Atth_3,_DD254.pdf
PDF 530 KB Posted
- Attached to
- USAFCENT Awards and Decoration Services Federal contract opportunity
- Solicitation number
- FA4803-16-R-0005
About this file
FA4803-16-R-0005 - Attachment 3 - DD Form 254
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DEPARTMENT OF DEFENSE
CONTRACT SECURITY CLASSIFICATION SPECIFICATION
(The requirements of the DoD Industrial Security Manual apply to all security aspects of this effort.)
1. AND SAFEGUARDING
a. CLEARANCE REQUIRED
b. LEVEL OF SAFEGUARDING REQUIRED
2. IS FOR: (X and complete as applicable)
a. CONTRACT NUMBER
b. SUBCONTRACT NUMBER
c. DUE DATE (YYYYMMDD)
3. IS: (X and complete as applicable)
a. (Complete date in all cases)
REVISION NO.
c. (Complete Item 5 in all cases)
DATE (YYYYMMDD)
b. REVISED (Supersedes all previous specs)
DATE (YYYYMMDD)
DATE (YYYYMMDD)
4. THIS A FOLLOW-ON CONTRACT? YES NO. Yes, complete the following:
Classified material received or generated under (Preceding Contract Number) is transferred to this follow-on contract.
5. THIS A FINAL DD FORM 254? YES NO. Yes, complete the following:
In response to the contractor's request dated , retention of the classified material is authorized for the period of
6. (Include Commercial and Government Entity (CAGE) Code)
a. ADDRESS, AND ZIP CODE b. CAGE CODE c. SECURITY OFFICE (Name, Address, and Zip Code)
7.
a. ADDRESS, AND ZIP CODE b. CAGE CODE c. SECURITY OFFICE (Name, Address, and Zip Code)
8. PERFORMANCE
a. b. CAGE CODE c. SECURITY OFFICE (Name, Address, and Zip Code)
9. IDENTIFICATION OF THIS PROCUREMENT
10. CONTRACTOR WILL REQUIRE ACCESS TO: 11. IN PERFORMING THIS CONTRACT, THE CONTRACTOR WILL:YES NO YES NO
a. COMMUNICATIONS SECURITY (COMSEC) INFORMATION
b. RESTRICTED DATA
c. CRITICAL NUCLEAR WEAPON DESIGN INFORMATION
d. FORMERLY RESTRICTED DATA
e. INTELLIGENCE INFORMATION
(1) Sensitive Compartmented Information (SCI)
(2) Non-SCI f.
g. NATO INFORMATION
h. FOREIGN GOVERNMENT INFORMATION
i. LIMITED DISSEMINATION INFORMATION
j. FOR OFFICIAL USE ONLY INFORMATION
k. (Specify)
a. HAVE ACCESS TO CLASSIFIED INFORMATION ONLY AT ANOTHER
CONTRACTOR'S FACILITY OR A GOVERNMENT ACTIVITY
b. RECEIVE CLASSIFIED DOCUMENTS ONLY
c. RECEIVE AND GENERATE CLASSIFIED MATERIAL
d. FABRICATE, MODIFY, OR STORE CLASSIFIED HARDWARE
e. PERFORM SERVICES ONLY
f. 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 TEMPEST REQUIREMENTS
j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS
k. BE AUTHORIZED TO USE THE DEFENSE COURIER SERVICE
l. (Specify)
CLEARANCE
FACILITY
THIS SPECIFICATION
PRIME
SOLICITATION OR OTHER NUMBER
THIS SPECIFICATION
ORIGINAL
FINAL
IS If
IS If
CONTRACTOR
NAME, COGNIZANT
SUBCONTRACTOR
NAME, COGNIZANT
ACTUAL
LOCATION COGNIZANT
GENERAL
SPECIAL ACCESS INFORMATION
OTHER
HAVE
OTHER
DD FORM 254, DEC 1999 PREVIOUS EDITION IS OBSOLETE.
RFP No. FA4803-16-R-0005 Attachment 3
12. RELEASE. Any information (classified or unclassified) pertaining to this contract shall not be released for public dissemination except as provided by the Industrial Security Manual or unless it has been approved for public release by appropriate U.S. Government authority. Proposed public releases shall be submitted for approval prior to release a.
Direct Through (Specify)
d. ADDRESS (Include Zip Code)
Yes No to the Directorate for Freedom of Information and Security Review, Office of the Assistant Secretary of Defense (Public Affairs)* for review.
*In the case of non-DoD User Agencies, requests for disclosure shall be submitted to that agency.
13. The security classifiection guidance needed for this classified 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. Add additional pages as needed to provide complete guidance.)
14. Requirements, in addition to ISM requirements, 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 cognizant security office. Use Item 13 if additional space is needed.)
Yes No15. Elements of this contract are outside the inspection responsibility of the cognizant security office.
(If Yes, explain and identify specific areas or elements carved out and the activity responsible for inspections. Use Item 13 if additional space is needed.)
16. CERTIFICATION AND SIGNATURE. Security requirements stated herein are complete and adequate for safeguarding the classified information to be released or generated under this classified effort. questions shall be referred to the official named below.
b. TITLE c. (Include Area Code) e.
17. DISTRIBUTION
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.
PUBLIC
TYPED NAME OF CERTIFYING OFFICIAL
SECURITY GUIDANCE.
ADDITIONAL SECURITY REQUIREMENTS.
INSPECTIONS.
All
TELEPHONE
SIGNATURE
REQUIRED
OTHERS AS NECESSARY
DD FORM 254 (BACK), DEC 1999
RFP No. FA4803-16-R-0005 Attachment 3
| a_FACILITY_CLEARANCE_REQU: SECRET |
| b_LEVEL_OF_SAFEGUARDING_R: N/A |
| FillText1: Off |
| a_PRIME_CONTRACT_NUMBER: |
| DATE_YYYYMMDD: |
| FillText3: Off |
| b_SUBCONTRACT_NUMBER: |
| REVISION_NO: |
| DATE_YYYYMMDD1: |
| FillText5: Yes |
| c_SOLICITATION_OR_OTHER_N: FA4803-16-R-0005 |
| DUE_DATE_YYYYMMDD: |
| DATE_YYYYMMDD2: |
| YES1: |
| FillText12: |
| FillText11: |
| a_NAME_ADDRESS_AND_ZIP_CO: |
| b_CAGE_CODE: |
| c_COGNIZANT_SECURITY_OFFI: |
| a_NAME_ADDRESS_AND_ZIP_C1: |
| b_CAGE_CODE1: |
| c_COGNIZANT_SECURITY_OFF1: |
| a_LOCATION: U.S. Air Force Central (USAFCENT)/A1 |
523 Shaw Drive Shaw AFB SC 29152
| b_CAGE_CODE2: |
| c_COGNIZANT_SECURITY_OFF2: |
| 9_GENERAL_IDENTIFICATION: |
| a_COMMUNICATIONS_SECURIT1: Off |
| a_COMMUNICATIONS_SECURIT2: Yes |
| b_RESTRICTED_DATA1: Off |
| b_RESTRICTED_DATA2: Yes |
| c_CRITICAL_NUCLEAR_WEAPO1: Off |
| c_CRITICAL_NUCLEAR_WEAPO2: Yes |
| d_FORMERLY_RESTRICTED_DA1: Off |
| d_FORMERLY_RESTRICTED_DA2: Yes |
| 1_Sensitive_Compartmente1: Off |
| 1_Sensitive_Compartmente2: Yes |
| 2_NonSCI1: Off |
| 2_NonSCI2: Yes |
| f_SPECIAL_ACCESS_INFORMA1: Off |
| f_SPECIAL_ACCESS_INFORMA2: Yes |
| g_NATO_INFORMATION1: Yes |
| g_NATO_INFORMATION2: Off |
| h_FOREIGN_GOVERNMENT_INF1: Off |
| h_FOREIGN_GOVERNMENT_INF2: Yes |
| i_LIMITED_DISSEMINATION_1: Off |
| i_LIMITED_DISSEMINATION_2: Yes |
| j_FOR_OFFICIAL_USE_ONLY_I: Yes |
| j_FOR_OFFICIAL_USE_ONLY_1: Off |
| k_OTHER_Specify: Yes |
| k_OTHER_Specify1: Off |
| a_COMMUNICATIONS_SECURIT3: Yes |
| a_COMMUNICATIONS_SECURIT4: Off |
| b_RESTRICTED_DATA3: Off |
| b_RESTRICTED_DATA4: Yes |
| c_CRITICAL_NUCLEAR_WEAPO3: Off |
| c_CRITICAL_NUCLEAR_WEAPO4: Yes |
| d_FORMERLY_RESTRICTED_DA3: Off |
| d_FORMERLY_RESTRICTED_DA4: Yes |
| e_INTELLIGENCE_INFORMATI3: Off |
| e_INTELLIGENCE_INFORMATI4: Yes |
| 1_Sensitive_Compartmente3: Off |
| 1_Sensitive_Compartmente4: Yes |
| 2_NonSCI3: Off |
| 2_NonSCI4: Yes |
| f_SPECIAL_ACCESS_INFORMA3: Off |
| f_SPECIAL_ACCESS_INFORMA4: Yes |
| g_NATO_INFORMATION3: Off |
| g_NATO_INFORMATION4: Yes |
| h_FOREIGN_GOVERNMENT_INF3: Off |
| h_FOREIGN_GOVERNMENT_INF4: Yes |
| i_LIMITED_DISSEMINATION_3: Off |
| i_LIMITED_DISSEMINATION_4: Yes |
| 1_OTHER_Specify: |
| FillText13: Off |
| FillText14: Yes |
| a_TYPED_NAME_OF_CERTIFYIN: Randall E. May |
| b_TITLE: Contracting Officer |
| c_TELEPHONE_Include_Area: (803) 895-5403 |
| d_ADDRESS_Include_Zip_Cod: 20 Contracting Squadron |
321 Cullen St, Bldg 216 Shaw AFB SC 29152
| FillText21: Yes |
| FillText22: Off |
| FillText23: Yes |
| FillText24: Off |
| FillText25: Yes |
| FillText26: Yes |
| f_OTHERS_AS_NECESSARY: |
| FillText15: |
| FillText16: |
| other1: |
| release: HQ USAFCENT/PA |
524 Shaw Drive Shaw AFB SC 29152 Note: Public release of classified information is not authorized security: Ref 10.g.: Special briefings are required for access to NATO IAW AFI 31-406, Applying NATO Protection Standards. Prior approval of the contracting activity is required for subcontracting. Access to classified NATO information requires a final U.S. Government clearance at the appropriate level.
Ref 10.j.: FOUO information provided under this contract shall be managed and safeguarded IAW DoD 5400:7-R, Chapter 4, DoD Freedom of information Act (FOIA).
Ref 10.k.: Contractor will require SIPRNET access.
Ref 11.a.: The highest level of security clearance required for contract performance is Secret. Using activities will provide security classification guidance of performance of this contract. The government will oversee the handling and storage of classified information in support of this contract. The government will provide storage capability for all classified material required for this contract. All classified information shall be returned to the government upon termination of the contract.
Ref 14.: Classified information IAW DoD 5200.1-R, Information Security Program; AFI 31-401, Information Security Program Management; AFB 1-601,industrial Security Program Management, and other directives deemed necessary by the Servicing Security Activity (SSA).
Ref 17.: 20 FW/IP, 524 Nelson Ave, Shaw AFB SC 29152
| addit_sec: Visitor Group contractors are required to enter into a security agreement with the host base Information Security Program Management (ISPM). Provide the information requested by the AFFARS 5252.204-9000; Notification of Government Security Activity and Visitor Group Security Agreements. Visitor Groups will safeguard collateral. |
| Inspections: When contractors are designated as Visitor Groups on Air Force installations, Industrial Security Reviews for collateral information will be conducted by the host base Servicing Security Activity. Defense Security Service retains cognizance over the contractor facility. |
| Reset: |
| 4_Yes: Off |
| 4_No: No |
| 5_Yes: Off |
| 5_No: No |
| 12_Public_Release_Direct: Off |
| 12_Public_Release_Through: Through. |
| 13_Rules: |
| 13_2: |
| 14_Yes: Yes |
| 14_No: Off |
| 15_Yes: Yes |
| 15_No: Off |
| 3_A: Original. |
| 3_B: Off |
| 3_C: Off |
File details come from the government source that posted it. Updated .