Att_7_DD_Form_254.pdf
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- Attached to
- DARPA STO SETA Program Support Federal contract opportunity
- Solicitation number
- D17PS00139
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Attachment 7
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DEPARTMENT OF DEFENSE
CONTRACT SECURITY CLASSIFICATION SPECIFICATION
(The requirements of the DoD Industrial Security Manual apply to all security aspects of this effort.)
1. CLEARANCE AND SAFEGUARDING
a. FACILITY CLEARANCE REQUIRED
b. LEVEL OF SAFEGUARDING REQUIRED
2. THIS SPECIFICATION IS FOR: (X and complete as applicable)
a. PRIME CONTRACT NUMBER
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)
REVISION NO.
c. FINAL (Complete Item 5 in all cases)
DATE (YYYYMMDD)
b. REVISED (Supersedes all previous specs)
DATE (YYYYMMDD)
DATE (YYYYMMDD)
4. IS THIS A FOLLOW-ON CONTRACT? YES NO. 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? YES NO. 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 (Name, Address, and Zip Code)
7. SUBCONTRACTOR
a. NAME, ADDRESS, AND ZIP CODE b. CAGE CODE c. COGNIZANT SECURITY OFFICE (Name, Address, and Zip Code)
8. ACTUAL PERFORMANCE
a. LOCATION b. CAGE CODE c. COGNIZANT SECURITY OFFICE (Name, Address, and Zip Code)
9. GENERAL IDENTIFICATION OF THIS PROCUREMENT
10. CONTRACTOR WILL REQUIRE ACCESS TO: 11. IN PERFORMING THIS CONTRACT, THE CONTRACTOR WILL:YES NO YES NO
a. COMMUNICATIONS SECURITY (COMSEC) INFORMATION
b. RESTRICTED DATA
c. CRITICAL NUCLEAR WEAPON DESIGN INFORMATION
d. FORMERLY RESTRICTED DATA
e. INTELLIGENCE INFORMATION
(1) Sensitive Compartmented Information (SCI)
(2) Non-SCI
f. SPECIAL ACCESS INFORMATION
g. NATO INFORMATION
h. FOREIGN GOVERNMENT INFORMATION
i. LIMITED DISSEMINATION INFORMATION
j. FOR OFFICIAL USE ONLY INFORMATION
k. OTHER (Specify)
a. HAVE ACCESS TO CLASSIFIED INFORMATION ONLY AT ANOTHER
CONTRACTOR'S FACILITY OR A GOVERNMENT ACTIVITY
b. RECEIVE CLASSIFIED DOCUMENTS ONLY
c. RECEIVE AND GENERATE CLASSIFIED 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 TEMPEST REQUIREMENTS
j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS
k. BE AUTHORIZED TO USE THE DEFENSE COURIER SERVICE
l. OTHER (Specify)
DD FORM 254, DEC 1999 PREVIOUS EDITION IS OBSOLETE. Adobe Professional X
12. PUBLIC RELEASE. Any information (classified or unclassified) pertaining to this contract shall not be released for public dissemination except as provided by the Industrial Security Manual or unless it has been approved for public release by appropriate U.S. Government authority. Proposed public releases shall be submitted for approval prior to release
a. TYPED NAME OF CERTIFYING OFFICIAL
Direct Through (Specify)
d. ADDRESS (Include Zip Code)
Yes No to the Directorate for Freedom of Information and Security Review, Office of the Assistant Secretary of Defense (Public Affairs)* for review.
*In the case of non-DoD User Agencies, requests for disclosure shall be submitted to that agency.
13. SECURITY GUIDANCE. The security classification guidance needed for this classified 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. Add additional pages as needed to provide complete guidance.)
14. ADDITIONAL SECURITY REQUIREMENTS. Requirements, in addition to ISM requirements, 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 cognizant security office. Use Item 13 if additional space is needed.)
Yes No15. INSPECTIONS. Elements of this contract are outside the inspection responsibility of the cognizant security office.
(If Yes, explain and identify specific areas or elements carved out and the activity responsible for inspections. Use Item 13 if additional space is needed.)
16. CERTIFICATION AND SIGNATURE. 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.
b. TITLE c. TELEPHONE (Include Area Code)
e. SIGNATURE
17. REQUIRED DISTRIBUTION
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. OTHERS AS NECESSARY
DD FORM 254 (BACK), DEC 1999
| fac_clear: TOP SECRET |
| safe_level: NONE |
| prime_no: |
| xprime: Off |
| sub_no: |
| xsub: Off |
| xsolic: Yes |
| solic_no: D17PS00139 |
| due_date: |
| xspec3: Orig |
| orig_date: 20160621 |
| rev_no: |
| rev_date: |
| final_date: |
| xfollowon: No |
| prec_no: |
| xfinal: No |
| req_dated: |
| period: |
| ctr_name: |
| ctr_cage: |
| ctr_ofc: |
| sub_name: |
| sub_cage: |
| sub_ofc: |
| perf_loc: Defense Advanced Research Projects Agency (DARPA) |
675 North Randolph Street Arlington VA 22203-2114
| perf_cage: N/A |
| perf_ofc: N/A |
| gen_id: Strategic Technology Office (STO) Scientific, Engineering, and Technical Assistance (SETA) Program Support |
| x10a: Yes |
| x10b: Yes |
| x10c: Yes |
| x10d: Yes |
| x10e1: Yes |
| x10e2: Yes |
| x10f: Yes |
| x10g: Yes |
| x10h: Yes |
| x10i: No |
| x10j: Yes |
| x10k: No |
| other10k: |
| x11a: Yes |
| x11b: No |
| x11c: No |
| x11d: No |
| x11e: No |
| x11f: No |
| x11g: Yes |
| x11h: Yes |
| x11i: No |
| x11j: Yes |
| x11k: No |
| x11l: No |
| other11l: |
| xrelease: No |
| release_thru: No information, except as provided in applicable U.S. Statutes, which is classified or unclassified pertaining to this contract shall be released for public dissemination without prior written approval of the DARPA. |
| guidance: 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 in accordance with DoD 52220.22-M. When access is required at Government facilities, contractor personnel will adhere to COMSEC rules and regulations as mandated by command policy and procedures. Written concurrence of the Contracting Officer is required prior to subcontracting. Contractor is authorized the use of secure telephone equipment (STE) with fax. |
10b: Restricted Data Information is not releasable to contractor employees who have not received a FINAL clearance at the appropriate security level. Contractor must contact DARPA, Chief Personnel Security, Russell Parsons to be briefed prior to subcontracting.
10c: CNWDI Information is not releasable to contractor employees who have not received a FINAL clearance at the appropriate security level. Contractor must contact DARPA, Chief Personnel Security, Russell Parsons to be briefed into CNWDI. Access to and handling of CNWDI shall be in accordance with DoDD 5210.02.
10d: The contractor is permitted access to Formerly Restricted Data (FRD) in the performance of this contract. Access to FRD requires a final U.S. Government clearance at the appropriate level. Contractor must contact DARPA, Chief Personnel Security, Russell Parsons, to be briefed prior to subcontracting.
10e(2): Access to Intelligence information is required for performance. The Director, DARPA, has exclusive security responsibility for Non-SCI released to the contractor or developed under this contract.
STO POCs: PM – Dr. Nils Sandell; PSO – Mark Doody, (703) 526-2687; PSR –Darnell Poledore, (571) 218-4813.
| xaddlsec: Yes |
| addl_sec: Program information shall be protected with various DARPA Security Classification Guides, which will be provided by SBPOs POC. |
When information is controlled by the United States Munitions List (USML), the Contractor must abide by the International Traffic Arms Regulation (ITAR) requirements.
| xinsp: Yes |
| inspections: SAP: DARPA is responsible for inspection of all SAP materials under this contract. |
SCI: DIA is responsible for inspection of all SCI materials under this contract.
| cert_name: Timothy R. Wood |
| cert_title: Chief, Industrial and Information Security |
| cert_phone: (703) 526-1057 |
| cert_addr: Defense Advanced Research Projects Agency (DARPA) |
675 North Randolph Street Arlington VA 22203-2114
| x17a: Yes |
| x17b: Off |
| x17c: Yes |
| x17d: Off |
| x17e: Yes |
| x17f: Yes |
| other_dist: |
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