Atch_2_Draft_DD254.pdf

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DRAFT

SAMPLE

PREVIOUS EDITION IS OBSOLETE.

Page of AEM LiveCycle Designer

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

DSN: 312-965-1867

CSO: Shaw AFB, SC 29154

DSN: 313-717-5825

MIEST, NEAL Maj USAF ACC ACC A3/A3CO <neal.miest@us.af.mil>

115 Thompson Street Langley AFB VA 23665

Contract Office Representative (COR): Maj Neal Miest ACC A3/A3CO 757-225-8541 Ref 10a: Contractor will require access to COMSEC information at the on-base locations listed in item 8a. Contractor will not require their own COMSEC account. Access will be controlled by the sponsoring agency. Contractor will protect COMSEC material IAW directives deemed necessary by the installation COMSEC officer. Access to COMSEC material by personnel is restricted to U.S. citizens holding final U.S. Government clearances. Such information is not releasable to personnel holding only reciprocal clearances.

Ref 10g: Special briefings are required for access to NATO IAW AFI16-1404, Air Force Information Security Program. 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 b,d,e,f,h,&i: Access requires a final U.S. Government clearance at the appropriate level.

Ref 10j: For Official Use Only (FOUO) information provided under this contract shall be managed and safeguarded IAW DoD 5400.7-R, Chapter 4, DoD Freedom of Information Act (FOIA) Program.

Ref 10k: The government will provide classified network access to include e-mail and web browser. Contractors will be held accountable for actions they initiate on the network and will conduct business IAW USAF, ACC, and local base instructions and policies. Sponsoring government agency will provide Information Assurance training prior to contractor access to network services.

Ref 11a,f,&j: Contract performance is restricted to the locations identified in item 8a. The highest level of security clearance required for contract performance is Top Secret. Using activities will provide security classification guidance for 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.

DD FORM 254, FOR OFFICIAL USE ONLY (FOUO) ADDENDUM

The following procedures will be used to protect FOUO material:

1. HANDLING:

a. Access to FOUO material shall be limited to those employees needing the material to do their jobs. The FOUO marking is assigned to material created by a DoD User Agency. It is not authorized as a substitute for a security classification marking, but is used on official government information that may be withheld from the public under exemptions 2 through 9 of the Freedom of Information Act (FOIA). FOUO marking is assigned to information at the time of its creation by a DoD User Agency.

b. Use of the above marking means the information must be reviewed by the Government prior to its release to the public to determine if a significant and legitimate government purpose is served by withholding the information or portions of it.

2. IDENTIFICATION MARKINGS:

a) An unclassified document containing FOUO information will be marked “For Official Use Only” at the bottom of the front cover, the first page, each page containing FOUO information, the back page, and the outside of the back cover. Each paragraph containing FOUO information shall be marked as such.

b) Within a classified document, an individual page that contains FOUO and classified information will be marked at the top and bottom with the highest security classification of information appearing on the page. If an individual portion contains FOUO information, but no classified information, the portion will be marked, “FOUO”.

c) If a classified document also contains FOUO material or if the classified material becomes FOUO when declassified, place the following statement on the bottom of the cover or first page under the classification marking: “NOTE: If declassified, review the document to make sure material is not FOUO and not exempt under DoD Regulation 5400.7/AF Supplement before public release”.

d) Mark other records such as computer print outs, photographs, films, tapes, or slides “FOR OFFICIAL USE ONLY” so the receiver or viewer knows the record contains FOUO material.

e) Mark each part of a message that contains FOUO material. Unclassified messages containing FOUO material must show the abbreviation “FOUO” before the test begins.

f) Insure documents that transmit FOUO material call attention to any FOUO attachments.

g) Any FOUO information released to a contractor by a DoD User Agency is required to be marked with the following statement prior to transfer: “This document contains information EXEMPT FROM MANDATORY DISCLOSURE under the FOIA. Exemptions ____ apply.”

h) The originator or other competent authority can only accomplish removal of the FOUO marking. When the FOUO status is terminated, all known holders will be notified to the extent practical.

3. DISSEMINATION: Contractors may disseminate FOUO information to their employees and subcontractors who have a need for the information in connection with the management of the contract.

NOTE: FOUO is not automatically linked to a “classified” contract; many non-classified contracts require access to FOUO information.

4. STORAGE: During normal duty hours, place FOUO material in an out-of-sight location, if your work area is accessible to persons who do not have a valid need for the material. After normal duty hours, store FOUO material to prevent unauthorized access. File with other unclassified records in unlocked buildings or rooms usually provide adequate after-hours protection. For additional protection, store FOUO material in a locked container such as file cabinets, desks or bookcases. Expenditure of funds for security container or closed areas solely for the protection of FOUO material is prohibited.

5. TRANSMISSION: FOUO material shall be transmitted by the same methods as other unclassified material. Discussion of FOUO material on the telephone is authorized if necessary for the performance of the contract. FOUO material may be transmitted over telephone lines in digital form, by telecopies, or by other DSN teletype lines.

6. RELEASE: FOUO material shall not be released outside the contractor’s facility except to representatives of the DoD. Unauthorized disclosure of FOUO information does not constitute a security violation, but the releasing agency should be informed of any unauthorized disclosure. The unauthorized disclosure of FOUO information protected by the Privacy Act may result in criminal actions.

7. DESTRUCTION: When no longer needed, FOUO material shall be disposed of by a method that precludes its disclosure to unauthorized individuals and placed in a regular trashcan.

text:

ACC/IP 757-764-2970

Information Protection Office text:

ACC/A2SD 757-764-3488

ACC SSO Industrial Security text:

ACC/A3I-2 757-764-7336

ACC IJSTO Chief text:

OAF AFOSJ/PJ 318-456-8884

Program Security Officer text:

ACC/SPPCO 757-764-1375

Focal Point Control Officer

Director, ACC Information Protection

129 Andrews Street Langley AFB VA 23665 Address: ACC AMIC/PKB 129 Andrews Street, Suite 110 Langley AFB VA 23665