Attachment_3_Eagle_Vision_DD254.pdf

Please wait...

If this message is not eventually replaced by the proper contents of the document, your PDF viewer may not be able to display this type of document.

You can upgrade to the latest version of Adobe Reader for Windows®, Mac, or Linux® by visiting http://www.adobe.com/go/reader_download.

For more assistance with Adobe Reader visit http://www.adobe.com/go/acrreader.

Windows is either a registered trademark or a trademark of Microsoft Corporation in the United States and/or other countries. Mac is a trademark of Apple Inc., registered in the United States and other countries. Linux is the registered trademark of Linus Torvalds in the U.S. and other countries.

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

(1) Sensitive Compartmented Information (SCI)

(2) Non-SCI CLASSIFICATION (When filled in):

CLASSIFICATION (When filled in):

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 DEFENSE COURIERS

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.)

i. 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

Additional persons assisting with completion of form (signatures and titles) CLASSIFICATION (When filled in):

CLASSIFICATION (When filled in):

9.0.0.2.20120627.2.874785

WHS/ESD/DD

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

1700 Air Force Pentagon Washington, DC Zip 20330

Unit 3224 APO, AE 09094 Flugplatz, Germany

8. Actual performance. a. Location.: Pentagon 1700 Air Force Pentagon Washington, DC Zip 20330

9. General unclassified description of this procurement.: The contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, materials, supervision, and other items necessary to perform support of continuing engineering, packaging, deployment, integration, and program management of Intelligence, Surveillance, and Reconnaissance (ISR) Interoperability, Headquarters, United States Air Force (HQ USAF) AF/A2Q, technical projects worldwide as defined in this Performance Work Statement, except for those items specified as government furnished property and services.

The Contractor shall provide specialized technical and engineering support for HQ USAF/A2 supporting the following:

(1) ISR Innovation projects;

(2) European Command (EUCOM);

(3) African Command (AFRICOM) Management (Ramstein Air Base (AB), Germany).

For detailed description of security guidance, please see added pages below.

13. Security guidance.: Ref 8a: ACTUAL LOCATION

(1) AF/A2Q, 1700 AF Pentagon, Washington, DC 20330

(2) 24th Intelligence Squadron, Eagle Vision One (24IS/DOOF), Bldg 2386 Flugplatz, Ramstein AB, DE 66877

(3) AF/A2Q, Bldg 5681, Joint Base Anacostia-Boling, Washington, DC Ref 8c: COGNIZANT SECURITY OFFICE

(1) 11 WG/IP, 1330 AF Pentagon, Washington, DC 20330

(2) 24th Intelligence Squadron, Unit 3065 Box 10, APO, AE 09094

Ref 10e(1): SCI Access required. Contractor will require access to DCID’s 117 (6/6) and 1119 (6/1). Visitor Group will require access to AFPD 14-3, AFI 14-302 and DoD 5-5105.21, Vol 1-3 and DoD 5220.22-M. See “RELEASE OF SENSITIVE COMPARTMENTED INFORMATION (SCI) INTELLIGENCE INFORMATION TO US VISITOR GROUPS ADDENDUM.”

Ref 10e(2): Access to Intelligence information required for performance. Visitor Group will require access to and comply with AFI 14-302 (DCID117) and 14-303. Release of intelligence information does not create an unfair competitive advantage for the Visitor Group nor a conflict of interest with the Visitor Group’s obligation to protect he information. See “RELEASE OF NON-SENSITIVE COMPARTMENTED INFORMATION (NON-SCI) INTELLIGENCE INFORMATION TO US VISITOR GROUPS ADDENDUM,” Attachment 3.

Ref 10g: Special briefings are required for access to NATO IAW AFI 31-406, Applying NATO Protection Standards. Prior approval of the contracting activity is required for subcontracting. Personnel not assigned to a NATO staff position, but requiring access to NATO classified information, NATO COSMIC, NATO Secret or access to the NATO accredited SIPRNET terminals, must possess the equivalent FINAL or Interim U.S. Security Clearance base upon the appropriate personnel security investigation required. Personnel with access to NATO ATOMAL information must have the appropriate level FINAL U.S. Security Clearance, at the appropriate level. The Visitor Group will maintain strict compliance in regards to NATO information IAW DoD S220.22-M, February 28, 2006 National Industrial Security Program Operating Manual (NISPOM) Section 7, NATO Information Security Requirements.

13. Security guidance.: Ref 10j: The GCA is responsible for providing the Visitor Group with the classification guidance necessary for the protection of the information. For Official Use Only (FOUO) information provided under this contract shall be safeguarded as specified in DoD 5400.7-R, 000 Freedom of Information Act, Chapter 4, Dated Sep 1998. The Visitor Group is responsible of incorporating safeguards in the contract. See “FOR OFFICIAL USE ONLY (FOUO) ADDENDUM” Attachment 4.

Ref 10k: Privacy Act: Work on this project may require that personnel have access to Privacy Act Information. Personnel shall adhere to the Privacy Act, Title 5 of the US Code, Section 552a and applicable agency rules and regulations.

Ref 10k: Contract will require access to sensitive unclassified government automated systems (AIS) at different levels. Visitor Group must comply with AF/A2Q AIS policies and procedures.

Ref 11a: Contract performance is restricted to those locations specified in Item 8a or other approved locations as directed by the COR. Using activity will provide security classification guidance for performance of this contract. If the classified information is provided at the Visitor Group’s facility, ensure compliance of the provisions of DoD 5220.22-R, “Industrial Security Regulation,” December 4, 1985.

Ref 11e: The Visitor Group requires access to classified source date up to and including the classification levels identified in item 1a of this DD 254 in support of this work effort. The Visitor Group will be required to have safeguarding capability at its facility at the level identified in item 1b. Contractor personnel performing on this contract that require access to classified information/material, must have a final U.S. Government clearance at the appropriate level. Contractor personnel will contact AF/A2Q for any and all reference material needed to comply with the security requirements.

Ref 11f: 24th Intelligence Squadron, Eagle Vision One (24IS/DOOF), Bldg 2386 Flugplatz, Ramstein AS, DE 66877. See Attachment 5. For DoD Visitor Groups performing on overseas contracts, provide a copy of the DD Form 254 to the appropriate DSS Office of Industrial Security, International. (See NISPOIM Appendix A or contact DSS).

Item 13: Continued in Attachment 1.

13. Security guidance.: Item 14: DSS has no responsibility for SCI material. AF/A2Q has exclusive security responsibility for all SCI material released or developed under this contract. Continued in Attachments 2-5.

Item 15: The AF/A2Q has exclusive security responsibility for all SCI material released or developed under this contract. DSS is relieved of security inspection responsibility for all such material bu retains responsibility for all non-SCI classified material released or developed under the contract and held within the Visitor Gorup’s facility. SCI will be processed on a SCI accredited system, located at the Pentagon, Washington, DC. Reproduction and destruction of this material is prohibited without written approval from AF/SSO. In all cases, provide DSS a copy of the DD Form 254.

Industrial security reviews fo rlong term visitor groups will be conducted by the SSA while operating on an Air Force Installation. The Visitor Group will comply with the visitor group security agreement provided by the USAF Program/Project Manager at the performance location.

2006 (NISPOM).