Attachment_12__-__DD_254.pdf
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- Attached to
- Unit Support Services (USS2) - Award Federal contract opportunity
- Solicitation number
- FA4830-17-R-S001
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Attachment 12 - DD 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. CLEARANCE AND SAFEGUARDING
a. FACILITY CLEARANCE REQUIRED
b. LEVEL OF SAFEGUARDING REQUIRED
2. THIS SPECIFICATION IS FOR: (X and complete as applicable)
a. PRIME CONTRACT NUMBER
b. SUBCONTRACT NUMBER
c. SOLICITATION OR OTHER NUMBER DUE DATE (YYYYMMDD)
3. THIS SPECIFICATION IS: (X and complete as applicable)
a. ORIGINAL (Complete date in all cases)
REVISION NO.
c. FINAL (Complete Item 5 in all cases)
DATE (YYYYMMDD)
b. REVISED (Supersedes all previous specs)
DATE (YYYYMMDD)
DATE (YYYYMMDD)
4. IS THIS A FOLLOW-ON CONTRACT? YES NO. 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? YES NO. 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 b. CAGE CODE c. COGNIZANT SECURITY OFFICE (Name, Address, and Zip Code)
7. SUBCONTRACTOR
a. NAME, ADDRESS, AND ZIP CODE b. CAGE CODE c. COGNIZANT SECURITY OFFICE (Name, Address, and Zip Code)
8. ACTUAL PERFORMANCE
a. LOCATION b. CAGE CODE c. COGNIZANT SECURITY OFFICE (Name, Address, and Zip Code)
9. GENERAL 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. SPECIAL ACCESS INFORMATION
g. NATO INFORMATION
h. FOREIGN GOVERNMENT INFORMATION
i. LIMITED DISSEMINATION INFORMATION
j. FOR OFFICIAL USE ONLY INFORMATION
k. OTHER (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. 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 TEMPEST REQUIREMENTS
j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS
k. BE AUTHORIZED TO USE THE DEFENSE COURIER SERVICE
l. OTHER (Specify)
DD FORM 254, DEC 1999 PREVIOUS EDITION IS OBSOLETE. Adobe Professional 7.0
12. PUBLIC 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. TYPED NAME OF CERTIFYING OFFICIAL
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. SECURITY GUIDANCE. The security classification 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. ADDITIONAL SECURITY REQUIREMENTS. 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. INSPECTIONS. 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. All questions shall be referred to the official named below.
b. TITLE c. TELEPHONE (Include Area Code)
e. SIGNATURE
17. REQUIRED 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. OTHERS AS NECESSARY
DD FORM 254 (BACK), DEC 1999
| fac_clear: SECRET |
| safe_level: |
| prime_no: |
| xprime: Yes |
| sub_no: |
| xsub: Off |
| xsolic: Yes |
| solic_no: FA4830-17-R-S001 |
| due_date: 20172015 |
| xspec3: Orig |
| orig_date: 20170131 |
| rev_no: |
| rev_date: |
| final_date: |
| xfollowon: Yes |
| prec_no: FA4830-12-C-2007 |
| xfinal: No |
| req_dated: |
| period: |
| ctr_name: |
| ctr_cage: 3C1K9 |
| ctr_ofc: Defense Security Services (DSS) |
2300 Lake Park Drive Smyrna, GA 30080-7606
| sub_name: |
| sub_cage: |
| sub_ofc: |
| perf_loc: See Item 13 |
| perf_cage: |
| perf_ofc: 23rd Wing/IPI |
7248 Robbins Road, Bldg 743 Moody AFB, GA 31699-1616
| gen_id: Contractor shall perform services for the 38 RQS, 41 RQS, 71 RQS, 347 OSS, 23 FG, 74 FS, and 75 FS at Moody AFB, GA, in the following positions: Unit Deployment/Mobility Managers, Current Operations Schedulers, Supply Manager, Vehicle Control Manager, and FAA Riggers. See PWS. |
| x10a: No |
| x10b: Yes |
| x10c: No |
| x10d: No |
| x10e1: No |
| x10e2: No |
| x10f: No |
| x10g: No |
| x10h: No |
| x10i: No |
| x10j: Yes |
| x10k: No |
| other10k: |
| x11a: Yes |
| x11b: Yes |
| x11c: Yes |
| x11d: Yes |
| x11e: Yes |
| x11f: Yes |
| x11g: Yes |
| x11h: Yes |
| x11i: Yes |
| x11j: Yes |
| x11k: Yes |
| x11l: Yes |
| other11l: |
| xrelease: Yes |
| release_thru: No public release of classified material pertaining to this contract is authorized. |
| guidance: 8a. Performance locations are at the 38 RQS, 41 RQS, 71 RQS, and 347th OSS under the 347 Rescue Group. Other locations are |
the 74 FS, 75 FS and the 23 OSS under the 23 Fighter Group.
10j. The "For Official Use Only" information provided under this contract shall be safeguarded as specified in Chapter 4 DoD Regulation 5400.7.
11a. This contract provides services to the 23 OSS, 38 RQS, 41 RQS, 71 RQS, 74 FS, 75 FS and 347th OSS in the positions of UDM, MDM, VCM, COS, and SM (FAA Riggers positions are optional). Contract performance is restricted to the location listed in 8a. The highest level of security clearance required for this contract is SECRET. All contractor personnel requiring access to classified material under this contract shall possess a SECRET security clearance. User activity will provide security classification guidance for the performance of this contract. The government will provide storage capability for all classified material required for this contract. All classified material shall be returned to the government upon the termination of this contract.
11e. Contract is for the 23 OSS, 38 RQS, 41 RQS, 71 RQS, 74 FS, 75 FS and 347th OSS personnel support functions at Moody AFB, GA. The home office will submit security clearance for SECRET clearance.
ROGERS COOPER, GS-11, USAF
Information Security Program Administrator 23 Wing/IPI Moody AFB, GA 31699-1616
| xaddlsec: Yes |
| addl_sec: Visitor Group contractors are required to enter into a security agreement with the host base Information Security Program Manager (ISPM). Provide the information requested by the Notification of Government Security Activity Clause, AFFARS 5352.204-9000, and Visitor Group Security Agreement Clause AFFARS 5352-204.9001, to the SSA. |
| xinsp: Yes |
| inspections: When contractors are designated as Visitor Groups on Air Force installations, Industrial Security Reviews for collateral classified information will be conducted by the host base SSA (23 WG/IPI). The Defense Security Service will have inspection oversight at the prime contractor cleared facility. |
| cert_name: |
| cert_title: |
| cert_phone: |
| cert_addr: |
| cert_sign: |
| x17a: Yes |
| x17b: Off |
| x17c: Off |
| x17d: Off |
| x17e: Off |
| x17f: Off |
| other_dist: |
| Reset: |
File details come from the government source that posted it. Updated .