Dive_Locker_RE-COMPETE_DD_254.pdf

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Attached to
Dive Locker Maintenance Federal contract opportunity
Solicitation number
FA4890-13-R-0103
Issued by
Department of the Air Force Air Combat Command

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DRAFT DD 254 Security

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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: NONE
prime_no: TBD
xprime: Off
sub_no:
xsub: Off
xsolic: Off
solic_no:
due_date:
xspec3: Off
orig_date:
rev_no:
rev_date:
final_date:
xfollowon: Off
prec_no: TBD
xfinal: Off
req_dated:
period:
ctr_name: TBD
ctr_cage:
ctr_ofc:
sub_name:
sub_cage:
sub_ofc:
perf_loc:
perf_cage:
perf_ofc:
gen_id:
x10a: No
x10b: No
x10c: No
x10d: No
x10e1: No
x10e2: No
x10f: No
x10g: Yes
x10h: No
x10i: No
x10j: Yes
x10k: Yes
other10k: Classified and Unclassified Network Access
x11a: Yes
x11b: Yes
x11c: Yes
x11d: Yes
x11e: Yes
x11f: Yes
x11g: Yes
x11h: Yes
x11i: Yes
x11j: Yes
x11k: Yes
x11l: Off
other11l:
xrelease: No
release_thru: HQ ACC/PA

115 Thompson Street Langley AFB, VA 23665 NOTE: Public Release of classified information is not authorized guidance: Contract Period of Performance:

Phase in: 1 March 2014 - 31 March 2014 Base Year: 1 April 2014 - 31 March 2015 Option Year 1: 1 April 2015 - 31 March 2016 Option Year 2: 1 April 2016 - 31 March 2017 Option Year 3: 1 April 2017 - 31 March 2018 Option Year 4: 1 April 2018 - 31 March 2019

xaddlsec: Yes
addl_sec: Refer to Item 13
xinsp: Off
inspections: When contractors are designated as Visitor Groups on Air Force installations, Industrial Security Reviews for collateral classified information will be conducted by the serving IPO. Defense Security Service retains cognizance over the cleared contractor facility.
cert_name:
cert_title:
cert_phone:
cert_addr:
cert_sign:
x17a: Yes
x17b: Off
x17c: Yes
x17d: Yes
x17e: Off
x17f: Yes
other_dist:
Reset:

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