Exhibit H-5 Contractor Badge Application (1).pdf
PDF 4 MB Posted
- Attached to
- Student Support/Facilities Operation Maintenance Services Federal contract opportunity
- Solicitation number
- 70LCHS25RPFB00001
About this file
This file contains multiple Department of Homeland Security (DHS) security and screening forms and a contractor security orientation training guide. The forms include DHS Form 11000-25 (Contractor Fitness/Security Screening Request Form), OF-306 (Declaration for Federal Employment), DHS Form 11000-6 (Non-Disclosure Agreement), DHS Form 11000-9 (Credit Report Authorization), Form I-9 (Employment Eligibility Verification), and DHS Form 11055 (Foreign Access Management Screening).
The contractor security orientation training guide covers key security topics including: protecting DHS assets, identifying threats, operations security (OPSEC), personnel security requirements, physical security procedures, information security protocols, and handling of Sensitive But Unclassified (SBU) information. The guide emphasizes proper safeguarding of For Official Use Only (FOUO) information, badge/PIV procedures, reporting requirements for adverse information, continuous evaluation processes, and security incident reporting. The materials are specifically designed for contractors working at the Federal Law Enforcement Training Centers (FLETC) facility in Charleston, SC under solicitation 70LCHS25RPFB00001/70LCHS25RPFB00002.
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Text version
Federal Law Enforcement Training Centers Charleston
SC 70LCHS25RPFB00001/70LCHS25RPFB00002
Exhibit H-5
Federal Law Enforcement Training Centers Charleston SC
70LCHS25RPFB00001
Form Approved:
OMB No. 3206-0182
This form may also be used to assess fitness for federal contract employment
The information collected on this form is used to determine your acceptability for Federal and Federal contract employment and your enrollment status in the Government's Life Insurance program.
Follow instructions that the agency provides. fore you are appointed you will be asked to update your responses on this form and on other materials submitted during the application process and then to recertify that your answers are true.
All your answers must be truthful and complete.
Either type your responses on this form or print clearly in dark ink. If you need additional space, attach letter-size sheets (8.5" X 11").
Include your name, Social Security Number, and item number on each sheet. We recommend that you keep a photocopy of your completed form for your records.
The Office of Personnel Management is authorized to request this information under sections 1302, 3301, 3304, 3328, and 8716 of title 5, U. S. Code. Section 1104 of title 5 allows the Office of Personnel Management to delegate personnel management functions to other Federal agencies. If necessary, and usually in conjunction with another form or forms, this form may be used in conducting an investigation to determine your suitability or your ability to hold a security clearance, and it may be disclosed to authorized officials making similar, subsequent determinations.
Your Social Security Number (SSN) is needed to keep our records accurate, because other people may have the same name and birth date. Public Law 104-134 (April 26, 1996) asks Federal agencies to use this number to help identify individuals in agency records. Giving us your SSN or any other information is voluntary. However, if you do not give us your SSN or any other information requested, we cannot process your application. Incomplete addresses and ZIP Codes may also slow processing.
ROUTINE USES: Any disclosure of this record or information in this record is in accordance with routine uses found in System Notice OPM/GOVT-1, General Personnel Records. This system allows disclosure of information to: training facilities; organizations deciding claims for retirement, insurance, unemployment, or health benefits; officials in litigation or administrative proceedings where the Government is a party; law enforcement agencies concerning a violation of law or regulation; Federal agencies for statistical reports and studies; officials of labor organizations recognized by law in connection with representation of employees; Federal agencies or other sources requesting information for Federal agencies in connection with hiring or retaining, security clearance, security or suitability investigations, classifying jobs, contracting, or issuing licenses, grants, or other benefits; public and private organizations, including news media, which grant or publicize employee recognitions and awards; the Merit Systems Protection Board, the Office of Special Counsel, the Equal Employment Opportunity Commission, the Federal Labor Relations Authority, the National Archives and Records Administration, and Congressional offices in connection with their official functions; prospective non-Federal employers concerning tenure of employment, civil service status, length of service, and the date and nature of action for separation as shown on the SF 50 (or authorized exception) of a specifically identified individual; requesting organizations or individuals concerning the home address and other relevant information on those who might have contracted an illness or been exposed to a health hazard; authorized Federal and non-Federal agencies for use in computer matching; spouses or dependent children asking whether the employee has changed from a self-and-family to a self-only health benefits enrollment; individuals working on a contract, service, grant, cooperative agreement, or job for the Federal government; non-agency members of an agency's performance or other panel; and agency-appointed representatives of employees concerning information issued to the employees about fitness-for-duty or agency-filed disability retirement procedures.
Public burden reporting for this collection of information is estimated to vary from 5 to 30 minutes with an average of 15 minutes per response, including time for reviewing instructions, searching existing data sources, gathering the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of the collection of information, including suggestions for reducing this burden, to the U.S. Office of Personnel Management, Reports and Forms Manager (3206-0182), Washington, DC 20415-7900. The OMB number, 3206-0182, is valid. OPM may not collect this information, and you are not required to respond, unless this number is displayed.
U.S. Office of Personnel Management 5 U.S.C. 1302, 3301, 3304, 3328 & 8716
Optional Form 306 Revised
Previous editions obsolete and unusable
Federal Law Enforcement Training Centers Charleston SC
(Provide your full name. If you have only initials in your name, provide them and indicate "Initial only". If you do not have a middle name, indicate "No Middle Name". If you are a "Jr.," "Sr.," etc. enter this under Suffix. First, Middle, Last, Suffix)
(Include city and state or country)
YES NO (If "NO", provide country of citizenship)
(MM / DD / YYYY)
(For example, maiden name, nickname, etc.) (Include area codes)
Day
Night
If you are a male born after December 31, 1959, and are at least 18 years of age, civil service employment law (5 U.S.C. 3328) requires that you must register with the Selective Service System, unless you meet certain exemptions.
7a. Were you born a male after December 31, 1959? YES NO (If "NO", proceed to 8.)
7b. Have you registered with the Selective Service System? YES (If "YES", proceed to 8.) NO (If "NO", proceed to 7c.)
7c. If "NO," describe your reason(s) in item 16.
Form Approved:
OMB No. 3206-0182
This form may also be used to assess fitness for federal contract employment
8. Have you ever served in the United States military? YES (If "YES", provide information below) NO
MM/DD/YYYY) MM/DD/YYYY)
The circumstances of each event you list will be considered. However, in most cases you can still be considered for Federal jobs.
For questions 9,10, and 11, your answers should include convictions resulting from a plea of (no contest), but omit (1) traffic fines of $300 or less, (2) any violation of law committed before your 16th birthday, (3) any violation of law committed before your 18th birthday if finally decided in juvenile court or under a Youth Offender law, (4) any conviction set aside under the Federal Youth Corrections Act or similar state law, and (5) any conviction for which the record was expunged under Federal or state law
9. During the last 7 years, have you been convicted, been imprisoned, been on probation, or been on parole?
(Includes felonies, firearms or explosives violations, misdemeanors, and all other offenses.)
YES NO
10. Have you been convicted by a military court-martial in the past 7 years? YES NO
11. Are you currently under charges for any violation of law? YES NO
12. During the last 5 years, have you been fired from any job for any reason, did you quit after being told that you would be fired, did you leave any job by mutual agreement because of specific problems, or were you debarred from Federal employment by the Office of Personnel Management or any other Federal agency?
YES NO
13. Are you delinquent on any Federal debt? (Includes delinquencies arising from Federal taxes, loans, overpayment of benefits, and other debts to the U.S. Government, plus defaults of Federally guaranteed or insured loans such as student and home mortgage loans.)
YES NO
U.S. Office of Personnel Management 5 U.S.C. 1302, 3301, 3304, 3328 & 8716
Optional Form 306 Revised
Previous editions obsolete and unusable
Federal Law Enforcement Training Centers Charleston SC
Form Approved:
OMB No. 3206-0182
This form may also be used to assess fitness for federal contract employment
14. Do any of your relatives work for the agency or government organization to which you are submitting this form?
(Include: father, mother, husband, wife, son, daughter, brother, sister, uncle, aunt, first cousin, nephew, niece, father-in-law, mother-in-law, son-in-law, daughter-in-law, brother-in-law, sister-in-law, stepfather, stepmother, stepson, stepdaughter, stepbrother, stepsister, half-brother, and half-sister.)
YES NO
15. Do you receive, or have you ever applied for, retirement pay, pension, or other retired pay based on military, Federal civilian, or District of Columbia Government service?
YES NO
16. Provide details requested in items 7 through 15 and 18c in the space below or on attached sheets. Be sure to identify attached sheets with your name, Social Security Number, and item number, and to include ZIP Codes in all addresses. If any questions are printed below, please answer as instructed
If you are applying for a position and received a tentative/conditional job offer or have not yet been selected, carefully review your answers on this form and any attached sheets.
, carefully review your answers on this form and any attached sheets, including any other application materials that your agency has attached to this form. If any information requires correction to be accurate as of the date you are signing, make changes on this form or the attachments and/or provide updated information on additional sheets, initialing and dating all changes and additions.
When this form and all attached materials are accurate, read item 17, complete 17b, read 18, and answer 18a, 18b, and 18c as appropriate.
17. that, to the best of my knowledge and belief, all of the information on and attached to this Declaration for Federal Employment, including any attached application materials, is true, correct, complete, and made in good faith.
that any information I give may be investigated for purposes of determining eligibility for Federal employment as allowed by law or Presidential order. to the release of information about my ability and fitness for Federal employment by employers, schools, law enforcement agencies, and other individuals and organizations to investigators, personnel specialists, and other authorized employees or representatives of the Federal Government.
that for financial or lending institutions, medical institutions, hospitals, health care professionals, and some other sources of information, a separate specific release may be needed, and I may be contacted for such a release at a later date.
17a. Applicant's Signature: Date:
(MM / DD / YYYY)
17b. Appointee's Signature: Date:
(MM / DD / YYYY)
18. Your elections of life insurance during previous Federal employment may affect your eligibility for life insurance during your new appointment. These questions are asked to help your personnel office make a correct determination.
18a. When did you leave your last Federal job? D
18b. When you worked for the Federal Government the last time, did you waive Basic Life Insurance or any type of optional life insurance?
YES NO DO NOT KNOW
18c. If you answered "YES" to item 18b, did you later cancel the waiver(s)? If your answer to item 18c is "NO," use item 16 to identify the type(s) of insurance for which waivers were not canceled.
YES NO DO NOT KNOW
U.S. Office of Personnel Management 5 U.S.C. 1302, 3301, 3304, 3328 & 8716
Optional Form 306 Revised
Previous editions obsolete and unusable
Enter Date of Appointment or Conversion
MM / DD / YYYY
Federal Law Enforcement Training Centers Charleston SC
DEPARTMENT OF HOMELAND SECURITY
DISCLOSURE AND AUTHORIZATION
PERTAINING TO CONSUMER REPORTS
PURSUANT TO THE FAIR CREDIT REPORTING ACT
DHS Form 11000-9 (07/2023)
This is a release for the Department of Homeland Security to obtain one or more consumer/credit reports about you in connection with your application for employment or in the course of your employment with the Department. One or more reports about you may be obtained for employment purposes, including evaluating your fitness for employment, promotion, reassignment, retention, or access to classified information and/or sensitive, but unclassified information.
I, authorized the Department of Homeland Security to obtain such report(s) from any consumer/credit reporting agency for employment purposes. Copies of this authorization that show my signature are as valid as the original signed by me.
, hereby
Signature
Date
Current Organization Assigned
PRIVACY ACT STATEMENT
Authority: Homeland Security Act of 2002; 5 U.S.C. § 11001, “Enhanced Personnel Security Programs”; and Executive Order 9397, “Numbering System for Federal Accounts Relating to Individual Persons”.
Principle Purpose: To obtain consumer/credit reports in connection with an individual’s application for employment or ongoing employment with the DHS.
Routine Use(s): The information collected on this form may be disclosed as generally permitted under 5 U.S.C. §552a(b) of the Privacy Act of 1974, as amended. This includes using the information as necessary and authorized by the routine uses published in “DHS/ALL-023 Personnel Security Management System of Records”.
Disclosure: Providing this information is voluntary; however, failure to provide this information may prevent an individual's fitness or suitability determination for employment, promotion, reassignment, retention, and/or access to information.
PUBLIC BURDEN STATEMENT
In accordance with 5 C.F.R. 1320.3(h)(1), this information collection is exempt from the requirements of Public Law 104-13, "Paperwork Reduction Act of 1995".
Federal Law Enforcement Training Centers Charleston SC
Employment Eligibility Verification Department of Homeland Security
U.S. Citizenship and Immigration Services
USCIS
START HERE: Employers must ensure the form instructions are available to employees when completing this form. Employers are liable for failing to comply with the requirements for completing this form. See below and the Instructions.
ANTI-DISCRIMINATION NOTICE: All employees can choose which acceptable documentation to present for Form I-9. Employers cannot ask employees for documentation to verify information in Section 1, or specify which acceptable documentation employees must present for Section 2 or Supplement B, Reverification and Rehire. Treating employees differently based on their citizenship, immigration status, or national origin may be illegal.
Section 1. Employee Information and Attestation: Employees must complete and sign Section 1 of Form I-9 no later than the first day of employment, but not before accepting a job offer.
Last Name (Family Name) First Name (Given Name) Middle Initial (if any) Other Last Names Used (if any)
Address (Street Number and Name) Apt. Number (if any) City or Town State ZIP Code
Date of Birth (mm/dd/yyyy) U.S. Social Security Number Employee's Email Address Employee's Telephone Number
I am aware that federal law provides for imprisonment and/or fines for false statements, or the use of false documents, in connection with the completion of this form. I attest, under penalty of perjury, that this information, including my selection of the box attesting to my citizenship or immigration status, is true and correct.
Check one of the following boxes to attest to your citizenship or immigration status (See page 2 and 3 of the instructions.):
1. A citizen of the United States
2. A noncitizen national of the United States (See Instructions.)
3. A lawful permanent resident (Enter USCIS or A-Number.)
4. A noncitizen (other than Item Numbers 2. and 3. above) authorized to work until (exp. date, if any)
If you check Item Number 4., enter one of these:
USCIS A-Number
OR
Form I-94 Admission Number
OR
Foreign Passport Number and Country of Issuance
Signature of Employee Today's Date (mm/dd/yyyy)
If a preparer and/or translator assisted you in completing Section 1, that person MUST complete the Preparer and/or Translator Certification on Page 3.
Section 2. Employer Review and Verification: Employers or their authorized representative must complete and sign Section 2 within three business days after the employee's first day of employment, and must physically examine documentation from List A OR a combination of documentation from List B and List C. Enter any additional documentation in the Additional Information box; see Instructions.
List A OR List B AND List C
Document Title 1
Issuing Authority
Document Number (if any)
Expiration Date (if any)
Document Title 2 (if any) Additional Information
Issuing Authority
Document Number (if any)
Expiration Date (if any)
Document Title 3 (if any)
Issuing Authority
Document Number (if any)
Expiration Date (if any)
Certification: I attest, under penalty of perjury, that (1) I have examined the documentation presented by the above-named employee, (2) the above-listed documentation appears to be genuine and to relate to the employee named, and (3) to the best of my knowledge, the employee is authorized to work in the United States.
First Day of Employment (mm/dd/yyyy):
Last Name, First Name and Title of Employer or Authorized Representative Today's Date (mm/dd/yyyy)
Employer's Business or Organization Name Employer's Business or Organization Address, City or Town, State, ZIP Code
For reverification or rehire, complete Supplement B, Reverification and Rehire on Page 4.
Form I-9 Edition 0 / /23 Page 1 of 4
Federal Law Enforcement Training Centers Charleston SC
LISTS OF ACCEPTABLE DOCUMENTS
All documents containing an expiration date must be unexpired.
* Documents extended by the issuing authority are considered unexpired.
Employees may present one selection from List A or a combination of one selection from List B and one selection from List C.
Examples of many of these documents appear in the Handbook for Employers (M-274).
LIST A
Documents that Establish Both Identity and Employment Authorization
OR
LIST B
Documents that Establish Identity
LIST C
Documents that Establish Employment Authorization
AND
1. U.S. Passport or U.S. Passport Card 1. Driver's license or ID card issued by a State or outlying possession of the United States provided it contains a photograph or information such as name, date of birth, gender, height, eye color, and address
1. A Social Security Account Number card, unless the card includes one of the following restrictions:
(1) NOT VALID FOR EMPLOYMENT
(2) VALID FOR WORK ONLY WITH
INS AUTHORIZATION
(3) VALID FOR WORK ONLY WITH
DHS AUTHORIZATION
2. Permanent Resident Card or Alien Registration Receipt Card (Form I-551)
3. Foreign passport that contains a temporary I-551 stamp or temporary I-551 printed notation on a machine-readable immigrant visa
2. ID card issued by federal, state or local government agencies or entities, provided it contains a photograph or information such as name, date of birth, gender, height, eye color, and address
4. Employment Authorization Document that contains a photograph (Form I-766) 2. Certification of report of birth issued by the
Department of State (Forms DS-1350, FS-545, FS-240)
3. School ID card with a photograph5. For an individual temporarily authorized to work for a specific employer because of his or her status or parole:
a. Foreign passport; and
b. Form I-94 or Form I-94A that has the following:
(1) The same name as the passport; and
(2) An endorsement of the individual's status or parole as long as that period of endorsement has not yet expired and the proposed employment is not in conflict with any restrictions or limitations identified on the form.
4. Voter's registration card 3. Original or certified copy of birth certificate issued by a State, county, municipal authority, or territory of the United States bearing an official seal
5. U.S. Military card or draft record
6. Military dependent's ID card
4. Native American tribal document
7. U.S. Coast Guard Merchant Mariner Card
5. U.S. Citizen ID Card (Form I-197)
8. Native American tribal document
6. Identification Card for Use of Resident Citizen in the United States (Form I-179)9. Driver's license issued by a Canadian government authority
7. Employment authorization document issued by the Department of Homeland Security
For examples, see Section and Section 1 of the M-274 on uscis.gov/i-9-central.
The Form I-766, Employment Authorization Document, is a List A, Item Number 4. document, not a List C document.
For persons under age 18 who are unable to present a document listed above:
10. School record or report card
6. Passport from the Federated States of
Micronesia (FSM) or the Republic of the Marshall Islands (RMI) with Form I-94 or Form I-94A indicating nonimmigrant admission under the Compact of Free Association Between the United States and the FSM or RMI
11. Clinic, doctor, or hospital record
12. Day-care or nursery school record
Acceptable Receipts May be presented in lieu of a document listed above for a temporary period.
For receipt validity dates, see the M-274.
Receipt for a replacement of a lost, stolen, or damaged List A document.
Form I-94 issued to a lawful permanent resident that contains an
I-551 stamp and a photograph of the individual.
Form I-94 with �RE� notation or refugee stamp issued to a refugee.
OR
Receipt for a replacement of a lost, stolen, or damaged List B document.
Receipt for a replacement of a lost, stolen, or damaged List C document.
*Refer to the Employment Authorization Extensions page on I-9 Central for more information.
Form I-9 Edition Page 2 of 4
Federal Law Enforcement Training Centers Charleston SC
Supplement A, Preparer and/or Translator Certification for Section 1
Department of Homeland Security U.S. Citizenship and Immigration Services
USCIS
Form I-9
Supplement A OMB No. 1615-0047 Expires 0 /31/2026
Last Name (Family Name) from Section 1. First Name (Given Name) from Section 1. Middle initial (if any) from Section 1.
Instructions: This supplement must be completed by any preparer and/or translator who assists an employee in completing Section 1 of Form I-9. The preparer and/or translator must enter the employee's name in the spaces provided above. Each preparer or translator must complete, sign, and date a separate certification area. Employers must retain completed supplement sheets with the employee's completed Form I-9.
I attest, under penalty of perjury, that I have assisted in the completion of Section 1 of this form and that to the best of my knowledge the information is true and correct.
Signature of Preparer or Translator Date (mm/dd/yyyy)
Last Name (Family Name) First Name (Given Name) Middle Initial (if any)
Address (Street Number and Name) City or Town State ZIP Code
I attest, under penalty of perjury, that I have assisted in the completion of Section 1 of this form and that to the best of my knowledge the information is true and correct.
Signature of Preparer or Translator Date (mm/dd/yyyy)
Last Name (Family Name) First Name (Given Name) Middle Initial (if any)
Address (Street Number and Name) City or Town State ZIP Code
I attest, under penalty of perjury, that I have assisted in the completion of Section 1 of this form and that to the best of my knowledge the information is true and correct.
Signature of Preparer or Translator Date (mm/dd/yyyy)
Last Name (Family Name) First Name (Given Name) Middle Initial (if any)
Address (Street Number and Name) City or Town State ZIP Code
I attest, under penalty of perjury, that I have assisted in the completion of Section 1 of this form and that to the best of my knowledge the information is true and correct.
Signature of Preparer or Translator Date (mm/dd/yyyy)
Last Name (Family Name) First Name (Given Name) Middle Initial (if any)
Address (Street Number and Name) City or Town State ZIP Code
Form I-9 Edition 0 / /23 Page 3 of 4
Federal Law Enforcement Training Centers Charleston SC
Supplement B, Reverification and Rehire (formerly Section 3)
USCIS
Form I-9 Supplement B
OMB No. 1615-0047 Expires 0 /31/2026
Department of Homeland Security U.S. Citizenship and Immigration Services
Last Name (Family Name) from Section 1. First Name (Given Name) from Section 1. Middle initial (if any) from Section 1.
Instructions: This supplement replaces Section 3 on the previous version of Form I-9. Only use this page if your employee requires reverification, is rehired within three years of the date the original Form I-9 was completed, or provides proof of a legal name change. Enter the employee's name in the fields above. Use a new section for each reverification or rehire. Review the Form I-9 instructions before completing this page. Keep this page as part of the employee's Form I-9 record. Additional guidance can be found in the Handbook for Employers: Guidance for Completing Form I-9 (M-274)
New Name (if applicable)Date of Rehire (if applicable)
Date (mm/dd/yyyy) Last Name (Family Name) First Name (Given Name) Middle Initial
Reverification: If the employee requires reverification, your employee can choose to present any acceptable List A or List C documentation to show continued employment authorization. Enter the document information in the spaces below.
Document Title Document Number (if any) Expiration Date (if any) (mm/dd/yyyy)
I attest, under penalty of perjury, that to the best of my knowledge, this employee is authorized to work in the United States, and if the employee presented documentation, the documentation I examined appears to be genuine and to relate to the individual who presented it.
Name of Employer or Authorized Representative Signature of Employer or Authorized Representative Today's Date (mm/dd/yyyy)
Additional Information (Initial and date each notation.)
Date of Rehire (if applicable) New Name (if applicable)
Date (mm/dd/yyyy) Last Name (Family Name) First Name (Given Name) Middle Initial
Reverification: If the employee requires reverification, your employee can choose to present any acceptable List A or List C documentation to show continued employment authorization. Enter the document information in the spaces below.
Document Title Document Number (if any) Expiration Date (if any) (mm/dd/yyyy)
I attest, under penalty of perjury, that to the best of my knowledge, this employee is authorized to work in the United States, and if the employee presented documentation, the documentation I examined appears to be genuine and to relate to the individual who presented it.
Name of Employer or Authorized Representative Signature of Employer or Authorized Representative Today's Date (mm/dd/yyyy)
Additional Information (Initial and date each notation.)
Date of Rehire (if applicable) New Name (if applicable)
Date (mm/dd/yyyy) Last Name (Family Name) First Name (Given Name) Middle Initial
Reverification: If the employee requires reverification, your employee can choose to present any acceptable List A or List C documentation to show continued employment authorization. Enter the document information in the spaces below.
Document Title Document Number (if any) Expiration Date (if any) (mm/dd/yyyy)
I attest, under penalty of perjury, that to the best of my knowledge, this employee is authorized to work in the United States, and if the employee presented documentation, the documentation I examined appears to be genuine and to relate to the individual who presented it.
Name of Employer or Authorized Representative Signature of Employer or Authorized Representative Today's Date (mm/dd/yyyy)
Additional Information (Initial and date each notation.)
Form I-9 Edition 0 / /23 Page 4 of 4
Federal Law Enforcement Training Centers Charleston SC
DEPARTMENT OF HOMELAND SECURITY
NON-DISCLOSURE AGREEMENT
Protected Critical Infrastructure Information (PCII)
Agreement in consideration of my being granted conditional access to certain information, specified below, that is owned by, produced by, or in the possession of the United States Government.
(Signer will acknowledge the category or categories of information that he or she may have access to, and the signer's willingness to comply with the standards for protection by placing his or her initials in front of the applicable category or categories.)
Initials:
I attest that I am familiar with, and I will comply with all requirements of the PCII program set out in the Critical Infrastructure Information Act of 2002 (CII Act) (Title II, Subtitle B, of the Homeland Security Act of 2002, Public Law 107-296, 196 Stat. 2135, 6 USC 101 et seq.), as amended, the implementing regulations thereto (6 CFR Part 29), as amended, and the applicable PCII Procedures Manual, as amended, and with any such requirements that may be officially communicated to me by the PCII Program Manager or the PCII Program Manager's designee.
Sensitive Security Information (SSI)Initials:
I attest that I am familiar with, and I will comply with the standards for access, dissemination, handling, and safeguarding of SSI information as cited in this Agreement and in accordance with 49 CFR Part 1520, "Protection of Sensitive Security Information," "Policies and Procedures for Safeguarding and Control of SSI," as amended, and any supplementary guidance issued by an authorized official of the Department of Homeland Security.
Other Sensitive but Unclassified (SBU)Initials:
As used in this Agreement, sensitive but unclassified information is an over-arching term that covers any information, not otherwise indicated above, which the loss of, misuse of, or unauthorized access to or modification of could adversely affect the national interest or the conduct of Federal programs, or the privacy to which individuals are entitled under Section 552a of Title 5, as amended, but which has not been specifically authorized under criteria established by an Executive Order or an Act of Congress to be kept secret in the interest of national defense or foreign policy. This includes information categorized by DHS or other government agencies as: For Official Use Only (FOUO); Official Use Only (OUO); Sensitive Homeland Security Information (SHSI); Limited Official Use (LOU); Law Enforcement Sensitive (LES);
Safeguarding Information (SGI); Unclassified Controlled Nuclear Information (UCNI); and any other identifier used by other government agencies to categorize information as sensitive but unclassified.
I attest that I am familiar with, and I will comply with the standards for access, dissemination, handling, and safeguarding of the information to which I am granted access as cited in this Agreement and in accordance with the guidance provided to me relative to the specific category of information.
I understand and agree to the following terms and conditions of my access to the information indicated above:
1. I hereby acknowledge that I have received a security indoctrination concerning the nature and protection of information to which I have been provided conditional access, including the procedures to be followed in ascertaining whether other persons to whom I contemplate disclosing this information have been approved for access to it, and that I understand these procedures.
I, , an individual official, employee, consultant, or subcontractor of or to
(the Authorized Entity), intending to be legally bound, hereby consent to the terms in this
PRIVACY ACT STATEMENT
Authority: Homeland Security Act of 2002; and DHS Management Directive 11042.1, “SAFEGUARDING SENSITIVE
BUT UNCLASSIFIED (FOR OFFICIAL USE ONLY) INFORMATION”.
Principle Purpose: To execute an agreement between DHS and contractors (or consultants) working for, or on behalf of DHS, to protect DHS Sensitive but Unclassified Information from unauthorized disclosure.
Routine Use(s): The information collected on this form may be disclosed as generally permitted under 5 U.S.C. §552a
(b) of the Privacy Act of 1974, as amended. This includes using the information as necessary and authorized by the routine uses published in “DHS/ALL-023 Personnel Security Management System of Records”.
Disclosure: Providing this information is voluntary; however, failure to provide this information may prevent the individual from being granted access to DHS Sensitive but Unclassified Information.
PUBLIC BURDEN STATEMENT
In accordance with 5 C.F.R. 1320.3(h)(1), this information collection is exempt from the requirements of Public Law 104-13, "Paperwork Reduction Act of 1995".
Page 1 of 3DHS Form 11000-6 (05/2023)
Federal Law Enforcement Training Centers Charleston SC
2. By being granted conditional access to the information indicated above, the United States Government has placed special confidence and trust in me and I am obligated to protect this information from unauthorized disclosure, in accordance with the terms of this Agreement and the laws, regulations, and directives applicable to the specific categories of information to which I am granted access.
3. I attest that I understand my responsibilities and that I am familiar with and will comply with the standards for protecting such information that I may have access to in accordance with the terms of this Agreement and the laws, regulations, and/or directives applicable to the specific categories of information to which I am granted access. I understand that the United States Government may conduct inspections, at any time or place, for the purpose of ensuring compliance with the conditions for access, dissemination, handling and safeguarding information under this Agreement.
4. I will not disclose or release any information provided to me pursuant to this Agreement without proper authority or authorization. Should situations arise that warrant the disclosure or release of such information I will do so only under approved circumstances and in accordance with the laws, regulations, or directives applicable to the specific categories of information. I will honor and comply with any and all dissemination restrictions cited or verbally relayed to me by the proper authority.
5. (a) For PCII - (1) Upon the completion of my engagement as an employee, consultant, or subcontractor under the contract, or the completion of my work on the PCII Program, whichever occurs first, I will surrender promptly to the PCII Program Manager or his designee, or to the appropriate PCII officer, PCII of any type whatsoever that is in my possession.
(2) If the Authorized Entity is a United States Government contractor performing services in support of the PCII Program, I will not request, obtain, maintain, or use PCII unless the PCII Program Manager or Program Manager's designee has first made in writing, with respect to the contractor, the certification as provided for in Section 29.8(c) of the implementing regulations to the CII Act, as amended.
(b) For SSI and SBU - I hereby agree that material which I have in my possession and containing information covered by this Agreement, will be handled and safeguarded in a manner that affords sufficient protection to prevent the unauthorized disclosure of or inadvertent access to such information, consistent with the laws, regulations, or directives applicable to the specific categories of information. I agree that I shall return all information to which I have had access or which is in my possession 1) upon demand by an authorized individual; and/or 2) upon the conclusion of my duties, association, or support to DHS; and/or 3) upon the determination that my official duties do not require further access to such information.
6. I hereby agree that I will not alter or remove markings, which indicate a category of information or require specific handling instructions, from any material I may come in contact with, in the case of SSI or SBU, unless such alteration or removal is consistent with the requirements set forth in the laws, regulations, or directives applicable to the specific category of information or, in the case of PCII, unless such alteration or removal is authorized by the PCII Program Manager or the PCII Program Manager's designee. I agree that if I use information from a sensitive document or other medium, I will carry forward any markings or other required restrictions to derivative products, and will protect them in the same matter as the original.
7. I hereby agree that I shall promptly report to the appropriate official, in accordance with the guidance issued for the applicable category of information, any loss, theft, misuse, misplacement, unauthorized disclosure, or other security violation, I have knowledge of and whether or not I am personally involved. I also understand that my anonymity will be kept to the extent possible when reporting security violations.
8. If I violate the terms and conditions of this Agreement, such violation may result in the cancellation of my conditional access to the information covered by this Agreement. This may serve as a basis for denying me conditional access to other types of information, to include classified national security information.
9. (a) With respect to SSI and SBU, I hereby assign to the United States Government all royalties, remunerations, and emoluments that have resulted, will result, or may result from any disclosure, publication, or revelation of the information not consistent with the terms of this Agreement.
(b) With respect to PCII I hereby assign to the entity owning the PCII and the United States Government, all royalties, remunerations, and emoluments that have resulted, will result, or may result from any disclosure, publication, or revelation of PCII not consistent with the terms of this Agreement.
Page 2 of 3DHS Form 11000-6 (05/2023)
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10. This Agreement is made and intended for the benefit of the United States Government and may be enforced by the United States Government or the Authorized Entity. By granting me conditional access to information in this context, the United States Government and, with respect to PCII, the Authorized Entity, may seek any remedy available to it to enforce this Agreement including, but not limited to, application for a court order prohibiting disclosure of information in breach of this Agreement. I understand that if I violate the terms and conditions of this Agreement, I could be subjected to administrative, disciplinary, civil, or criminal action, as appropriate, under the laws, regulations, or directives applicable to the category of information involved and neither the United States Government nor the Authorized Entity have waived any statutory or common law evidentiary privileges or protections that they may assert in any administrative or court proceeding to protect any sensitive information to which I have been given conditional access under the terms of this Agreement.
11. Unless and until I am released in writing by an authorized representative of the Department of Homeland Security (if permissible for the particular category of information), I understand that all conditions and obligations imposed upon me by this Agreement apply during the time that I am granted conditional access, and at all times thereafter.
12. Each provision of this Agreement is severable. If a court should find any provision of this Agreement to be unenforceable, all other provisions shall remain in full force and effect.
13. My execution of this Agreement shall not nullify or affect in any manner any other secrecy or non-disclosure Agreement which I have executed or may execute with the United States Government or any of its departments or agencies.
14. These provisions are consistent with and do not supersede, conflict with, or otherwise alter the employee obligations, rights, or liabilities created by existing statute or Executive Order relating to (1) classified information, (2) communications to Congress, (3) the reporting to an Inspector General or the Office of Special Counsel of a violation of any law, rule, or regulation, or mismanagement, a gross waste of funds, an abuse of authority, or a substantial and specific danger to public health or safety, or (4) any other whistleblower protection. The definitions, requirements, obligations, rights, sanctions, and liabilities created by controlling Executive Orders and statutory provisions are incorporated into this agreement and are controlling.
15. Signing this Agreement does not bar disclosures to Congress, the Special Counsel, the Inspector General of any agency, or any other agency component responsible for internal investigation or review of any information that relates to any violation of any law, rule, or regulation, or mismanagement, a gross waste of funds, an abuse of authority, or a substantial and specific danger to public health or safety, or any other whistleblower protection. In addition, signing this agreement does not bar disclosure to an authorized official of an executive agency or the Department of Justice that are essential to reporting a substantial violation of law.
16. I represent and warrant that I have the authority to enter into this Agreement.
17. I have read this Agreement carefully and my questions, if any, have been answered. I acknowledge that the briefing officer has made available to me any laws, regulations, or directives referenced in this document so that I may read them at this time, if I so choose.
Acknowledgement
Typed/Printed Name: Government/Department/Agency/Business Address Telephone Number:
Typed/Printed Name: Government/Department/Agency/Business Address Telephone Number:
I make this Agreement in good faith, without mental reservation or purpose of evasion.
Signature:
WITNESS:
Date:
Signature: Date:
DHS Form 11000-6 (05/2023) Page 3 of 3
Federal Law Enforcement Training Centers Charleston SC content
Department of Homeland Security Contractor Security Orientation
Presented by:
DHS Office of the Chief Security Officer
Compliance / Standards and Training Division
IMPORTANT:
The contents of this training guide are
UNCLASSIFIED.
All information and instructions contained herein are in accordance with Executive Order 13526, 32 CFR, part 2001, DHS Management Directive (MD) 11042.1, DHS IT policies and MD 11056.1: DHS policy regarding the recognition, identification, and safeguarding of Sensitive But Unclassified Information (SBU). The policies and directives referenced in this guide are applicable to all persons who are permanently or temporarily assigned, attached, detailed to, employed, or under contract with
DHS.
DO NOT duplicate, copy, or redistribute any information contained in this guide without written permission from the DHS Office of Security Compliance, Standards and Training Branch.
securitytraining@hq.dhs.gov
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Page | 1 Department of Homeland Security Office of The Chief Security Officer C/S&TD Contractor Security Orientation Guide V 1.3
Introduction
The Office of the Chief Security Officer would like to welcome you to the Department of Homeland Security. This Contractor Security Orientation was developed to provide contractors with general information regarding DHS asset protection policies and safeguarding procedures. In addition to the information contained herein, be sure to review your specific operational policies and procedures, as they may contain additional helpful information and/or details.
Once you have read the information provided in this orientation, you will be able to:
The Department of Homeland Security’s mission Identify what DHS protects and the types threats being protected Identify the basic principles of each major security discipline Discuss how OPSEC applies to you and the DHS mission Explain your roles and responsibilities in accordance with the Department of Homeland Security's mission to protect America's assets, including Sensitive But Unclassified and Classified National Security Information.
Understand the terms "Need-to-Know" and "unauthorized disclosure"
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C/S&TD Contractor Security Orientation Guide V 1.3
Protecting America’s Assets Skip to main content The department of Homeland Security employs a comprehensive security program to ensure the operational integrity and protection of our assets. The acronym "PIE-FAO" is an easy way to remember what these assets are.
• Personnel: People are our most important asset. Without the protection of people, some of the other items listed here could also be compromised.
• Information: In all DHS environments, information is something we all work with on a daily basis; both classified and unclassified.
• Equipment: From computer network systems and telecommunications, to facsimiles and COMSEC equipment, we use these things on a daily basis to process and disseminate the information we work with.
• Facilities: We need to protect places we work, process, and store information and equipment. No two facilities are alike.
• Activities: Many activities also need protection. This includes our travel, meetings, working groups, and project teams that we may be involved with.
• Operations: Protecting the continuity of essential security operations, like immigration and terrorism task force operations is crucial.
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C/S&TD Contractor Security Orientation Guide V 1.3
Identifying Threats
There are primarily two types of threats we are most concerned with. The first type of threat is known as a natural disaster - an adverse condition or event imposed by nature. without certain security efforts, the after effect of natural disasters could leave our facilities damaged, creating vulnerability to further threats and compromises. Normally, these happenings are not predictable, therefore we have to be emergency prepared and establish and maintain a Continuity Of Government (COG) and Continuity of Operations Plan (COOP).
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C/S&TD Contractor Security Orientation Guide V 1.3
The second type of threat we need to be concerned with is the human threat. The human threat ranges from International, domestic, gangs, to the insider threat. International and Domestic Terrorist threats run the gamut; from hate-filled white supremacists…to highly destructive eco-terrorists…to violence-prone anti-government extremists…to radical separatist groups. U.S.
Immigration and Customs Enforcement (ICE) is continually working to rid our streets of violent foreign-born gang members who are in our country illegally and represent a threat to our community and government.
Are there any other kinds of threats you can think of? Maybe you’ve heard of the term “insider threat”? Executive Order (EO) 13587 directs U.S. Government Executive Branch agencies and departments to establish an Insider Threat Task Force to develop a government-wide Insider Threat program, to protect classified national security information. But what exactly is an Insider threat? In the next section, we will briefly discuss the insider threat and what you can do to identify and report suspected insider threats.
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C/S&TD Contractor Security Orientation Guide V 1.3
Insider Threat
The National Insider Threat Task Force (NITTF) provides the following definitions to better understand and identify insider threats.
An insider is a person with authorized access to any United States Government resource to include personnel, facilities, information, equipment, networks or systems.
The Insider Threat is identified as someone who uses his/her authorized access, wittingly or unwittingly, to do harm to the security of the United States.
Top, left to right: Edward Joseph Snowden, Nidal Malik Hasan, and Chelsea Manning Bottom, left to right: Aaron Alexis, David Petraeus
Anyone with positioning and/or access could be an insider threat, either through intentional or unintentional efforts. In some cases, simply a lack of training, knowledge of experience can create security vulnerabilities. As a contractor for the Department of Homeland Security, you may also be required to complete Insider threat-specific training and direct your Insider Threat matters/questions to: dhs_insider_threat_program@hq.dhs.gov or (202) 447-4200.
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C/S&TD Contractor Security Orientation Guide V 1.3
Operations Security (OPSEC)
Operations Security (OPSEC) is systematic and proven process by which the U.S.
Government and its supporting contractors can deny to potential adversaries’ information about capabilities and intentions by identifying, controlling, and protecting generally unclassified evidence of the planning and execution of sensitive Government activities.
Being able to identify indicators and following your Operational Security (OPSEC) processes are essential in protecting information about missions, activities, and operations.
We can never underestimate the capabilities or strength of conviction of an adversary. Nothing is more dangerous than someone who is willing to die for a cause. Who is the adversary? It is important to remember that the U.S. Government has many adversaries with bad intentions. For example, foreign intelligence services continue to collect information on us that could be used to hurt us in the future. We sometimes only focus on what just happened, but it is a certainty that our adversaries will continually look for and find any weak links.
Their intent may be to:
• Collect Information
• Conduct Espionage
• Disrupt/Impact Service
• Secure Criminal advantage
• Terrorism
• Obtain Publicity/Propaganda
• Gain Competitive Advantage
• Exploit Personnel/Vulnerabilities
• Offensive Cyber Operations
Think about what someone may observe regarding your activities. What do you do when you go to work? What are you revealing by your predictable routines and the way you do business?
These are called "indicators". As a DHS contractor, you are responsible for identifying the indicators and vulnerabilities that may exist in your activities and operations, so that the OPSEC Process can be applied effectively.
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C/S&TD Contractor Security Orientation Guide V 1.3
The OPSEC…
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