B08. Attachment 5 - DRAFT DD Form 254 - SBIR_STTR (8FEB24).pdf
PDF 76 KB Posted
- Attached to
- USAMRDC PPA&E SBIR/STTR Support Services Federal contract opportunity
- Solicitation number
- HT9425-24-R-0031
- Issued by
- Defense Health Agency
About this file
This document outlines requirements for small business innovation research and technology transfer support services. The contractor shall assist the U.S. Army Medical Research and Development Command's Plans, Programs, Analysis and Evaluation directorate in managing various aspects of the Defense Health Agency's SBIR and STTR programs, including coordinating topic submissions and reviews, proposal evaluations, financial reporting and tracking, and responding to taskers. The contractor must have a secret facility clearance and be able to receive, store, and generate controlled unclassified information. The period of performance is one base year with four optional one-year periods. The contracting agency is the U.S. Army Medical Research Acquisition Activity.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| HT9425 24-R-0031 Questions and Answers.docx | DOCX document | |
| B08 Attachment 1 - Non-Disclosure Agreement.docx | DOCX document | |
| B08 Attachment 3 - Past Performance References.pdf | ||
| B08 Attachment 2 - Organizational Conflict of Interest Certification Form.docx | DOCX document | |
| B08. Solicitation HT9425-24-R-0031.docx | DOCX document | |
| B08 Attachment 4 Pricing Sheet.xlsx | XLSX spreadsheet |
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DRAFT
SAMPLE
PREVIOUS EDITION IS OBSOLETE.
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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"
| CurrentPage: |
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| Select classification from drop-down list.: Secret |
| SerialNum: |
| a. Facility clearance level. Select one.: 2 |
| b. Level of safeguarding for classified information/material required at contractor facility. Select one.: 2 |
| Select for "original.": 1 |
| Select for "original.": 1 |
| Enter prime contract number.: TBD |
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| Enter solicitation or other number.: |
| Enter due date in format YYYYMMDD.: |
| Enter date in format YYYYMMDD.: 20240208 |
| Enter revision number.: |
| Enter date in format YYYYMMDD.: |
| Enter final specification.: |
| Enter date in format YYYYMMDD.: |
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| Enter preceding contract number.: |
| Enter contractor's request date in format YYYYMMDD.: |
| Enter period.: |
| Enter typed name of certifying official (last, first, middle initial).: TBD |
| Enter typed name of certifying official (last, first, middle initial).: Myers, James, R |
| Enter CAGE code of the prime contractor.: TBD |
| Enter CAGE code of the prime contractor.: TBD |
| Enter cognizant security office(s) (Name, Address, ZIP Code, Telephone required; Email Address optional).: TBD |
| Enter cognizant security office(s) (Name, Address, ZIP Code, Telephone required; Email Address optional).: U. S. Army MRDC/G2 |
810 Schreider Street Ft. Detrick, MD 21702 3016199176
| Select to add row to locations.: |
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| Enter location(s).: U.S. Army Medical Research and Development Command |
Building 810, Attn: FCMR-PPA 810 Schreider Street Fort Detrick, MD 21702-5012 Enter general unclassified description of this procurement.: The SBIR and STTR Programs are both highly competitive and encourages US-based small businesses to engage in Federal Research/Research and Development (R/R&D) that has the potential for commercialization. Through a competitive awards-based program, SBIR/STTR enables small businesses to explore their technological potential and provides the incentive to profit from its commercialization. The contractors working in PPA&E under this contract assist in the planning and managing of activities and programs in the functional areas listed below.
- Provide program coordination for all aspects of the USAMRDC's SBIR/STTR Programs.
- Provide program coordination of SBIR/STTR topic submissions and all internal/external topic reviews.
- Provide program coordination for the receipt, evaluation, due diligence review, selection, proposal feedback, and award of SBIR/STTR proposals.
- Provide Work Breakdown Structures (WBSs) and Purchase Requisitions (PRs), to include PR modifications, for DHA SBIR/STTR Programs via General Fund Enterprise Business System (GFEBS).
- Provide SBIR/STTR financial reporting via internal and external mechanisms.
- Provide official responses to SBIR/STTR related taskers and request for information.
- Provide periodic SBIR/STTR briefings and information papers.
| Select for "a. CONTRACTOR.": 0 |
| Select for "a. CONTRACTOR.": 1 |
| Select for "a. CONTRACTOR.": 1 |
| Select for "f. OTHER AS NECESSARY.": 0 |
| Select for "f. OTHER AS NECESSARY.": 0 |
| Select for "f. OTHER AS NECESSARY.": 0 |
| Select for "b. SUBCONTRACTOR.": 0 |
| Select for "b. SUBCONTRACTOR.": 0 |
| Select for "b. SUBCONTRACTOR.": 1 |
| Select for "g. BE AUTHORIZED TO USE THE SERVICES OF DEFENSE TECHNICAL INFORMATION CENTER (DTIC) OR OTHER SECONDARY DISTRIBUTION CENTER.": 0 |
| Select for "g. BE AUTHORIZED TO USE THE SERVICES OF DEFENSE TECHNICAL INFORMATION CENTER (DTIC) OR OTHER SECONDARY DISTRIBUTION CENTER.": 0 |
| Select for "c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR.": 0 |
| Select for "c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR.": 0 |
| Select for "c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR.": 1 |
| Select for "h. REQUIRE A COMSEC ACCOUNT.": 0 |
| Select for "h. REQUIRE A COMSEC ACCOUNT.": 0 |
| Select for "d. U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECURITY ADMINISTRATION.": 0 |
| Select for "d. U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECURITY ADMINISTRATION.": 0 |
| Select for "d. U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECURITY ADMINISTRATION.": 0 |
| Select for "i. HAVE A TEMPEST REQUIREMENT.": 0 |
| Select for "i. HAVE A TEMPEST REQUIREMENT.": 0 |
| Select for "e. NATIONAL INTELLIGENCE INFORMATION: - (1) Sensitive Compartmented Information (SCI).": 0 |
| Select for "e. NATIONAL INTELLIGENCE INFORMATION: - (2) Non-SCI.": 0 |
| Select for "j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS.": 1 |
| Select for "j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS.": 1 |
| Select for "k. BE AUTHORIZED TO USE DEFENSE COURIER SERVICE.": 0 |
| Select for "k. BE AUTHORIZED TO USE DEFENSE COURIER SERVICE.": 0 |
| Enter infomration for "other.": |
| Select for "e. ADMINISTRATIVE CONTRACTING OFFICER.": 0 |
| Select for "e. ADMINISTRATIVE CONTRACTING OFFICER.": 1 |
| Select for "l. RECEIVE, STORE, OR GENERATE CONTROLLED UNCLASSIFIED INFORMATION (CUI). .": 1 |
| Select for "m.OTHER.": 0 |
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| Enter specification for "through".: NO PUBLIC RELEASE OF CLASSIFIED |
INFORMATION IS AUTHORIZED
| Enter public release authority.: USAMRDC Public Affairs Office |
| Select to add signature.: |
| Select to remove last signature.: |
| text: Ref 10j: Controlled Unclassified Information (CUI) generated and/or provided under this contract shall be safeguarded and marked as specified DoDI 5200.48 "Controlled Unclassified Information." And NIST Special Publication 800-171 Rev. 2 “Protecting Controlled Unclassified Information in Nonfederal Systems and Organizations.”+ |
6.)Ref 11a: Contractor performance is at USAMRDC. Government agency or activity will provide security classification guidance for performance of this contract. Submit visit request to the COR and/or Security Management Office for need-to-know verification.
Ref 11j: The contractor will comply with OPSEC requirements contained in the contract or attached under separate cover. IAW AR 530-1 Operations Security (OPSEC Regulations).
9.) Ref 11l: All classified information received and/or generated under this contract is the property of the U.S. Government regardless of proprietary claims. Upon completion or termination of this contract, the U.S. Government will be contacted for destruction or disposition instructions.
a.) Classification information/material shall be accounted for, protected, stored, copied, and destroyed IAW DoD 5200. 01, Vols 1-4, AR 380-5, AR 380-49, AR 25-400-2, and DoD 5220.22-M, “National Industrial Security Program Operating Manual (NISPOM).
b.) All information systems used to execute the contract and process government information must meet requirements of DoD 8510.01, Information Assurance Certification and Accreditation Process (DIACAP).
c.) Protection of Classified Information during working will be IAW regulations above to minimize risk of access by unauthorized personnel. After working hours, classified information will be stored in approved containers IAW regulations above.
d.) Electronic transmission of classified information by voice, data, facsimile or similar means, will be by approved US. Government secure communication.
e.) The National Agency Check with Local Checks T3 (NACLC) adjudicated by Department of Defense Consolidated Adjudication Facility (DoDCAF) for a secret clearance, “Prior” to start of the contract is required. Contract personnel must obtain and maintain a secret clearance prior to start of the contract for this task. All classified information generated must be marked appropriately for accountability and safeguarding.
f.) All Contract Companies must have and maintain a Facility Clearance approved by DSS and verified in DSS/ISFD data base prior to the start of the contract by the HQ MRDC and USAG Security offices.
g.) Personnel identified as requiring access at IT/ADP II and IT/ADP III under this contract must have a National Agency Check with Law and Credit T3 (NACLC) that has been completed by Office of Personnel Management and adjudicated by DoDCAF with a determination eligibility of SECRET “Prior” to the start of the contract. All other contractors’ personnel working on unclassified work “only” will require a favorably adjudicated National Agency Check with Inquiries (NACI) and IT/ADP III.
6.2.1 Security Requirements
Contractor personnel performing work shall follow the USAMRDC personnel security policy.
Key Control: The Contractor shall establish and implement methods of making sure all keys/key cards issued to the Contractor by the Government are not lost or misplaced and are not used by unauthorized persons. NOTE: All references to keys include key cards. No keys issued to the Contractor by the Government shall be duplicated. The Contractor shall develop procedures covering key control that shall be included in the Quality Control Plan. Such procedures shall include turn-in of any issued keys by personnel who no longer require access to locked areas. The Contractor shall immediately report any occurrences of lost or duplicate keys/key cards to the COR.
Security Badges: Contractor staff members shall wear their Government issued, individual identification badge at all times while performing work under this contract. Contractor staff shall wear the badge on outer clothing, positioned between the neck and waist on the front part of the body and the badge shall remain visible at all times.
Safety and Accident Prevention: While performing work under Government contract, Contractor shall conform to the specific safety rules prescribed in AR 385-55 and the Army Safety Program in AR 385-10, as applicable. Contractor shall take all reasonable steps and precautions to prevent accidents and preserve the life and health of both Contractor and Government personnel.
Security and Fire Prevention Statement. While performing work under Government contract, Contractor shall comply with the Army Physical Security Program, AR 190-13, and the Army Fire Protection and Fire Prevention Program, AR 420-90. Contractor management and staff shall review these regulations within 30 days following contract award. These AR's are available for viewing/downloading at the following URL: http://www.usapa.army.mil
The Facility Security Officer (FSO) will initiate all contractors for their T3/T3R investigations whom require a SECRET clearance and access to classified information. Those positions are identified above.
In-processing with the MRDC G2 requires an appointment and will be coordinated with the Contractor by the PCO. The Contractor shall allow at least two weeks for scheduling of security appointments.
In order to facilitate the MRDC G2 Security appointment, the Contractor shall notify the COR when a new contract employee has been identified. Email notifications must be properly encrypted. The notification shall include the contractor’s full name (first, middle, and last), social security number, date of birth, and date of availability. The Contractor shall provide verification of citizenship, in the form of an original birth certificate, naturalization certificate, or current passport during the MRDC Security Appointment.
Personnel requiring a Secret clearance may begin work (with limitations) with an interim Secret clearance. This will require a favorable final adjudication to continue performance.
All Contractors not requiring a clearance will follow MRDC G2 policy for HSPD12 credentialing and provide vetting required documentation. Contractors meeting the Investigation requirements will be reciprocated and may on-board after official notification from the MRDC G2. Contractors not meeting the investigation requirement will be processed for an interim local suitability. The MRDC G2 will initiate investigations for Contractors and provide interim suitability adjudication. Required documentation will be the SF85, Security documents and fingerprint results. Contractors receiving a favorable interim local suitability review, may commence with on-boarding. Contractors that do not meet the interim local suitability, will be pending final investigation by OPM and adjudication by the DoD CAF for HSPD12 credentialing.
The Contractor shall have a Secret Facility Security Clearance (FCL) for performance under this award. The Contractor shall be able to work with classified material, support classified meetings and safeguard classified information in accordance with Industrial Security Regulations. Contractor shall comply with FAR 52.204-2, Security Requirements. This clause involves access to information classified “Confidential,” “Secret,” or “Top Secret” and requires contractors to comply with— (1) The Security Agreement (DD Form 441), including the National Industrial Security Program Operating Manual (DoD 5220.22-M); (2) any revisions to DOD 5220.22-M, notice of which has been furnished to the contractor.
| Click on this button to attach a file(s).: |
| rep: James R Myers, COR |
| Enter signature.: |
| Explain and identify specific areas and government activity responsible for inspections.: |
| Enter GCA name.: USA Medical Research Acquisition Activity |
| Enter AAC of the contracting office.: HT9425 |
| Enter AAC of the contracting office.: HT9425 |
| Enter address (include zip code).: U.S. Army Medical Research Acquisition Activity |
820 Chandler St. - Fort Detrick Frederick, MD 21702 Enter address (include zip code).: U.S. Army Medical Research and Development Command Building 810, Attn: FCMR-PPA 810 Schreider Street, Fort Detrick, MD 21702-5012
| Enter POC name.: Terrie L Bloom |
| Enter telephone number (include area code).: 3016197354 |
| Enter telephone number (include area code).: 2403441186 |
| Enter email address.: terrie.l.bloom.civ@health.mil |
| Enter email address.: james.r.myers38.civ@health.mil |
| Enter title.: SBIR Project Manager/Contracting Officer Representative |
| Enter the datesigned in format YYYYMMDD.: |
File details come from the government source that posted it. Updated .