DD Form 254.pdf

DEPARTMENT OF DEFENSE

1. CLEARANCE AND SAFEGUARDING

CONTRACT SECURITY CLASSIFICATION SPECIFICATION a. FACILITY CLEARANCE REQUIRED:

(The requirements of the DoD Industrial Security Manual apply to all security aspects of this effort)) b. LEVEL OF SAFEGUARDING REQUIRED:

2. THIS SPECIFICATION IS FOR: (X and complete as applicable) 3. THIS SPECIFICATION IS: (X and complete as applicable)

a. PRIME CONTRACT NUMBER a. ORIGINAL (Complete date in all cases) Date (YYMMDD)

b. SUBCONTRACT NUMBER b. REVISED (Supersedes all previous specs) Revision No. Date (YYMMDD)

c. SOLICITATION OR OTHER NUMBER DUE DATE (YYMMDD) c. FINAL (Complete item 5 in all cases) Date (YYMMDD)

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 contractors request dated , retention of the identified classified material is authorized for a period of:

6. CONTRACTOR (Include Commercial and Government Entity (CAGE) Code)

a. NAME, ADDRESS, AND ZIP b. CAGE CODE c. COGNIZANT SECURITY OFFICE (Name, Address, and Zip Code)

7. SUBCONTRACTOR

a. NAME, ADDRESS, AND ZIP 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. THIS CONTRACT WILL REQUIRE ACCESS TO: YES NO 11. IN PERFORMING THIS CONTRACT, THE CONTRACTOR WILL: YES NO

a. COMMUNICATIONS SECURITY (COMSEC) INFORMATION a. HAVE ACCESS TO CLASSIFIED INFORMATION ONLY AT ANOTHER CONTRACTORS FACILITY OR

GOVERNMENT ACTIVITY

b. RESTRICTED DATA b. RECEIVE CLASSIFIED DOCUMENTS ONLY

c. CRITICAL NUCLEAR WEAPON DESIGN INFORMATION c. RECEIVE AND GENERATE CLASSIFIED MATERIAL

d. FORMERLY RESTRICTED DATA d. FABRICATE, MODIFY, OR STORE CLASSIFIED HARDWARE

e. INTELLIGENCE INFORMATION e. PERFORM SERVICES ONLY

(1) Sensitive Compartmented Information (SCI) f. HAVE ACCESS TO US CLASSIFIED INFORMATION OUTSIDE THE U.S., PUERTO RICO, U.S. POSSESSIONS

AND TRUST TERRITORIES

(2) Non-SCI g. BE AUTHORIZED TO USE THE SERVICES OF THE DEFENSE TECHNICAL INFORMATION CENTER (DTIC) OR

OTHER SECONDARY DISTRIBUTION CENTER

f. SPECIAL ACCESS INFORMATION h. REQUIRE A COMSEC ACCOUNT

g. NATO INFORMATION i. HAVE TEMPEST REQUIREMENTS

h. FOREIGN GOVERNMENT INFORMATION j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS

i. LIMITED DISSEMINATION INFORMATION k. BE AUTHORIZED TO USE THE DEFENSE COURIER SERVICE

j. FOR OFFICIAL USE ONLY INFORMATION l. OTHER (Specify)

k. OTHER (Specify)

DD Form 254, DEC 99 (EF) Previous editions are obsolete. (DISA IRXDTS, Inc.)

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

DIRECT THROUGH (Specify) to the Directorate for Freedom of Information and Security Review, Office of the Assistant Secretar of Defense (Public Affairs)* for review. y *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, in addition to NISPOM requirements, are established for this contract. (If Yes, identify the pertinent contractual clauses in YES NO the contract document itself, or provide an appropriate statement which identifies additional requirements. Provide a copy of the requirements to the cognizant security office. Use Item 13 if additional space is required.)

15. INSPECTIONS. Elements of this contract are outside the inspection responsibility of the cognizant security office. (If yes, explain and identify specific areas or YES NO elements carved out and the activity responsible for inspections. Use Item 13 if more 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.

a. TYPED NAME OF CERTIFYING OFFICIAL b. TITLE c. TELEPHONE (Include Area Code)

d. ADDRESS (Include Zip Code)

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

e. SIGNATURE f. OTHERS AS NECESSARY

DD FORM 254 Reverse, DEC 99 Previous editions are obsolete. (DISA IRXDTS, Inc.)