Attachment4-DD254.pdf

CLASSIFICATION (When filled in):

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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

a. LEVEL OF FACILITY SECURITY CLEARANCE (FCL) REQUIRED (See Instructions)

b. LEVEL OF SAFEGUARDING FOR CLASSIFIED INFORMATION/

MATERIAL REQUIRED AT CONTRACTOR FACILITY

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

a. PRIME CONTRACT NUMBER (See instructions.)

b. SUBCONTRACT NUMBER

c. SOLICITATION OR OTHER NUMBER DUE DATE (YYYYMMDD)

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)

(-- 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

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

(Additional Performance Locations are located in block 13)

Unclassified

Unclassified

Top Secret Top Secret

✘ FA8210-21-R-5001

2021/01/21

1 2021/02/04

TBD

SEE SECTION 13 CONTINUATION SECTION AT THE BOTTOM OF THIS FORM

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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 DoDM 5200.01, Volume 4 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:

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. See instructions for additional guidance.)

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

Ref. 10.a: COMSEC safeguarding requirements apply. See the NISPOM chapter 9, section 4 for details. Access to COMSEC information is restricted to U.S.

Citizens holding a final U.S. government clearance at the appropriate level. Personnel must receive the required COMSEC briefing. Prior approval is required from the Government Contracting Activity prior to granting access to COMSEC information to a subcontractor.

Ref. 10.j.: CUI information provided under this contract shall be safeguarded as specified in DoDI 5200.48.

Ref 10.k.: The contractor is permitted access to the Secret Internet Protocol Router Network (SIPRNet). Actual knowledge, generation, or production of NATO information is not required for performance on this contract; however, a NATO awareness briefing will be completed prior to granting access to the SIPRNet.

Ref 11.c.: The contractor requires access to classified source data up to and including top secret in support of the work effort. All classified information received

SEE SECTION 13 CONTINUATION SECTION AT THE BOTTOM OF THIS FORM

Unclassified

Unclassified

SEE SECTION 13 CONTINUATION SECTION AT THE BOTTOM OF THIS

FORM

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NAME & TITLE OF REVIEWING OFFICIAL 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. (See instructions for additional guidance.)

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. (See instructions for additional guidance.)

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

a. GCA NAME

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

c. ADDRESS (Include ZIP Code) d. POC NAME

e. POC TELEPHONE (Include Area Code)

f. EMAIL ADDRESS (See Instructions)

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.

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.)

Unclassified

Unclassified

Regulation Or Supplement = DFARS Clause Number = N/A Clause Title = N/A Clause Effective Date = 2021/01/25 ClauseFullText=No additional clauses

AFLCMC/PZZKA

6039 Wardleigh Road Bldg. 1206, Hill AFB, UT, 84056

ZACK, RACHAEL E.

+1 (801) 777-5068

FA8210 rachael.zack@us.af.mil

Rachael Zack FA8210

Contracting Officer

Rachael Zack

FA8210 AFLCMC PZZK, CP 801 777 7148 6039 WARDLEIGH RD BLDG

1206 HILL AFB UT 84056-5838, HILL AFB, UT, 84056-5838, USA

801-777-5068 2021/02/04 rachael.zack@us.af.mil

13. SECURITY GUIDANCE. The security classification guidance 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 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 document/guides/extracts referenced herein.

Add additional pages as needed to provide complete guidance.

CONTINUATION OF ITEM 13

[Block: 13 Continuation] or generated will be properly stored and handled according to the markings on the material. Any extracts or use of such data requires the contractor to apply derivative classification markings consistent with the source documents and Executive Order (E.O.) 13526, as amended. Use of “Multiple Sources” on the “Derived From” line necessitates compliance with E.O. 13526, the NISPOM, and use of bibliography. Contractor will abide by applicable security classification guidance as defined in each task order. The applicable SCG will be provided under a separate cover. At the termination or expiration of this contract, the U.S. Government will be contacted for proper disposition instructions.

Ref 11.g.: The contractor is authorized to use the services of the Defense Technical Information Center (DTIC). The contractor must prepare a DD Form 1540, Registration for Scientific and Technical Information Services, for GCA submittal. The contractor may submit a DD Form 2345, Military Critical Technical Data Agreement, (after registration with DTIC) to the Defense Logistics Services Center for access to unclassified, militarily critical technical data from other DoD sources. Reference the NISPOM chapter 11, section 2 for preparation of these forms. The GCA must be involved in certifying need-to-know for contractors to utilize DTIC.

Ref 11.h.: A COMSEC account will be established and COMSEC will be protected per the NISPOM chapter 9, section 4.

Ref 11.i. TEMPEST requirements are as follows: (future requirements TBA) Ref 11.j. The contractor must comply with the U.S. Government, DOD, Air Force, AFMC, Hill AFB, and AFLCMC/HBZ Operation Security (OPSEC) Programs. The contractor must comply with any additional OPSEC requirements referenced in attachment within Item 13.

Ref 11.k Contractor must be authorized to use defense courier service.

Ref 11.l. In accordance with DFARS Subpart 252.204-7012, contractors and subcontractors will safeguard covered defense information that resides in or transits through contractor information systems by applying specified network security controls, and will report cyber incidents. Contractors are prohibited from releasing unclassified information to the public without approval of the contracting activity.”

Ref 10a: Classified COMSEC material is not releasable to contractor employees who have not received a FINAL clearance at the appropriate security level.

COMSEC access shall be IAW DoD 5220.22-M. Written concurrence of the GCA is required prior to subcontracting.

Ref 10j: Controlled Unclassified Information (CUI) generated and/or provided under this contract shall be safeguarded and marked as specified in DoD Instruction 5200.48.

Ref 11c: The contractor requires access to classified information. Any extracts must apply derivative classifications and markings consistent with the source documents.

Use of "Multiple Sources" on the "Derived From" line necessitates compliance with the NISPOM, paragraph 4-208b.

Ref 11g

Ref 11h: A COMSEC account must be established when accountable COMSEC material is to be provided, acquired, or produced under a contract. The GCA will inform the contractor that a COMSEC account is required.

Ref 11i: TEMPEST Information is not releasable to contractor employees who have not received a FINAL Clearance at the appropriate security level. Written concurrence of the GCA is required prior to subcontracting.

Ref 11j

Ref 11k

Ref 11l

[Block: 9] The Range Systems Branch (assigned to the Aerospace Dominance Enabler Division) provides threat radar systems, along with supporting tools and infrastructure, to US Air Force’s Combat Training Ranges. These radars train aircrews for survivability in high-threat environments. The systems range from over 30 years old to brand new designs. Therefore, a contract vehicle is needed to support multiple different types of engineering studies, sustainment activities, and development and acquisition of new systems. The objective of this contract is to provide the Air Force Life Cycle Management Center, Aerospace Dominance Enabler Division’s Range Systems Branch (AFLCMC/HBZC) with the necessary prototypes, hardware/software upgrades, production assets, and engineering analysis needed to support the overall mission. RISE is a multiple award Indefinite Delivery Indefinite Quantity (IDIQ) type contract that will be based on individual task order requirements.

This contract covers efforts to develop, produce, or modify range threat systems. This will include acquisition of subscale and full scale prototype systems, threat radar system upgrades/modifications, production, and engineering studies. The contractors shall be proficient in some or all of the following processes and disciplines: hardware design; software design; redesigns; modifications; modeling and simulation; prototype fabrication; integration; installation;

manufacturing or fabrication of components; test execution; user training; and production or fielding transition support. Specific requirements will be defined in each applicable task order.

[Block: 12] DoDAAC[FA8210] Release Information[Information requiring AF/DoD-level reviews will be forwarded by entry level public affairs office through MAJCOM/DRU PA Office] Location Code/Agency Name/Address[FA8210, FA8210 AFLCMC PZZK FA8210 AFLCMC PZZK, CP 801 777 7148 6039 WARDLEIGH RD BLDG 1206 HILL AFB UT 84056-5838, HILL AFB, UT, 84056-5838, USA]