

f. EMAIL ADDRESS (See Instructions) antoinette.ceglia.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.

VALENTINO.JACOB.

CARTER.1170837491

Digitally signed by

VALENTINO.JACOB.CARTER.

1170837491 Date: 2025.05.07 12:38:49 -07'00'

PREVIOUS EDITION IS OBSOLETE. Page 7 of 7DD FORM 254, APR 2018

a. TYPED NAME OF CERTIFYING OFFICIAL (Last, First, Middle Initial) (See Instructions)

Dent, Lillian

b. TITLE

Contracting Officer's Security Representative

c. ADDRESS (Include ZIP Code)

COMMANDING OFFICER, NSWC PHD

4363 MISSILE WAY, CODE 1051

PORT HUENEME, CA 93043

d. AAC OF THE CONTRACTING OFFICE (See Instructions)

N63394

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

f. TELEPHONE (Include Area Code)

+1 (805) 415-6981

g. EMAIL ADDRESS (See Instructions) lillian.j.dent.civ@us.navy.mil

h. SIGNATURE

i. DATE SIGNED (See Instructions)

20250507

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.)

DENT.LI

LLIAN.JU

ANITA.13

67523545

Digitally signed by

DENT.LILLIAN

.JUANITA.1367

523545 Date: 2025.05.07 14:34:14 -07'00'