DD254-N63126-03022021-37322.pdf

CLASSIFICATION (When filled in):

PREVIOUS EDITION IS OBSOLETE. Page 1 of 3 AEM LiveCycle Designer

PREVIOUS EDITION IS OBSOLETE. Page 1 of 3 AEM LiveCycle Designer

DD DD FFOORMRM 252544,, APR 2018

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

Secret None

✘ HTC711-21-R-R014

2021/10/01

NAWCWD Point Mugu

Drone recovery and logistics services Tracking No: USTANSCOM-TCCS-000-21

PREVIOUS EDITION IS OBSOLETE. Page 2 of 3 AEM LiveCycle Designer

PREVIOUS EDITION IS OBSOLETE. Page 2 of 3 AEM LiveCycle Designer

DD DD FFOORMRM 252544,, APR 2018

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)

a. The contractor shall comply with FAR 52.204-2 that includes responsibility for ensuring all security requirements outlined in the National Industrial Security Operating Manual (NISPOM-Change 2, May 2016) and the Performance Work Statement (PWS) are accomplished upon award of the contract.

b. Controlled Unclassified Information (CUI) may be accessed. Contractors will comply with the requirements stated in DoD Instruction 5200.48 with emphasis on section 5.3. No CUI information will be discarded in trash or recycle bins. The contractor will monitor CUI for compilation and will contact USTRANSCOM contracting team when such compilations are believed to reach the specified level stated in a Security Classification Guide or need to be provided to a USTRANSCOM Original Classification Authority (OCA) for a classification by compilation decision (also see block

SEE SECTION 13 CONTINUATION SECTION AT THE BOTTOM OF THIS FORM

Unclassified

Unclassified

Includes legacy For Official Use Only Information (FOUO)

SEE SECTION 13 CONTINUATION SECTION AT THE BOTTOM OF THIS

FORM

PREVIOUS EDITION IS OBSOLETE. Page 3 of 3 AEM LiveCycle Designer

PREVIOUS EDITION IS OBSOLETE. Page 3 of 3 AEM LiveCycle Designer

DD DD FFOORMRM 252544,, APR 2018

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

11J. Operations Security (OPSEC) office, 618-220-7510. See USTRANSCOM Instruction 31-12.

1. Operations Security (OPSEC): Information furnished to the Contractor is sensitive and may be legacy FOR OFFICIAL USE ONLY (FOUO) or Controlled Unclassified Information (CUI). The Contractor is required to be aware of USTRANSCOM OPSEC requirements. Information determined as legacy FOUO or CUI included as part of the OPSEC Critical Information List (CIL) is not to be released to the public.

2. Security Regulation Compliance: The Contractor shall be required to comply with all security regulations and directives as identified herein, and other security requirements in this contract. The Contractor shall not divulge any financial, planning, programming, or budgeting information without the express consent of the Government as outlined in Operational Security (OPSEC) and Information Security regulations

Steven Stegen Security Administration Steven Stegen

USTRANSCOM

508 Scott Drive, Scott AFB, Illinois, 62225-5357 Barbara Wolf

(618) 220-7148

TCAR-R barbara.l.wolf11.civ@mail.mil

HTC711

Steven.M.Strait.civ@mail.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]

14).

c. Contractor employees may derivatively classify information only if they have been annually trained on derivative classification. USTRANSCOM can provide this training.

d. Contractors will comply with the following Instructions:

1. OPSEC requirements in USTRANSCOM instruction 31-12 that includes the Critical Information List .

2. DISA 300.115.3 Circular: (SIPRNet Security Classification Guide)

3. USTRANSCOM INSTRUCTION 31-02 (USTRANSCOM Classification Guide)

4. DoDM 5200.01, Vol. 2, (Marking of Classified Information)

5. DoD 4500.9-R, Part II, Appendix E, Defense Transportation Regulation’s (movements) – DTR

e. No DoD classified information will be disseminated to anyone in the contractor company that is not performing on this contract.

f. Contractor employees will comply with all USTRANSCOM security practices and policies.

g. Upon receipt of a contract, the designated contractor shall, within 60 days, provide the Cognizant Security Office listed in block 6c, a copy of the award DD- 254 with any continuation pages, attachments or enclosures and the contract PWS.

h. USTRANSCOM will conduct a NATO indoctrination for all on-site contractor employees and load that access in JPAS. FSO’s may conduct annual refresher training for their personnel but are also responsible for updating JPAS.

i. Notes: Contractors will be made aware that the term "NOFORN" is identified as classified INTELLIGENCE information that may not be released to foreigners, without permission of the originator. AUTHORIZED FOR RELEASE (REL TO) identifies classified information that an originator has predetermined to be releasable, to the foreign county(ries) indicated.

j. Note-taking and recordings are not authorized during classified sessions at USTRANSCOM.

k IAW DISA Security Technical Implementation Guide (STIG) V-32342 (12 Jul 2013) for the Department of Defense, contractors performing work in privileged IS roles must undergo successful Federal Investigative Standards Tier 5 (SSBI) investigations with 6-year reviews. Privileged users must undergo a Tier 5 (SSBI) investigation regardless of the security clearance level required for contract performance (e.g., even if no clearance or only Confidential or Secret is required). Foreign Nationals or Local Nationals employed by the DoD ARE NOT AUTHORIZED to have (IT-I) privileged access to US Information Systems.

l. Note (1) FSO's: Without approval of the USTRANSCOM Mission Assurance Office, only cleared personnel from the CAGE code listed in block 6b, are approved for access to classified on this contract; upon its award.

m. Note (2): Contractors will be made aware that the term "NOFORN" is identified as classified INTELLIGENCE information that may not be released to foreigners, without permission of the originator. AUTHORIZED FOR RELEASE (REL TO) identifies classified information that an originator has predetermined to be releasable or has been released, through established foreign disclosure procedures and channels, to the foreign country (ries)/international organizations(s) indicated.

n. Note (3): Employees of Companies without a Facility clearance (FCL) are not cleared for access to USTRANSCOM facilities and information. If such employees would visit USTRANSCOM, they must display an UNCLEARED visitors badge and be escorted at all times. They will not have access to USTRANSCOM Information systems. Uncleared visitors must obtain their Visitor Badges from the Protection Service Center (PSC) for each period of their visit.

o. Note (4): FSO's: Prime contractor personnel assigned to these locations (cited in block 8a), will be required to produce a copy of their award DD-254 to the Protection Service Center, that matches the visit notice in JPAS and includes the POC, telephone number, assigned position and contract number. Sub-contractors must submit Visit Notifications to USTRANSCOM with the same notations that states their personnel are assigned to the (name the prime contractor and the primes contract number, (listed in the Visits' additional information block).

p. Note (5): FSO’s: Contractor employees with out-of-scope background investigations and are not enrolled in continuous evaluation (CE), are not authorized to work in USTRANSCOM secure room areas until a new open investigation is on their JPAS/DISS record or they have been enrolled in CE.

q. Note (6): FSO’s are required, at a minimum, to familiarize themselves with the Security section of the contract PWS.

r. (Note 7): Prime contractors will provide the CAGE code and name of all subcontracted companies that will require classified access to the USTRANSCOM contracting team.

s. Note (8): The FSO will provide a copy of the Contract DD-254 (Page 1) to each employee, for their initial visit/assignment for work in UTRANSCOM (USTC) facilities. They will present the document (including 2 forms of picture identification) to the USTC Protection Services Center (PSC), for assignment verification, against the Company Visit Notice in JPAP or DISS. Services Center (PSC), for assignment verification, against the Company Visit Notice in JPAP or DISS.

Ref 10g: Personnel not assigned to a NATO staff position, but requiring access to NATO classified information, NATO COSMIC, NATO Secret or access to the NATO accredited SIPRNET terminals, must possess the equivalent FINAL or Interim U.S. Security Clearance based upon the appropriate personnel security investigation required. Personnel with access to NATO ATOMAL information must have the appropriate level FINAL U.S. Security Clearance. The

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

government program/project manager is the designated representative that will ensure the contractor security manager and concerned employees are NATO briefed prior to access being granted. The contractor will maintain strict compliance in regards to NATO information IAW NISPOM Ch 10, Section 7. Prior approval from the GCA is required for 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 11a: Contractor performance is restricted to locations identified in Block 13.

Government agency or activity will provide security classification guidance for performance of this contract.

Ref 11j

Ref 11l

[Block: 8] [Location] [Location Code] China Lake and vicinity 575 I Ave Point Mugu [Location] [Location Code] CA. 93042 [Installation Name] Naval Base Ventura County ¿¿¿ Point Mugu Operating Facility [Installation Location] 575 I Ave Suite 1 Point Mugu, CA 93042

[Block: 12] DoDAAC[HTC711] Release Information[Office of Public Affairs (TCPA), USTRANSCOM, Scott AFB, IL 62225-5357, (618)-220-5102.] Location Code/Agency Name/Address[HTC711, USTRANSCOM-AQ USTRANSCOM-AQ, 508 SCOTT DR SCOTT AFB IL 62225-5357, SCOTT AFB, IL, 62225-5357, USA]