DD254_22_Jun_18_SIGNED.pdf

CLASSIFICATION (When filled in): Unclassified

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AEM LiveCycle Designer

DD FORM 254, 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:

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

a. LEVEL OF FACILITY SECURITY CLEARANCE (FCL) REQUIRED

(See Instructions)

Top Secret

b. LEVEL OF SAFEGUARDING FOR CLASSIFIED INFORMATION/

MATERIAL REQUIRED AT CONTRACTOR FACILITY

None (See instructions)

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

a. PRIME CONTRACT NUMBER (See instructions.)

TBD

b. SUBCONTRACT NUMBER

c. SOLICITATION OR OTHER NUMBER

FA254318RA003

DUE DATE (YYYYMMDD)

20180628

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

TBD

b. CAGE CODE c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional)

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) Add Row Remove last Row Delete All Rows

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 (Click button to add more locations.) Add Row Remove last Row Delete All Rows

a. LOCATION(S) (For actual performance, see instructions.)

50TH Space Wing Restricted Area (RA) 712 Kepler Ave.

Schriever AFB, CO 80912

b. CAGE CODE (If applicable, see Instructions.)

N/A

c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional) 50 SW/IPO (Collateral)

460 SW/SSO (SCI)

9. GENERAL UNCLASSIFIED DESCRIPTION OF THIS PROCUREMENT

The contractor shall provide non-personal services in support of the mission of Schriever Air Force Base (SAFB) to the extent defined in the Performance Work Statement. These services consist of, but are not limited to, Receptionist functions at the 11th Space Warning Squadron.

The Receptionist functions support the 460 SW Senior Intelligence Officer & Special Security Representative in maintaining SCI operations and facilities. These services shall be performed on a 24-hour-per- day, 7-day-per-week basis.

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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.)

SCI Billets

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.)

AIS Processing Required

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)

NOTE: NO PUBLIC RELEASE OF SCI IS AUTHORIZED;

PUBLIC RELEASE OF ANY ASPECT OF THIS CONTRACT IS

Public Release Authority:

HQ AFSPC/PA must be consulted prior to release of any information

13. SECURITY GUIDANCE Add Signature Remove last Signature Delete All Signatures

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.)

13a. Period of Performance is: 04 October 2018 - 03 October 2019 with four 12 month option years. This requirement will have a two (2) week phase-in period, (20 September 2018 -4 October 2018) if needed, which will be executed prior to base period for successful transition of services.

13b. Non-AFSPC SCIFs will be used only when covered by a co-utilization Memorandum of Agreement (MOA) between AFSPC and the facility sponsor. The supporting SSO AFSPC is 460 SW/SSO.

13c. The following documents (with subsequent revision/changes) are applicable security guidance: DoD 5105.21-M-1, Sensitive Compartmented Information Administrative Security Manual, August 1998; AF Manual 14-304, The Security, Use, and Dissemination of Sensitive Compartmented Information,1 May 1999; Defense Support Program (DSP) and Space Based Infrared System (SBIRS) Highly Elliptical Orbit (HEO) Security Classification Guide (SCG), 1 October 2009; National System for Geospatial Intelligence(NSG) Security Classification Guide for Overhead Persistent Infrared (OPIR), December 2010; DoDM 5200.01, Vols 1-4, AFI 16-1404, AFI 16-1406, and AFI 31-501 13d. Inquiries pertaining to classification guidance on SCI will be directed to the contract monitor.

13e. SCI data furnished to or generated by the contractor will require security handling and controls beyond those in the NISPOM. These

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supplemental instructions will be furnished and/or made available to the contractor through the contract monitor by 460 SW/SSO.

13f. Names of contractor personnel requiring access to SCI will be submitted to the 460 SW/SSO. Forms requesting Special Background Investigations will be prepared in accordance with the NISPOM and submitted to DSS.

13g. 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 460 SW/SSO.

13h. The contractor will advise the 460 SW/SSO immediately upon reassignment of personnel to other duties not associated with this contract.

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

DD254 Continuation and Signatures page.pdf

Add Attachment View Selected Attachment Remove Selected Attachment

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. 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.)

Provide the information requested by the Notification of Government Security Activity and Visitor Group Security Agreements Clause, AFFARS 5352.204-9000 to the Chief, Information Protection.

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. 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.)

460 SW/SSO has exclusive security responsibility for SCI classified material released or developed under this contract and held within a contractors SCIF. SCI inspections will be conducted by 460 SW/SSO. Industrial Security Reviews, while operating on an Air Force Installation, will be conducted by the 50 SWIP.

16. GOVERNMENT CONTRACTING ACTIVITY (GCA) AND POINT OF CONTACT (POC)

a. GCA NAME

460th Contracting Flight

b. ACTIVITY ADDRESS CODE (AAC) OF THE CONTRACTING OFFICE (See Instructions)

FA2543

c. ADDRESS (Include ZIP Code) 510 South Aspen Street (Stop 92) Aurora, CO, 80011

d. POC NAME

Lizon, Emily

e. POC TELEPHONE (Include Area Code)

+1 (720) 847-9283

f. EMAIL ADDRESS (See Instructions) emily.lizon.1@us.af.mil

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.

a. TYPED NAME OF CERTIFYING OFFICIAL (Last, First, Middle Initial) (See Instructions)

Raffaeli, Damaris

b. TITLE

Contracting Officer

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c. ADDRESS (Include ZIP Code) 510 South Aspen Street (Stop 92) Aurora, CO, 80011

d. AAC OF THE CONTRACTING OFFICE (See Instructions)

FA2543

e. CAGE CODE OF THE PRIME CONTRACTOR

(See Instructions.)

f. TELEPHONE (Include Area Code)

+1 (720) 847-6803

g. EMAIL ADDRESS (See Instructions) damaris.raffaeli@us.af.mil

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.)

Attachment 1, DD Form 254 Continuation Sheet

Additional Information for DD Form 254 Department of Defense Contract Security Classification Specification

BLOCK: write additional information for each block you find necessary to define. Below are examples:

10.a. Access to COMSEC material is restricted to U.S. citizens holding final U.S. Government clearances. Such information is not releasable to personnel holding only reciprocal clearances.

10.g. Access to classified NATO information requires a final U.S. Government clearance at the appropriate level.

10.j. FOUO information provided under this contract shall be safeguarded as specified in the attachment "Protecting For Official Use Only (FOUO) Information."

11.e. 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.

11.j. See attached OPSEC addendum 11.k. Request DCS services from the Commander, Defense Courier Service, A ITN: Operations Divisions, Fort George G. Meade, MD 20755-3570. Only certain classified information qualifies for shipment by DCS. It is the responsibility of the contracting activity to comply with DCS policy and procedures.

13.i. 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 460 SW/SSO or OJA upon demand by such personnel. The contractor may release such material to any other personnel. including contractor and subcontractor employees, and employees of any Federal Government agency, only upon prior written approval from the 460 SW /SSO. An access certification to an AFSPC contractor-occupied SCIF does not constitute approval to release AFSPC contractual material to these other personnel; Contract Monitor approval is nevertheless required. Contract Monitor approval of an AFSPC contractor visit certification or permanent certification to another facility will constitute approval to discuss contractual material at facility to be visited.

13.j. 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 accountability of all SCI released to his/her custody, regard less of whether the release is within a contractor or US Government SCI r. Upon completion/cancellation of the contract, the contractor must return all such material to 460 SW/SSO unless a followon contract specifies that the material will be transferred to a subsequent contract. SCI inventories will be conducted !AW DIA Manual 50-5 and AFM 14-304.

13.k. This contract requires the use of the Defense Courier Service (DCS). 460 SW/SSO will validate DCS requirements.

13. I. Contractor Special Security Officers (CSSOs) must coordinate with the 460 SW /SSO and obtain the concurrence of 460 SW /SSO prior to subcontracting any portion of SCI efforts involved in this contract.

13.m. o contractor personnel will be granted access to SCI material under this contract unless they are filling a DOD SCJ billet. The contractor will coordinate with the 460 SW/SSO to ensure adequate billets are requested under this contract. Multiple contract employees sponsored by the organizations other than Space Command must be certified lo 460 SW/SSO for use on the contract.

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

13.o. The following activity is designated as the User Agency SS for SCI requirements lAW DlA Manual 50-5;

460 SW/SSO, Buckley AFB, CO 80011.

REQUIRED COORDINATION:

ETHAN W. MATTOX, Lt Col, USAF Program Project Manager

JACOB E. SALINAS, SSgt, USAF Unit Security Manager

Who???

COMSEC Manager

Who???

OPSEC Manager

WILLARD M. VIAR, GS-12

USAF 460 SW/SSO

DRAFT

SAMPLE

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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) DD254 Continuation and Signatures page.pdf

460 SW/SSO (SCI)

712 Kepler Ave.

Schriever AFB, CO 80912

13b. Non-AFSPC SCIFs will be used only when covered by a co-utilization Memorandum of Agreement (MOA) between AFSPC and the facility sponsor. The supporting SSO AFSPC is 460 SW/SSO.

13c. The following documents (with subsequent revision/changes) are applicable security guidance: DoD 5105.21-M-1, Sensitive Compartmented Information Administrative Security Manual, August 1998; AF Manual 14-304, The Security, Use, and Dissemination of Sensitive Compartmented Information,1 May 1999; Defense Support Program (DSP) and Space Based Infrared System (SBIRS) Highly Elliptical Orbit (HEO) Security Classification Guide (SCG), 1 October 2009; National System for Geospatial Intelligence(NSG) Security Classification Guide for Overhead Persistent Infrared (OPIR), December 2010; DoDM 5200.01, Vols 1-4, AFI 16-1404, AFI 16-1406, and AFI 31-501 13d. Inquiries pertaining to classification guidance on SCI will be directed to the contract monitor.

13e. SCI data furnished to or generated by the contractor will require security handling and controls beyond those in the NISPOM. These supplemental instructions will be furnished and/or made available to the contractor through the contract monitor by 460 SW/SSO.

13f. Names of contractor personnel requiring access to SCI will be submitted to the 460 SW/SSO. Forms requesting Special Background Investigations will be prepared in accordance with the NISPOM and submitted to DSS.

13g. 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 460 SW/SSO.

13h. The contractor will advise the 460 SW/SSO immediately upon reassignment of personnel to other duties not associated with this contract.

Aurora, CO, 80011 Address: 510 South Aspen Street (Stop 92) Aurora, CO, 80011