Attachment O - DD254.pdf

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DRAFT

SAMPLE

PREVIOUS EDITION IS OBSOLETE.

Page of

DD FORM 254, MAY 2019

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:

20220531 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.)

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 whs.mc-alex.esd.mbx.formswebmaster@mail.mil

WHS

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

TBD

Name:

TBD

NASA Goddard Space Flight Center (GSFC) 8800 Greenbelt Road Greenbelt, MD 20771 Block9:

The purpose of the ETIS IV contract is to procure Environmental Test and Integration Services support for NASA's Goddard Space Flight Center (GSFC) within the Engineering and Technology Directorate (ETD). ETD is responsible for providing multi-discipline engineering expertise to both in-house and out-of-house instrument and spacecraft programs. To fulfill these responsibilities and ultimately achieve missions, the ETD must acquire a wide range of engineering services to implement the GSFC mission.

Greenbelt, MD 20771

2. In addition, the contractor must comply with the security requirements specified in the 32 CFR Part 117, National Industrial Security Program Operating Manual (NISPOM) Published 7/13/2022, and NASA security procedures and guidelines. The contractor is not authorized to disclose or release classified information (including to a subcontractor) without prior written authorization from NASA Protective Services.

3. The contractor must ensure that all employees remain current on all Agency training to include CNSI, NASA Annual Security Education and Awareness training, etc.

4. The Contractor/Facility Security Officer is required to submit visit requests annually to ensure security clearance information and access justification in the systems is up to date. This can be a bulk VAR (Visit Access Request) with necessary information in the spreadsheet. The contractor will only send the annual (and new employee working on the contract) VAR’s to NASA GSFC Protective Services Division for those personnel who are working on a Classified portion of the contract. The Contractor, Task and Project Managers should be prepared to provide Task Order Numbers and be able to justify the need for access to Classified National Security Information at GSFC. These inspections and inquiries by GSFC PSD will be ongoing. If a Contractor is only working on a Classified Project under this Contract for two weeks then the VAR will reflect that, not a full 364 day window.

5. The contractor FSO will notify GSFC Industrial Security personnel of all staff terminations, resignations, and departures to ensure immediate updates to online databases and Center access.

6. As a visitor to NASA GSFC, the contractor will comply with all applicable NASA security issuances, memorandums, policies/procedures and regulations as directed.

7. Item 10.j: The contractor must comply with requirements specified in NPR 2810.7, Controlled Unclassified Information, dated October 22, 2021.

8. The contractor must comply with NPR 1600.2A NASA Classified National Security Information (CNSI), September 11, 2019.

1. DOD 5220.22-M, National Industrial Security Program Operating Manual (NISPOM) (02/28/06) (Revalidation w/Chg 1) (March 28, 2013)

2. NPR 1600.1A, NASA Security Program Procedural Requirements updated with Change 1(08/12/2013)

3. NPR 1600.2 NASA Classified National Security Information (CNSI) (09/11/2019)

4. NPR 1600.3A Personnel Security (08/02/2020)

5. NPR 1600.4A Identity and Credential Management (04/08/2016)

6. NPR 1620.2B Facility Security Level Determinations (06/21/2021)

7. NPR 1620.3B Physical Security Requirements for NASA Facilities and Property (05/13/2019)

8. NPR 1660.1C, NASA Counterintelligence and Counterterrorism (05/07/2015)

9. NPR 2810.1F, Security of Information and Information Systems (01/03/2022)

10. NPD 1600.2E, NASA Security Policy (Revalidated on 4/2/2015 w/Change 1)

11. NPD 1600.4 National Security Programs (Revalidated with Change 1 on July 28, 2016)

12. NPD 2810.1F NASA Information Security Policy (01/21/2022)

13. NM 1600-55 Sensitive But Classified (SBU) Controlled Information

14. GPR 1600.1A, Goddard Security Requirements, (02/21/2014 or latest edition)

15. GPR 1600.2 GSFC Protective Service Division Classified National Security Information and Industrial Security (06/29/2018)

Greenbelt, MD, 20771 Address: 8800 Greenbelt Road, Code 175 Greenbelt, MD, 20771