Attch21DDForm254.pdf

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ADDENDUM TO DD FORM 254 (Block 10e (1)) SENSITIVE

COMPARTMENTED INFORMATION

(SCI) CLAUSES

As of July 2020

Supporting SSO:

Office Symbol:

Address:

Phone Number:

Contract #:

Company Name:

Expiration Date:

SCI COR/CM:

Office Symbol:

Phone Number:

1. Reference Block 14: This contract requires access to Sensitive Compartmented Information (SCI).

The following references (use current versions) are offered to provide the necessary guidance for physical, personnel, information, and information systems security measures and is part of the SCI security specifications for the contract:

National Security Act of 1947, as amended; Executive Order (EO) 12333, as amended; EO 13526; EO 13549; EO 12829; EO 12968, as amended; 32 CFR Part 2001; 32 CFR Part 2003, 32 CFR Part 2004;

and other applicable provisions of law; DoD Manual 5105.21, Volumes 1 -3; AFMAN 14-401;

5220.22-M (NISPOM and Supplement); ICD 701, ICD 702, ICD 703, ICD 704/ICPGs 704.1. ICPG 704.2, ICPG 704.3, ICPG 704.4, ICD 710, ICD 705, ICS 705-1; ICD 503 and related NIST/CNSSI guidance for Risk Management Framework, and the ICD 503 Practitioner Manual; (this defines the RMF, Reciprocity, Roles & Responsibilities and each of the 6 steps of RMF), and CNSS policies and instructions, as applicable.

2. SCI will not be released to contractor employees without the specific release approval by the originator of the material as outlined in the governing directives and based on prior approval and certification of “need-to-know” by the SCI Contracting Officer’s Representative (COR) or Contract Monitor (CM), identified above.

3. Names of contractor personnel requiring access to SCI and justification for SCI positions will be submitted for coordination and action to the supporting SSO after the COR/CM approval/concurrence.

Upon receipt of written approval from the COR/CM, the Facility Security Officer (FSO) and/or Contractor Special Security Officer (CSSO) may submit the necessary forms to Defense Security Service (DSS) for a Tier 5 investigation for those personnel nominated for SCI access in accordance with the National Industrial Security Program Operating Manual (NISPOM). The FSO/CSSO will monitor JPAS for status changes affecting adjudication and eligibility for personnel under their cognizance and notify the SSO when changes are noted.

4. This contract will require ______ SCI positions in order to fulfill contractual obligations incurred. SCI access is subject to U.S. Government review and approval as outlined in the aforementioned SCI security guidance. Upon completion or cancellation of the contract, the SSO/CSSO will debrief all personnel not required for contract closeout and those positions will be disestablished.

5. The SSO/CSSO must restrict access to only those individuals who possess the necessary security clearance and who are actually providing services under the contract. Further dissemination to other contractors, sub-contractors, other government agencies, private individuals or organizations is prohibited unless authorized in writing by the releasing agency

6. SCI materials furnished in support of this contract remain the property of the DoD department or command that released it. Upon completion or cancellation of the contract, all SCI materials furnished will be returned to the direct custody of the originator of the materials or the COR.

7. Classified foreign intelligence materials must not be released to foreign nationals or immigrant aliens whether or not they are also consultants, US contractors, or employees of the contractor, regardless of the level of their security clearance, except with advanced written permission from the originator.

8. The CSSO must not reproduce classified foreign intelligence without advance approval of the releasing agency. If permission is granted, each copy will be controlled in the same manner as the original. The CSSO must not destroy any classified foreign intelligence without advance approval of the releasing agency.

9. Contractor personnel must maintain accountability for all intelligence (to include foreign intelligence) materials released to their custody.

10. Inquiries pertaining to classification guidance on SCI will be directed to the COR listed in para 2 above. SCI security management issues shall be directed to the supporting SSO, identified at the top of this document.

11. All DD Form 254s prepared for subcontracts involving access to SCI under this contract must be forwarded to the COR for approval and then to the servicing SSO for review and concurrence prior to award of the subcontract. Inquiries pertaining to classification guidance on SCI will be directed to the COR listed above. SCI security management issues shall be directed to SSO office listed above.

12. If SCI access is for meeting, conferences, demonstrations, etc. ONLY check box and skip para 13.

13. An SCI Facility (SCIF) meeting the physical security requirements outlined in ICD 705 is required for this contracting effort. All SCI used for this contract shall be stored, handled, and maintained in an accredited SCIF, be it the local contractor SCIF or similarly SCI- accredited facilities used by the contractor. If the contractors' place of performance is in a SCIF, or if they are accessing an SCI IT system, or generating SCI in any format, the places of performance will be identified in the DD 254 item 8a and listed on this form. List the address for SCIF execution below in the following format:

(FOUO) Office Symbol and/or Company Name; Street Address, Bldg#, City , State, Zip Code; SCIF ID Number(s); SSR/CSSO Name, Phone Number

**NOTE: CUA/JUA REQUIRED FOR NON AF SCIF. DOCUMENT IS FOUO WHEN SCIF

LOCATION IS IDENTIFIED. MARK DOCUMENT ACCORDINGLY**

Phone: SCI requirements reviewed and approved by:

(SSO WPAFB)

Continuation Block

14. For contract work within an approved contractor facility, all SCI information systems will be accredited and authorized following the Risk Management Framework (RMF), IAW ICD 503 and the ICD 503 Practitioners Manual. All SCI systems will be accredited through the Designated Authorizing Official using the XACTA system. These are processed through the Command CISO at HQ AFMC/A2S to the 25th AF/A6S (AF Intelligence Community - AO). Other applicable policy as directed by DIA, ODNI, or HQ AFMC shall apply. This includes all electronic connectivity and electronic methods for storing and communicating within and outside the SCIF.

15. Other networks processing corporate unclassified, SIPRNET, or other collateral information will follow the cognizant authority policy requirements. Prior authorization by a cognizant authority must be obtained prior to operation. Non-AF SCI systems must be accredited by the designated authority and may require a CUA/JUA for operation in DIA facilities.

16. Reference DD254 Block 15: This contract requires access to SCI. If the contractor has established a SCIF, DIA and its designees are responsible for all inspections of the contractor SCIF and SCI security management for ensuring compliance related to SCI security regulations and policies. The supporting SSO maintains security cognizance for all SCI requirements on this contract. Inspections of the SCIF(s) will be conducted by the Intelligence Community accrediting agency who approved the SCIF or their delegated official. The Defense Security Service (DSS) is relieved of security oversight for SCI performance.

17. Visits. The contractor will submit the written request for SCI visit certifications through the COR/CM for approval of the visit. The certification must arrive at their servicing SSO at least three working days prior to the visit.

18. This contract requires that the contractor requires courier authorization in order to transport classified materials between work locations. This authorization is based on duty location and distance and will be processed IAWDODM 5105.21 V1. Check here:

This contract will require: 16

Text6: Raytheon Company

Text8: Natalie A. Quint

Text9: AFLCMC/WIE-IP

Text10: (937) 255-6616

Check Box15: Yes

Check Box16: Yes

2020-12-17T13:54:04-0500

RICE.MEAGAN.MARIE.1366218692

Text20:

Text21:

Text7: 12/31/2025

Text13: 2450 D Street

WPAFB OH 45433

Text14: (937) 713-3492

Text12: 21 IS/INS

Text11: SSO WPAFB

Text5: FA8577-21-C-0002

Text1:

Text2:

Text22:

Text17: MEAGAN M. RICE, GG-12, DAF; 21 IS/INS

Text18: (937) 713-3492

DRAFT

SAMPLE

PREVIOUS EDITION IS OBSOLETE.

Page of AEM LiveCycle Designer

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:

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

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.)

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

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

Raytheon Company 2000 E. El Segundo Blvd.

El Segundo CA 90245-0902 Name:

N/A

Los Angeles Field Office, 3452 E Foothill Blvd, Ste 600 Pasadena, CA 91107; (626) 463-0515; fax (626) 844-0318 dcsa.dcsa-western.dcsa-isfo.mbx.

los-angeles-field-office@mail.mil

CSO:

N/A CSO: DCSA Los Angeles Field Office 3452 East Foothill Boulevard, Suite 600 Pasadena, CA 91107; (626) 463-0515; fax (626) 844-0318 dcsa.dcsa-western.dcsa-isfo.mbx.

los-angeles-field-office@mail.mil

CSO: 36 WG/IP

Unit 14013

APO AP 96543-4013

(671) 366-5108; DSN: 315-366-5108

36wg.ip.1@us.af.mil

CSO: HQ USAFE-AFAFRICA/IP

Unit 3050 Box 135

APO AE 09021-3050

DSN 314-480-5161; 011-49-6371-47-5161;

usafeip.ip@us.af.mil CSO: 9 RW/IP, Beale AFB 5950 C Street, Beale AFB, CA 95903

(530) 643-2335 9RW.IP.Workflow@us.af.mil

Raytheon Company 2000 E. El Segundo Blvd.

El Segundo CA 90245-0902 Location: [Andersen AFB, Yigo, Guam] 319 OG/Det 1 Unit 14019

APO AP 96543-4019

Location: 9 OG/Det 2, Bldg 452, NAS Sigonella Strada Statale, 417 Catania-Gela, Sigonella, Italy Location: 9 RW 17852 16th Street Beale AFB CA 95903-1616 Block9: RQ-4B Global Hawk Contractor Logistics Support and Services. Sustainment Support of the Global Hawk Enhanced Integrated Sensor Suite (EISS)

(2) IT systems. See Item 13.

"12. PUBLIC RELEASE Cont'd:" below PublicAuthority: See 13. SECURITY GUIDANCE, "12. PUBLIC RELEASE Cont'd:" below

a. Contractor is to submit requests through the Contracting Officer for OPSEC Program Manager review and public release authorization. The Contracting Officer will provide contractor with written approval/disapproval. Information requiring AF or DoD–level review will be reviewed by the unit’s OPSEC Program Manager or Coordinator who will in-turn forward to the entry-level public affairs office through the AFIMSC Public Affairs Office to the Secretary of the Air Force, Office of Public Affairs, Security and Review Division (SAF/PAX), 1690 Air Force Pentagon, Washington DC 20330-1690. Transmission of public release request via e-mail is not authorized.

b. Ref Item 10e(1): Public release of Sensitive Compartmented Information (SCI) is not authorized.

13. SECURITY GUIDANCE Cont'd:

The National Industrial Security Program Operating Manual (NISPOM), February 2006, Incorporating Change 2, 18 May 2016, applies.

a. Ref Item 10a: Access to Communications Security (COMSEC) information

(1) The contractor is authorized to receive Government furnished cryptographic equipment through the Government COMSEC account. Access to classified COMSEC information requires a final U.S. Government clearance at the appropriate level. Further disclosure of COMSEC information by a contractor, to include subcontracting, requires prior approval of the GCA. Non-accountable COMSEC information, though not tracked in the COMSEC material control system, may still require a level of control within a document control system. Refer to NSA/CSS Manual 3-16, “Control of Communications Security Material,” and the Committee on National Security Systems Instruction (CNSSI) 4001, “Controlled Cryptographic Items,” for guidance.

(2) Contractor will comply with AFMAN 17-1302-O, "Communications Security (COMSEC) Operations," 9 Apr 20.

(3) Contractor personnel will follow the security requirements of the host government activity.

b. Ref Item 10e(1): Contractor requires access to SCI materials; SCI security requirements apply. See 21 IS/INS, SSO WPAFB, SCI Addendum, for details.

c. Ref Item 10e(2): Contractor will require access to intelligence information and must comply with directions provided by the Contracting Officer’s Representative (COR). The Program Manager has determined that disclosure does not create an unfair competitive advantage for the contractor or a conflict of interest with the contractor’s obligation to protect the information. The COR will identify what intelligence information is required for the contractor to satisfy the contract and will submit that information to the servicing Senior Intelligence Officer (21 IS) for approval prior to granting access.

d. Ref Item 10g: A formal NATO briefing is required prior to granting access to NATO Secret information. See NISPOM Chapter 10, Section 7, for details.

e. Ref Items 10j/11L: The contractor shall comply with DoDI 5200.48, "Controlled Unclassified Information"; AFI 16-1404, "Air Force Information Security Program"; Air Force Guidance Memorandum 2020-16-01, "Air Force Guidance Memorandum for CUI," dated 23 Jul 20; and DoDM 5400.7-Air Force Manual 33‑302, "DoD Freedom of Information Act (FOIA) Program." The contractor shall monitor CUI aggregation and compilation based on the potential to generate classified information pursuant to security classification guidance addressing the accumulation of unclassified data or information.

[Cont'd; next page]

13. SECURITY GUIDANCE Cont'd:

f. Ref Item 10k: Access to information technology (IT) systems, including Secret Internet Protocol Router Network (SIPRNET)

(1) Authorized users of an IT system with no privileged access (IT Level III), must obtain, at a minimum, a favorably completed Tier 1 background investigation in accordance with DoDM 5200.02_AFMAN 16-1405, "Air Force Personnel Security Program," 1 Aug 18, Para 3.2b(2) Table 2 (Added)(AF).

(2) Access to SIPRNET is authorized. SIPRNET users shall receive the Air Force North Atlantic Treaty Organization (NATO) Security Awareness Briefing and sign an acknowledgment prior to SIPRNET access.

g. Ref Item 11c: Contractor is authorized to have SIPRNET access at Raytheon Company, 2000 E. El Segundo Blvd, El Segundo CA 90245-0902.

h. Ref Item 11f: Contractor will access US classified at:

• 319 OG/Det 1 [Andersen AFB, Yigo, Guam], Unit 14019, APO AP 96543-4019

• 9 OG/Det 2, NAS Sigonella [Building 452, NAS Sigonella], Strada Statale, 417 Catania-Gela, Sigonella, Italy

i. Ref Item 11k: Go to https://www.ustranscom.mil/cmd/associated/dcd/?page=FAQ.cfm for Defense Courier Service points of contact and guidance.

j. Ref Item 11m: Provide the information requested by the Notification of Government Security Activity and Visitor Group Security Agreements clause, Air Force Federal Acquisition Regulation Supplement (AFFARS) 5352.204-9000, to the following servicing security activities:

• 36 WG/IP, Unit 14013, APO AP 96543-4013; DSN: 315-366-5108; 36wg.ip.1@us.af.mil

• HQ USAFE-AFAFRICA/IP, Unit 3050, Box 135, APO AE 09021-3050; 011-49-6371-47-5161; DSN 314-480-5161;

usafeip.ip@us.af.mil

• 9 RW/IP, 5950 C Street, Beale AFB CA 95903; (530) 643-2335; 9RW.IP.Workflow@us.af.mil

The contractor shall comply with DoDM 5220.22 Vol 2_AFMAN 16-1406 Vol 2, "National Industrial Security Program:

Industrial Security Procedures for Government Activities," 8 May 20, by following security procedures of the installation in accordance with (IAW) Para 3.8.a.; report adverse information IAW Para 4.14 (Added)(AF); and support commander self-inspections and self-assessments IAW Para 14.1.f (Added)(AF).

k. Program Manager (PM): Michelle L. Brown, AFLCMC/WIG, (478) 222-2026, michelle.brown.9@us.af.mil

l. Security Manager (SM): Donald R. Nalley, AFLCMC/WIE-IP, (937) 255-3189, donald.nalley.1@us.af.mil.

m. The Contractor will notify the Government Contracting Activity and the Government Security Manager within 48 hours of any incident involving the actual or suspected compromise/loss of classified information to enable the Government to conduct immediate assessment of potential impact pending formal inquiry/investigation. Actual or suspected compromise of Covered Defense Information will be reported IAW DFARS Clause 252.204-7012.

n. Ref Item 18d (Overseas Security Oversight):

• 36 WG/IP, Unit 14013, APO AP 96543-4013; 36wg.ip.1@us.af.mil

• HQ USAFE-AFAFRICA/IP, Unit 3050 Box 135, APO AE 09021-3050; usafeip.ip@us.af.mil

o. Ref Item 18f (Distribution):

• 88 ABW/IPD, 1801 Tenth Street, WPAFB OH 45433-7625; 88ABW.IPD.Industrial.Security@us.af.mil

• AFLCMC/WIE-IP, Attn: SM - D Nalley, 2530 Loop Road West, WPAFB OH 45433-7101; ISR.Industrial@us.af.mil

• AFLCMC/WIG, Attn, PM - M Brown, 235 Byron Street, Robins AFB GA 31098; michelle.brown.9@us.af.mil

• 21 IS/INS, SSO WPAFB, 2450 D Street, Building 20, Area B, WPAFB OH 45433-7629;

WPAFBSpecialSecurityOffice.Mailbox@us.af.mil

• 21 IS/INI, Attn: SIO, 2450 D Street, Building 20, WPAFB OH 45433-7629; afmc.oas.xri.workflow@us.af.mil

• 78 ABW/IP, 985 Macon Street, Robins AFB GA 31098-2441; 78abw.ipworkflow@us.af.mil

• Each Cognizant Security Office/Information Protection Office listed in Item 8c text: 88th Air Base Wing Information Protection Directorate Industrial Security Division (88 ABW/IPD, WPAFB OH)

COORDINATION/PRIME CONTRACT REVIEW

88 ABW/IPD, Industrial Security Specialist rep: Meagan Rice Industrial Security

SSO WPAFB

b. Ref Item 11j: OPSEC requirements apply. See Performance Work Statement for requirements.

c. Ref Blk 10e (1): SCI security requirements apply, see SCI addendum for details.

Enter your name here.:

a. Ref Items 10a/11h: NSA has oversight for COMSEC. For COMSEC accessed at Government installations, the installation COMSEC Manager will maintain oversight.

b. Ref Item 11f: Security oversight will be maintained by the host installation. The host installation is the custodian of the releasable classified information and defense articles.

c. Ref Item 11m: Contractor performance will occur at locations identified in Items 8a. DCSA Field Offices and Information Protection Offices identified in Items 8c will maintain security oversight.

d. Ref Blk 10e (1): SCI security requirements apply, see SCI addendum for details. (para 16)

Attn: Contracting 235 Byron Street Suite 19A Robins AFB GA 31098 Address: AFLCMC/WIUKB, Attn: PCO - A Ruffin 235 Byron Street, Suite 19A Robins AFB GA 31098