Attachment_4_-_DD_254.pdf

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DRAFT

SAMPLE

PREVIOUS EDITION IS OBSOLETE.

Page of AEM LiveCycle Designer

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:

October 31, 2020 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.)

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 List of Attachments [1] (All Files Must be Attached Prior to Signing, i.e., for any digital signature on the form) OPSEC requirements.pdf

21 SW/IPC, 135 Dover St, Ste 1055 Peterson AFB, CO 80914-115

(719) 556-8235 See Block 13

See Block 13

21 SW/IPC

Ref 8a: Contractor will regularly perform work and require access to: Collateral and SCI facilities, Peterson AFB CO, 80914. Contractor will also regularly work as an Administrator on the AMAG Alarm system allowing them the opportunity to manipulate the alarm status of SCI facilities on Peterson AFB, CO.

Ref 8c: (collateral): 21 SW/IPC, 135 Dover St, Ste 1055, Peterson AFB, CO 80914-115 Item 10j: See DoDM 5200.01, Volume 4, and enclosure 3 for Specific FOUO information Item 11a: Contract performance is restricted to Peterson AFB. Using activity will provide security classification guidance for performance of this contract.

Item 11e: Perform Service Only: Contract is for alarm maintenance. Actual knowledge of, generation, or production of classified information is not required for performance of the contract. Cleared personnel are required to perform this service because security measures which are in force do not preclude access to classified information.

Item 11j: Have Operations Security (OPSEC) Requirements: Contractor must comply with OPSEC requirements attached below.

Item 12: Public Release: Contractor is to submit requests through the Contracting Officer for OPSEC Program Manager review and public release authorization. The Contracting Officer will provide contractor with written approval/disapproval. (T-1) Information requiring AF or DoD–level review will be reviewed by the unit’s OPSEC Program Manager or Coordinator who will in-turn forward to the entry-level public affairs office through the AFIMSC Public Affairs Office to the Secretary of the Air Force, Office of Public Affairs, Security and Review Division (SAF/PAX), 1690 Air Force Pentagon, Washington DC 20330-1690.” MAJCOM/DRUs will send information requiring AF or DoD-level review directly to SAF/PAX Item 13a: Contract Expiration DAte: 01 April 2020, or as options are exercised up to 01 April 2024.

Item 13b: The SCIFs on Peterson AFB will be used to perform SCI contractual requirements. SCI material released to the contractor under this contract will be separately stored and maintained only in such properly accredited facilities. Non AFSPC or pre-designated SCIF areas on Peterson AFB will be used only when covered by a co-utilization Memorandum of Agreement (MOA) between HQ NORAD-USNORTHCOM and the sponsor of the facility.

Item 13c: The following documents with subsequent revision or changes will be used for specific SCI security guidance on this contract. DCID 6/9, DCID 6/3, DCID 6/4, JDCSISSS, and DIA Manual 50-14 Item 13d: All inquiries pertaining to classification guidance on SCI will be directed to the Contract Monitor.

Item 13e: SCI data furnished to or generated by the contractor will require security handling and controls beyong those in the National Industrial Security Program Operating Manual (NISPOM). Supplemental instructions will be furnished and/or made available to the contractor through the Contract Monitor by the User Agency Special Security Office, HQ AFSPC SSO.

Item 13f: Position name and clearance required of contractor personnel requiring access to SCI will be submitted to the SCI Contract Monitor (QAE). Provide HQ AFSPC SSO a SCI manpower list showing job description of each SCI position, level or access required per positions, and statement of work justifying SCI-level clearances.

Item 13g: The contractor will establish and maintain a current access list of those employees (by position) working on this contract. A copy of this list will be furnished to the SCI Monitor (QAP) Item 13h: The contractor will advise the SCI Contract Monitor (QAE) immediately upon reassignment of personnel to other duties not associated with this contract.

An occupied SCIF does not constitute approval to release AFSPC contractual material to these other personnel; Contractor approval is nevertheless required. Contract Monitor approval of anAFSPC contractor visit certification or permanent certification to another facility will constitute approval to discuss contractual material at the facility to be visited.

Item 13j: Any SCI released to the contractor in support of this contract remains the property of the DoD department, agency, or command that releases it. The contractor will maintain an active accountability of all SCI released to his/her custody, regardless of whether the release is within a contactor or US Government SCIF. Upon completion/cancellation of the contract, the contractor must return all such material to HQ AFSPC SSO unless a follow-on contract specifies that material will be transferred to a subsequent contract. SCI inventories will be conducted JAW DIA Manual 50-14.

Item 13k: SCIF at contractor facility will not be used.

Item 13L: This contract does not require Defense Courier Service.

Item 13m: No SCI processing required on this task order.

Item 13n: Contractor Special Security Officers (CSSOs) must coordinate with the SCI Contract Monitor and obtain the concurrence of the HQ AFSPC SSO prior to subcontracting any portion of SCI efforts involved in this contract.

Item 13o: No contractor personnel will be granted access to SCI material under this contract unless they are filling a DoD SCI position. The contractor will coordinate with the SCI contract monitor to ensure adequate positions are requested under this contract. Multiple contract employees sponsored by organizations other than AFSPC must be certified to HQ AFSPC for use of this contract.

Item 13q: Contractor will not use references to SCI accesses, even by unclassified acronyms, in advertising, promotional efforts, or recruitment for employees.

Item 13r: The following activity is designated as the User Agency SSO for SCI requirements IAW DIA Manual 50-14: HQ AFSPC, Special Security Office, 250 Vandenberg St, Bldg 1, Peterson AFB, C0.80914.

Colorado Springs, CO 80914 Address: 135 Dover St, Ste 2255 Peterson AFB, CO 80914