Attachment J1 - DD 254.pdf

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DRAFT

SAMPLE

PREVIOUS EDITION IS OBSOLETE.

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DD FORM 254, MAY 2019

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:

20220531 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 whs.mc-alex.esd.mbx.formswebmaster@mail.mil

WHS

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

150 Vandenberg Ave, Suite 1105 Peterson AFB, CO 80914 CSO: CPT R. Scott Patterson U.S. Army Satellite Operations Brigade (USASOB) 350 Vandenburg Street, BLDG 3 Peterson AFB, CO 80914-4901 Commercial: 719-554-1994

150 Vandenberg St. Ste 1105 Peterson AFB, CO 80914 Location: U.S. Army Satellite Operations Brigade 350 Vandenberg Ave Peterson AFB, CO 80914

CONTRACT EXPIRATION DATE: XX XXX XXXX. This date reflects, among other things, when the SCI indoctrinated contractor personnel will be debriefed. Ref. 8a-c: SAP performance is authorized ONLY at the locations identified in the SAP Addendum attached.

Ref. 10a: If the contractor is authorized to receive Government furnished cryptographic equipment, the guidance will state that fact. Access to classified COMSEC information requires a final U.S. Government clearance at the appropriate level. Further disclosure of COMSEC information by a contractor, to include subcontracting, requires approval of the GCA. Non-accountable COMSEC information, though not tracked in the COMSEC material control system, may still require a level of control within a document control system. Refer to NSA/CSS Manual 3-16, “Control of Communications Security Material,” and the Committee on National Security Systems Instruction (CNSSI) 4001, “Controlled Cryptographic Items,” for guidance. If access to COMSEC information is required at Government facilities, or the material is under Government control, contractor personnel will follow the security requirements of the host government activity.

Ref 10b: Access to RESTRICTED DATA requires a final U.S. Government clearance at the appropriate level.

Ref. 10c: GCA approval is required prior to granting CNWDI access to a subcontractor. Special briefings and procedures are also required. Access to CNWDI requires a final U.S. Government clearance at the appropriate level.

Ref 10e: (1)(2): Contractor employee access to SCI and Non-SCI information will be at the place of work identified on DD 254 block 8a. The contractor material marked as ORCON, PROPIN, NOFORM, or REL may be released to the contractor by the contract monitor only under provision of ICD 301. The controls and definitions specified in ICD 301 are applicable to the contract. The CSSO must ensure all contractor employees who have access to this material are fully trained in the ICD 301 requirements. The CSSO must provide a list of contractor personnel who have need-to-know for this information and the contract monitor must validate need-to-know by signature before the contractor employee has access to this information. SCI Billets - IAW para 4.1 of PWS

Ref 10f: Access to SAP information requires a final U.S. Government clearance at the appropriate level. See attached Special Access Program Addendum.

Ref 10g: Access to classified NATO information requires a final U.S. Government clearance at the appropriate level. NATO in-briefs are required prior to accessing the SIPRNET. Actual knowledge of, generation, or production of NATO information is required for performance of the contract.

Ref 10j: DoD Components; refer to DoDM 5200.01, Volume 4, “DoD Information Security Program: Controlled Unclassified Information (CUI),” available at http://www.esd.whs.mil/DD/DoD-Issuances/, when considering protection for CUI. Non-DoD Components must consult with their Component specific information security policy office to determine if they have any existing authority by law, government-wide policy or government- wide regulation to impose this requirement.

Ref 10k: a) This contract requires access to NC2-ESI. NC2-ESI material remains under US Government control at all times. Access to NC2-ESI by contractor personnel will be limited to US Government facilities.

b) In order to be considered for access to NC2-ESI, applicant must be United States citizens. No waivers will be considered. In addition, applicant must have a Top Secret clearance based on a favorable Single Scope Background Investigation (SSBI) completed within the past five years. No waivers will be considered.

c) Contractor will nominate personnel to USSTRATCOM / J050. Contractor will nominate only technically qualified personnel who meet citizenship and clearance requirements stated above.

d) Nominations will contain full identifying data on the nominee, statement that he/she meets the above citizenship requirements, description of the applicant's duties under the contract, which will require access to NC2-ESI, applicant's current clearance and the basis for the clearance.

e) If the applicant meets the clearance and investigation criteria, nomination must be received by USSTRATCOM / J050 and must be received 60 days prior to anticipate date NC2-ESI access is required.

f) NC2-ESI access will require briefing and debriefing to be accomplished by USSTRATCOM / J050. Contractor will cooperate with USSTRATCOM / J050 in making personnel available with sufficient lead time to permit USSTRATCOM to arrange for required briefings and debriefings.

g) Contractor will advise USSTRATCOM / J050 of any adverse information or change in status of an employee who has been granted access to NC2-ESI, i.e., marriage, divorce or remarriage.

Ref 11a: The contractor requires access to classified source data up to and including TOP SECRET in support of the work effort. Any extracts or use of such data requires the contractor to apply derivative classifications and markings consistent with the source documents. Use of Multiple sources on the classified by line necessitates compliance with the NISPOM (or DoDM 5200.01, Vol 2 and AFI 16-1404 if operating on an Air Force installation), and use of bibliography. Security Classification Guides (SCGs) will be identified upon task order award.

Ref 11j: The contractor shall adhere to OPSEC guidance: Be familiar with the organization’s Critical Information and Indicator List (CIIL) and ensure indicators & vulnerabilities are protected from disclosure per HQ U.S. Space Force (USSF) countermeasures/measures. The contractor shall complete OPSEC in-processing training to include complete follow on OPSEC training such as event-driven and annual OPSEC training as required provided by the USSF Program Manager per DoDD 5205.02E, DoD OPSEC; DoD 5205.02, DoD OPSEC Manual; and CJCSI 3213.0D, Joint OPSEC; and AFI 10-701, OPSEC.

Ref 11l: Receive, Store or Generate Controlled Unclassified Information (CUI) Security of Unclassified DoD Information on Non-DoD Information Systems: The Contractor must implement security safeguards for the protection of DoD CUI and Unclassified Controlled Technical Information (UCTI) as specified in DoDI 8582.01, Security of Unclassified DoD Information on Non-DoD Information Systems, CNSSP No. 18, National Policy on Classified Information Spillage, and Chairman of the Joint Chiefs of Staff Instruction (CJCSI) 6510.01.

For all unclassified Information Systems (IS) processing, storing, displaying, or transmitting National Security Information (NSI) designated as CUI, the Contractor will comply with the following FAR and Defense Federal Acquisition Regulation Supplement (DFAR) Clauses: 52-204-21, Basic Safeguarding of Covered Contractor Information Systems; 252-204-7000, Disclosure of Information; 252-204-7008, Compliance with Safeguarding Covered Defense Information Controls; 252-204-7012 and subpart 204-73, Safeguarding Covered Defense Information and Cyber Incident Reporting; and associated National Institute of Standards and Technology (NIST) Special Publication (SP) 800-171, Protecting Controlled Unclassified Information in Non-federal Information Systems and Organizations.

Ref 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. No public release of SCI is authorized. See SAP Addendum for SAP release procedures.

Ref. 13a: Insert SCG statement with POC information. Example: Please contact the requirements Owner Ted Egan at edward.egan.1@us.af.mil for further information.

Ref. 13b: Inquiries pertaining to classification guidance on SCI will be directed to the Contract Monitor.

Ref. 13c: SCI data furnished to or generated by the contractor will require security handling and controls beyond those in the National Industry Security Program Operating Manual (NISPOM). These supplemental instructions will be furnished and/or made available to the contractor thru the Contract Monitor by the User Agency Special Security Office, SSO USSF.

Ref. 13d: Names of contractor personnel requiring access to SCI will be submitted to the SCI Contract Monitor. Forms requesting Special Background Investigations will be prepared in accordance with the NIPSOM and submitted to Defense Counterintelligence and Security Agency (DCSA).

Ref. 13e: The contractor will establish and maintain a current access list of those employees working on this contract. A copy of this list will be furnished to the SCI Contract Monitor.

Ref. 13f: The contractor will advise the SCI Contract monitor, COR and PSO immediately upon reassignment of personnel provided access to classified portions of the contract to other duties not associated with this contract.

Ref. 13g: Release of Information. SCI with restrictive caveats (e.g., ORCON, PROPIN, etc.) will be released to contractors only when originator approval has been obtained. The contractor will control SCI, which has been originated or obtained under this contract as follows. The contractor may release such material to any contractor employee working against a billet under this contract only when a need-to-know exists. The contractor will release such material to any Special Security Office personnel assigned to USSF or DIA upon demand by such personnel. The contractor may release such material to any other personnel, including contractor and subcontractor employees, and employees of nay Federal Government agency, only upon prior written approval from the SCI Contract Monitor. An access certification to an USSF contractor-occupied SCIF does not constitute approval to release USSF contractual material to these other personnel; Contract Monitor approval is nevertheless required. Contract Monitor approval of an USSF contractor visit certification or permanent certification to another facility will constitute approval to discuss contractual material at facility to be visited.

Ref. 13h: Any SCI released to the contractor in support of this contract remains the property of DoD department, agency, or command that releases it. The contractor will maintain active control of all SCI released to his/her custody, regardless of whether the release is within a contractor or US Government SCIF.

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

Ref 13j: No contractor personnel will be granted access to SCI material under this contract unless they are filling a DoD SCI billet. The contractor will coordinate with SCI Contract Monitor to ensure adequate billets are requested under this contract. Multiple contract employees sponsored by the organizations other than Space Command must be certified to SSO USSF for use on the contract.

Ref. 13k: The contractor will designate a Special Security Point of Contact (POC) to SSO USSF. The POC will be responsible for all personnel and information security transactions between the contractor and SSO USSF

Ref. 131: Contractor will not use references to SCI or SAP accesses, even by unclassified acronyms, in advertising, promotional efforts, or recruitment for employees.

Ref. 13m: The following activity is designated as the User Agency SSO for SCI requirements IAW DoD 5105.21m_vol 1/2/3; USSF/ S2S, Peterson AFB CO 80914-4311.

text: DIANE C. DEE HQ SpOC/S3/6X

(719) 554-0557 text: DONALD A. GOUDY HQ SpOC/S3/6XOS

(719) 554-1199 text: MARK W. EVANGER HQ SpOC/S2/SSO

(719) 554-2402 text: DEAN R. MALONEY AFOSI PJ Det 5 OL-A

(719) 554-9028 text: R. SCOTT PATTERSON

CPT, LG

(719) 554-1994 text: ROBERT C LARSEN Jr.

21 SW/IP

(719) 556-4670

Contracting Officer Representative rep: Goudy, Donald A., GS-11 DAFC Security Manager rep: Evanger, Mark W., GG-14, DAFC Chief, Special Security Officer rep: Maloney, Dean R., GS-14, DAFC Program Security Officer rep: Patterson, R. Scott, CPT, LG U.S. Army Satellite Operations Brigade rep: Larsen, Robert C. Jr, GS-13, DAFC Chief, Information Protection

See Sensitive Compartmented Information (SCI) Release of Intelligence Information for additional security requirements. Prior approval of the contracting activity is required for subcontracting. Access to intelligence information requires special briefings and a final U. S. Government clearance at the appropriate level. Industrial Security reviews while operating on an Air Force installation will be conducted by the ISPM. All SCI and material will be handled according to special security requirements furnished by the responsible Special Security Office (SSO) designated in item 13. Upon completion of this contract, all SCI material provided to or generated by the contractor will be returned to the Air Force activity. If the material has been superseded or is no longer applicable, the Air Force activity will provide disposition instructions to the SSO. The contractor will follow all applicable security guidance related to the protection of classified information. Baseline guidance includes the NISPOM, applicable Program Security Directives, Security Classification Guides and Standard Operating Procedures. Task specific security classification guidance: This will be provided once received from the government agency and will be used to include all revisions and changes thereto. See SAP Addendum for SAP security guidance.

Peterson AFB, CO 80914-1159 Address: 150 Vandenberg St., Bldg 1, Suite 1100 Peterson AFB, CO 80914-1159