RAP__DD254-Attach_2.pdf

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DEPARTMENT OF DEFENSE

CONTRACT SECURITY CLASSIFICATION SPECIFICATION

(Please read Instructions BEFORE completing this application.) (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. LEVEL OF FACILITY SECURITY CLEARANCE (FCL) REQUIRED (See instructions.)

b. LEVEL OF SAFEGUARDING FOR CLASSIFIED INFORMATION/MATERIAL REQUIRED AT CONTRACTOR FACILITY

DUE DATE (YYYYMMDD)

c. SOLICITATION OR OTHER NUMBER

b. SUBCONTRACT NUMBER

a. PRIME CONTRACT NUMBER (See instructions.)

DATE (YYYYMMDD)

c. FINAL (Complete Item 5 in all cases.)

DATE (YYYYMMDD)

REVISION NO.

b. REVISED (Supersedes all previous specifications.)

DATE (YYYYMMDD)

a. ORIGINAL (Complete date in all cases.)

(Preceding Contract Number) is transferred to this follow-on contract.

Classified material received or generated under YES. If Yes, complete the following:

NO

4. IS THIS A FOLLOW-ON CONTRACT?

, retention of the classified material is authorized for the period of:

In response to the contractor's request dated YES. If Yes, complete the following:

NO

5. IS THIS A FINAL DD FORM 254?

c. COGNIZANT SECURITY OFFICE (CSO) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

a. NAME, ADDRESS, AND ZIP CODE

6. CONTRACTOR (Include Commercial and Government Entity (CAGE) Code.)

c. COGNIZANT SECURITY OFFICE(S) (CSOs) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

a. NAME, ADDRESS, AND ZIP CODE

7. SUBCONTRACTOR(S) (Click button to add more subcontractors.)

c. COGNIZANT SECURITY OFFICE(S) (CSOs) (Name, Address, ZIP Code, Telephone) (If applicable, see instructions.)

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

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

8. ACTUAL PERFORMANCE (Click button to add more locations.)

9. GENERAL UNCLASSIFIED DESCRIPTION OF THIS PROCUREMENT (Click here if more space is needed.)

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

d. FORMERLY RESTRICTED DATA

c. CRITICAL NUCLEAR WEAPON DESIGN INFORMATION (CNWDI) (If CNWDI applies, RESTRICTED DATA must also be marked.)

b. RESTRICTED DATA

e. NATIONAL INTELLIGENCE INFORMATION:

f. SPECIAL ACCESS PROGRAM (SAP) INFORMATION

k. OTHER (Specify) (See instructions.)

j. CONTROLLED UNCLASSIFIED INFORMATION (CUI) (See instructions.)

i. ALTERNATIVE COMPENSATORY CONTROL MEASURES (ACCM) INFORMATION

h. FOREIGN GOVERMENT INFORMATION

g. NORTH ATLANTIC TREATY ORGANIZATION (NATO) INFORMATION

DD FORM 254, NOV 2017

PREVIOUS EDITION IS OBSOLETE.

Adobe LiveCycle Designer ES4 CLASSIFICATION (When filled in):

CLASSIFICATION (When filled in):

(1) Sensitive Compartmented Information (SCI)

(2) Non-SCI

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.)

h. REQUIRE A COMSEC ACCOUNT

k. BE AUTHORIZED TO USE THE DEFENSE COURIER SERVICE (DCS)

j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS

i. HAVE A TEMPEST REQUIREMENT

b. RECEIVE AND STORE CLASSIFIED DOCUMENTS ONLY

c. RECEIVE, STORE, AND GENERATE CLASSIFIED INFORMATION OR MATERIAL

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

e. PERFORM SERVICES ONLY

d. FABRICATE, MODIFY, OR STORE CLASSIFIED HARDWARE

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)

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)

PUBLIC RELEASE AUTHORITY:

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. Click button to add additional pages as needed to provide complete guidance.)

14. ADDITIONAL SECURITY REQUIREMENTS. Requirements, in addition to NISPOM requirements for classified information, are established for this contract.

Yes No (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. Use Item 13 or click button if additional space is needed.)

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. Click button or use Item 13 if additional space is needed.)

Yes No

e. POC TELEPHONE (Include Area Code.)

f. EMAIL ADDRESS (See instructions.)

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

d. AAC OF THE CONTRACTING OFFICE (See instructions.)

e. CAGE CODE OF THE PRIME CONTRACTOR (See instructions.)

d. POC NAME (See instructions.)

c. ADDRESS (Include ZIP Code.)

a. GCA NAME

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

18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL

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.

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

f. TELEPHONE (Include Area Code.)

g. EMAIL ADDRESS (See instructions.)

h. SIGNATURE

h. DATE

b. TITLE

c. ADDRESS (Include ZIP Code.)

f. OTHERS AS NECESSARY (If more room is needed, continue in Item 13 or on additional page if necessary.)

e. ADMINISTRATIVE CONTRACTING OFFICER

d. U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECURITY ADMINISTRATION

c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR

b. SUBCONTRACTOR

a. CONTRACTOR

DD FORM 254 (BACK), NOV 2017

CLASSIFICATION (When filled in):

CLASSIFICATION (When filled in):

c. COGNIZANT SECURITY OFFICE(S) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

a. NAME, ADDRESS, AND ZIP CODE

7. SUBCONTRACTOR(S) (Continued)

c. COGNIZANT SECURITY OFFICE(S) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

a. NAME, ADDRESS, AND ZIP CODE

c. COGNIZANT SECURITY OFFICE(S) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

a. NAME, ADDRESS, AND ZIP CODE

c. COGNIZANT SECURITY OFFICE(S) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

a. NAME, ADDRESS, AND ZIP CODE

c. COGNIZANT SECURITY OFFICE(S) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

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

c. COGNIZANT SECURITY OFFICE(S) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

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

c. COGNIZANT SECURITY OFFICE(S) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

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

c. COGNIZANT SECURITY OFFICE(S) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

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

8. ACTUAL PERFORMANCE (Continued)

9. GENERAL UNCLASSIFIED IDENTIFICATION OF THIS PROCUREMENT (Continued)

DD FORM 254, NOV 2017

Pages of Continuation Page CLASSIFICATION (When filled in):

CLASSIFICATION (When filled in):

15. INSPECTIONS (Continued)

14. ADDITIONAL SECURITY REQUIREMENTS (Continued)

13. SECURITY GUIDANCE (Continued) Pages of Continuation Page

DD FORM 254, NOV 2017

CLASSIFICATION (When filled in):

CLASSIFICATION (When filled in):

Additional persons assisting with completion of form (signatures and titles) 9.0.0.2.20120627.2.874785

WHS/ESD/DD

DD 254, Nov 2017, "DoD Contract Security Classification Specification" Orig No No No No No

18 AGRS 2865 Flightline Ave Eielson AFB AK 99702; 19 FS 800 Hangar Avenue JBPHH HI 96818; 36 FS Unit 2052 Osan AB, AA 96278; 25 FS APO AP Osan AB AP 96266; 80 FS Bldg 915 Kunsan AB 96264; 35 FS Bldg 1305 Kunsan AB AA 96264;

67 FS Kadena AB APO AP 96368; 44 FS Kadena AB APO AP 96368; 13 FS Unit 5011 Misawa AB APO AP 96319; 14 FS Misawa AB APO AP 96319; 525 FS 11551 Slammer Ave JBER AK 99506 ; 90 FS 16716 Talley Rd JBER AK 99506

See Blk 13 Continuation

13. Security guidance.: 4. Visitor Group contractors are required to enter into a security agreement with the Installation Commander to ensure contractor's security procedures are properly integrated with those of the installation IAW Visitor Group Security Agreements Clause, AFFARS 5352.204.9001. In addition, the contractor shall provide the information requested per the Notification of Government Security Activity Clause,AFFARS 5352.204.9000 to 15th W/Information Protection Office or Servicing Security Activity (SSA)."

Contract Period of Performance Base Period: 23 Dec 18 - 22 Dec 19 // Option Year 1: 23 Dec 19 - 22 Dec 20 // Option Year 2: 23 Dec 20 - 22 Dec 21// Option Year 3 : 23 Dec 21 - 22 Dec 22 // Option Year 4: 23 Dec 22 - 22 Dec 23 // Option Year 5: 23 Dec 18 23 - 22 Dec 24 Ref blk 10f: The National Industrial Security Program Operating Manual (NISPOM) is the authoritative manual concerning baseline standards for the protection of classified information in connection with classified contract and activities under the National Industrial Security Program.

As stated in the SAF/AAZ implementing memorandum, dated 4 Apr 2016, the DoD Manual 5205.07 Volumes 1-4 are the authoritative SAP Security Policy documents: - DoD Manual 5205.07 Vol 1: DoD Special Access Program (SAP) Security Manual: General Procedures, dated 18 Jun 2015

- DoD Manual 5205.07 Vol 2: Special Access Program (SAP) Security Manual: Personnel Security, dated 24 Nov 2015

- DoD Manual 5205.07 Vol 3 – AFMAN 16-703 V3: Special Access Program (SAP) Security Manual: Physical Security, dated 31 Dec 2015

- DoD Manual 5205.07 Volume 4: Special Access Program (SAP) Security Manual, dated 10 Oct 2013, and Air Force Security Marking Guide for Special Access Programs, Rev 1, dated 16 Oct 2013.

- Applicable Program Security Directives (PSDs), Security classification Guides (SCG), and local Standard Operating Procedures (SOPs)

- Risk Management Framework (RMF) and the Joint Special Access Program Implementation Guide (JSIG) Rev 4, dated 11 Apr 2016.

All Special Access work must be conducted within an AFOSI Office of Special Projects (PJ) approved location. Modifications to an existing SAP facility must comply with DoD Manual 5205.07 Vol 3 – AFMAN 16-703 V3; ICD 705; AFI 16-701; additional information can be found on the AF Portal Specific SAP access requirements, personnel access controls, SAP-Mandated security education, training, reporting, records retention, etc. associated with contractor SAP performance under this contract will be managed at the government performance location. The contractor is responsible for maintenance of personnel security clearance necessary for SAP access eligibility IAW DoD Manual 5205.07 Vol 2 and DoD SAPCO Memorandum, Temporary Periodicity and Clearance Submission Implementation Guidance for Special Access Programs, dated 10 Feb 2017. The contractor will provide DSS (JPAS) reporting of security incidents committed by contractor personnel at the performance location as determined by the government program office and the Program Security Officer.

Ref Blk 12: "Public release of SAP related data is NOT authorized without prior coordination through the Air Force Office of Special Investigation (AFOSI), Office of Special Projects (PJ) Security Director and subsequent approval of the OCA and AF Special Access Program Central Office (SAPCO). Submit all proposed public disclosures related to SAP data to the Government Program Manager and the AFOSI, PJ, Program Security Officer (PSO).

15. Inspection. If yes is checked, explain and identify specific areas or elements carved out and the activity responsible for inspections.: Item 15: AFOSI/PJ OL-B, or designated representative, will conduct security reviews of all SAP facilities, material, personnel, and operations related to this contract. DSS and local SF oversight over SAP portions of this contract is carved-out.

The PSO is Mr. Jeremy A. Kane; Phone # 808-449-3885 The GPM isTBD The Command GSSO is Mr. Lee A. Ray; Phone # 808-449-3801

2. Requests for SAP accesses will be made through the local GSSO or Program Manager (PM).

3. Continued contractor access to SAPs requires initial and recurring (annual) SAP security education training. The GSSO/PM will conduct the training at the location where the contractor’s program access records are kept. The contractors’ program access records will be kept in the servicing program security office.

4. Inquiries regarding SAP classification guidance will be directed to the local GSSO or PM.

5. All SAP material furnished or generated in support of this contract remains the property of the government and will be returned to the servicing program office upon completion of this contract.

6. All procedures, equipment, and devices used for data processing or data transfer of SAP information must be accredited (approved) by the DAO before any processing is permitted. Any subsequent configuration or procedural changes must be approved by the PSO prior to use.

560 CENTRAL AVE

JBPH-H, HI 96

560 CENTRAL AVE

JBPH-H, HI 96

HQ PACAF/A8XZ

All Wing Advanced Program Offices listed in 8a

HQ PACAF/IPO, 808-449-2802

Title.: Jeremy A. Kane, SA, USAF

AFOSI PJ OL-H (PACAF PSO)