Attachment_8_DD_Form_254.pdf
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- Attached to
- USAFA Civil Engineering Base Maintenance Support
- Solicitation number
- FA7000-17-R-0012
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Attachment 8_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. 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 X
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: |
| xprime: Off |
| sub_no: |
| xsub: Off |
| xsolic: Off |
| solic_no: |
| due_date: |
| xspec3: Orig |
| orig_date: |
| rev_no: |
| rev_date: |
| final_date: |
| xfollowon: No |
| prec_no: |
| xfinal: No |
| req_dated: |
| period: |
| ctr_name: |
| ctr_cage: |
| ctr_ofc: |
| sub_name: |
| sub_cage: |
| sub_ofc: |
| perf_loc: 10 CES |
8120 EDGERTON DR
USAF ACADEMY, CO 80840
| perf_cage: |
| perf_ofc: HQ USAFA/IPD |
2360 VANDENBERG DR SUITE 1C4E
USAFA ACADEMY, CO 80840
| gen_id: Service provider will be responsible for executing Civil Engineering functions that require classified access. Examples include: installation-wide emergency management program, conducting classified GSORTS, ART and other readiness data and reports via DRRS, Security Alarm Systems maintenance and repair, CE Anti-Terrorism Engineering program management, IT systems management, GEOBase program management, and CE Program Management. Some contractors will require access to SIPRNET and maintain active SIPR accounts in the performance of contractual duties and IAW the performance work statement (PWS). |
| x10a: Yes |
| x10b: No |
| x10c: No |
| x10d: No |
| x10e1: No |
| x10e2: No |
| x10f: No |
| x10g: Yes |
| x10h: No |
| x10i: No |
| x10j: Yes |
| x10k: Off |
| other10k: |
| x11a: Yes |
| x11b: No |
| x11c: No |
| x11d: No |
| x11e: No |
| x11f: No |
| x11g: No |
| x11h: No |
| x11i: Yes |
| x11j: Yes |
| x11k: No |
| x11l: Off |
| other11l: |
| xrelease: No |
| release_thru: The contracting officer will forward requests to the installation Public Affairs (PS) Office. The PA office will process the requests in accordance with AFI 35-104, Media Operations; AFI 35-102, Security and Policy Review Process; and AFI 35-107, Public Web Communications. |
| guidance: Ref 10a: The Contractor shall meet and maintain all security investigation requirements. The contractor may require access to classified COMSEC material. Access will be at the government installation and will be granted by the using activity. The contractor is governed by DoD 5200.22M, Chapter 9, Section 4, to the NISPOM in the control and protection of COMSEC |
information/material. Access to COMSEC material by personnel is restricted to US citizens holding final US Government clearances. Such information is not releaseable to personnel holding only reciprocal clearances. Access to SIPRNet and/or classified information is required to fulfill the duties of this position. Contractor will maintain the SIPRNet and may enter classified facilities on USAFA.
Reg 10g: Contractor has access to a classified information system (i.e.SIPRNet). SIPRNet access provide contractors potential access to NATO classified or restricted information. Contractors are not to actively seek NATO information from websites or others individuals who may have access to NATO classified or restricted information. If contractor(s) receive a document marked COSMIC TOP SECRET (CTS), NATO SECRET (NS), NATO CONFIDENTIAL (NC), or NATO RESTRICTED, safeguard the material, do not retransmit it and report it immediately to the Security Manager, Wing Information Protection Office, or NATO Control Officer.
Ref 10j: For Official Use Only (FOUO) information provided under this contract shall be safeguarded as specified in DoD 5200.01_V4, Controlled Unclassified Information (CUI); DoD 5400.7-R, AFMAN 33-302, Freedom of Information Act Program; and AFI 16-1404, Air Force Information Security Program. Contractor will adhere to guidance of the Health Insurance Portability and Accountability Act (HIPPA).
(See page 3 for a continuation of security requirements)
| xaddlsec: No |
| addl_sec: |
| xinsp: No |
| inspections: |
| cert_name: |
| cert_title: CONTRACTING OFFICER |
| cert_phone: 719-333-XXXX |
| cert_addr: 8110 INDUSTRIAL DR, STE 200 |
USAF ACADEMY, CO 80840-2315
| x17a: Off |
| x17b: Off |
| x17c: Off |
| x17d: Off |
| x17e: Off |
| x17f: Off |
| other_dist: |
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