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B-2 Radar Antenna/Circuit Card Repair
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FA8119-15-R-0028
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254 TIPS AND INSTRUCTIONS

1/21/2015

Below is an example for a 254 for a contractor not working on Tinker.

Items in black are standard. They DO NOT need to be changed.

Items in red are the items on a standard 254 for SAP work; you must input the correct information applicable to your contract.

Items in blue are specialty items not always needed by every contract, if not needed for your contract change the yes/no blocks in 10 and 11 to “no” and remove the corresponding statements in blocks 13 & 14.

The FOUO attachment is standard for all contracts, just print out with 254 The SAP 13 attachment is required for all 254’s. Complete and submit with 254. (Tip sheet on how to complete is located on the last page.

New guidance in the SAP 254 handbook states that if you have a contract that requires both a “Prime” and “Sub-contractor” that both require SAP work; you must complete the “Prime” contract 254 first. It must be approved & signed by all parties prior to submitting the “Sub-Contractor” 254.

For Sub-contractors to Prime contractors, their information goes in block 7. Remember you cannot give anything extra to a sub-contractor that the prime contract does not have.

Please use Chapter 3 of the 254 handbook to make sure all your references are correct for an additional times you require, or different versions of the 254’s (i.e.- revisions vs original contracts).

Change all items in different colors to black after completed.

Remember to have the program manager sign the bottom of block 13

If you scan into .pdf after signature, send the word version also

The SPO has requested that you use no SMALLER THAN 10 PT font, especially in block 13…. Please use a continuation sheet, but leave enough room in block 13 for the Program managers signature.

ABOVE ALL – IF THE TEXT IS NOT RED OR BLUE… DON’T CHANGE THE WORDING OR PLACEMENT!!!!!

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

SECRET

b. LEVEL OF SAFEGUARDING REQUIRED

SECRET

2. THIS SPECIFICATION IS FOR: (X and complete as applicable)
3. THIS SPECIFICATION IS: (X and complete as applicable)

a. PRIME CONTRACT NUMBER

a. ORIGINAL (Complete date in all cases)
Date (YYMMDD)

|X|

150320

b. SUBCONTRACT NUMBER

b. REVISED (Supersedes all previous specifications)
Revision No.
Date (YYMMDD)
c. SOLICITATION OR OTHER NUMBER
c. Due Date (YYMMDD)
c. FINAL (Complete item 5 in all cases)
Date (YYMMDD)
|X|
FD2030-15-00003
20151230
|_|
4. IS THIS A FOLLOW-ON CONTRACT?
|_|
YES
|X|
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
|X|
NO. If Yes, complete the following:

In response to the contractor’s request dated retention of the identified 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)

Raytheon Company 2000 East El Segundo Blvd El Segundo, CA 90245-0902 Level of Classified performance at this Location Collateral Secret

4U884
Defense Security Services (IOFWL)

3452 E. Foothill Blvd, Suite 600 Pasadena, CA 91107

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)

Raytheon Company 200 East El Segundo Blvd El Segundo, CA 90245-0902 Level of Classified performance at this Location Collateral Secret

4U884
Defense Security Services (IOFWL)

3452 E. Foothill Blvd, Suite 600 Pasadena, CA 91107

9. GENERAL IDENTIFICATION OF THIS PROCUREMENT

This repair contract is for the B-2 Radar Modernization Program for NSNs 5895015623494FW; 5996015163950FW; 6130015773453FW; 5985015777664NR; 5998015810562FW; 5998015810537FW; 5998015810566FW; 5998015810570FW; 6610015812662FW; 5998015810481FW; 5998015810512FW; 5998015810533FW; 5998015810567FW; 5998015810572FW; . This contract expires upon last delivery which is projected to be on 20 Jan 2022. This contract supports 4 SAP briefs.

10. THIS CONTRACT WILL REQUIRE ACCESS TO:
YES
NO
11. IN PERFORMING THIS CONTRACT, THE CONTRACTOR WILL:
YES
NO
a. COMMUNICATIONS SECURITY (COMSEC) INFORMATION
|_|
|X|
a. HAVE ACCESS TO CLASSIFIED INFORMATION ONLY AT ANOTHER CONTRACTOR’S FACILITY OR A GOVERNMENT ACTIVITY
|_|
|X|
b. RESTRICTED DATA
|_|
|_|
b. RECEIVE CLASSIFIED DOCUMENTS ONLY
|_|
|_|
c. CRITICAL NUCLEAR WEAPON DESIGN INFORMATION
|_|
|_|
c. RECEIVE AND GENERATE CLASSIFIED MATERIAL
|X|
|_|
d. FORMERLY RESTRICTED DATA
|_|
|_|
d. FABRICATE, MODIFY, OR STORE CLASSIFIED HARDWARE
|X|
|_|

e. INTELLIGENCE INFORMATION:

e. PERFORM SERVICES ONLY
|_|
|_|
(1) Sensitive Compartmented Information (SCI)
|_|
|_|
f. HAVE ACCESS TO CLASSIFIED INFORMATION OUTSIDE THE U.S., PUERTO RICO, U.S. POSSESSIONS AND TRUST TERRITORIES
|_|
|_|
(2) Non-SCI
|_|
|X|
g. BE AUTHORIZED TO USE THE SERVICES OF DEFENSE TECHNICAL INFORMATION CENTER (DTIC) OR OTHER SECONDARY DISTRIBUTION CENTER
|_|
|_|
f. SPECIAL ACCESS INFORMATION
|X|
|_|
h. REQUIRE A COMSEC ACCOUNT
|_|
|X|
g. NATO INFORMATION
|_|
|_|
i. HAVE TEMPEST REQUIREMENTS
|_|
|_|
h. FOREIGN GOVERNMENT INFORMATION
|_|
|X|
j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS
|X|
|_|
i. LIMITED DISSEMINATION INFORMATION
|_|
|_|
k. BE AUTHORIZED TO USE THE DEFENSE COURIER SERVICE
|_|
|_|
j. FOR OFFICIAL USE ONLY INFORMATION
|X|
|_|
l. OTHER (Specify)
|_|
|_|

k. OTHER (Specify)

X
Block 11l: Notification of Security Activity is required, See addendum.
DD FORM 254, DEC 99Previous editions are obsolete805/340
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 Government authority. Proposed public release shall be submitted for approval prior to release.
|_|
Direct
|_|
Through (Specify):

Ref Blk 10f: Public release of SAP related data is NOT authorized without prior coordination through the AFOSI, PJ Security Director and subsequent approval of the OCA and Air Fore Special Access Program Central Office (AFSAPCO). Submit all proposed public disclosures related to SAP data to the GPM and the AFOSI PJ PSO.

AFLCMC/WWZP, 2690 Loop Road West, Wright-Patterson AFB, 45433-7148, for non-SAR related material. Transmission of public release request via e-mail is not authorized.

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 referred herein. Add additional pages as needed to provide complete guidance.)

a. Ref Blk 10f: DOD 5220.22-M, National Industrial Security Program Operating Manual (NISPOM) (latest version) 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/AA Implementing Memorandum dated 24 July 2008, the Joint Air Force Army Navy (JAFAN) Manual 6/0 – Revision 1, is the authoritative SAP security manual. JAFAN 6/9, “Physical Security Standards for Special Access Program Facilities” with Change 1, 20 December 2005, will serve as the baseline for physical security of SAP facilities. The SAF/AAZ Memorandum, “Air Force Special Access Programs Nomination Process (SAPNP), dated 30 September 2013, and USD(I) Memorandum with attachment, Special Access Program Nomination Process, dated 20 May 2013, (or latest version) will be utilized for all Program Access Requests (PARs). The DoD Manual 5205.07, Volume 4, dated 10 October 2013, “Special Access Program (SAP) Security Manual: Marking” (latest version). SAF/AAZ Implementation Memorandum, dated 7 November 2013, and “United States Air Force Security Marking Guide for Special Access Programs”, dated 1 July 2011, Revision 1, dated 16 October 2013 (latest version), will serve as the marking guide(s) for all SAP material generated under this contract, as well as any subsequent revisions to the above publications.

b. Compliance with SAP requirements is also covered under DOD Directive (DoDD) 5205.07, Special Access Program (SAP) Policy (latest version). DOD Manual (DoDM) 5200-01, Volumes 1-4, 24 February 2012 (or latest version). AFI 16-701, Management, Administration, and Oversight of Special Access Programs (latest version).

SEE CONTINUATION SHEET

Program Manager must sign here at bottom of block 13 GEOFFREY T. OLSEN, SJ-S, PSO

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.)
|X|
YES
|_|
NO

Ref Blk 10f: OPSEC Plan will be provided under separate cover.

Ref Blk 11j: OPSEC requirements apply. See Performance Work Specification (PWS) for requirements.

SEE CONTINUATION SHEET

15. 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.)
|X|
YES
|_|
NO

In accordance with DOD 5220.22-M, National Industrial Security Program Operating Manual (NISPOM), Paragraph 1-104(a), the Defense Security Service (DSS) has been relieved of inspection oversight responsibilities for SAP programs associated with this contract. The Air Force is identified as the Cognizant Security Authority (CSA) with the AFOSI PJ fulfilling the execution role for all contractor inspections under the purview of SAF/AAZ.

SEE CONTINUATION SHEET (if 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.

a. TYPED NAME OF CERTIFYING OFFICIAL
b. TITLE
c. TELEPHONE (Include Area Code)
Toni McKinney
Flight Chief
(405) 736-3388
d. ADDRESS (Include Zip Code)
17. REQUIRED DISTRIBUTION

424 SCMS/GUME

3001 Staff Drive Tinker AFB, OK 73145

|_|
a. CONTRACTOR
|X|
b. SUBCONTRACTOR
|X|
c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR
e. SIGNATURE
|_|
d. U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECURITY ADMINISTRATION
|X|
e. ADMINSTRATIVE CONTRACTING OFFICER
|_|
f. OTHERS AS NECESSARY:

DD Form 254 Continuation Sheet Contract Number: ________________________________________

Block #13: (continued)

c. Department of Defense Joint Special Access Program Implementation guide (JSIG) Implementation:

In accordance with DoD SAPCO Memorandum, “Transition to the Risk Management Framework”, dated 18 December 2013, certification and authorization of any information system after 1 January 2014 must be accomplished utilizing the Risk Managed Framework (RMF) and the Joint Special Access Program Implementation Guide (JSIG), dated 9 October 2013. Currently accredited systems will continue to operate in accordance with JAFAN 6/3, “Protecting Special Access Program Information Within Information Systems”, dated 15 October 2004, and the JAFAN 6/3 Implementation Guide, Version 1, dated September 2006. Upon Approval to Operate (ATO) expiration, all existing information systems certified under JAFAN 6/3 will be re-accredited utilizing the JSIG. All systems will be re-accredited under the JSIG no later than 18 December 2016.

d. Ref Blk 11a: Using activity will provide security classification guidance for performance on this contract. On base performance in support of AFLCMC/WWZP will occur in Bldg 1083 on Tinker AFB, OK. If any classified information is generated in the performance of this contract at the identified location, the contractor shall apply derivative classification and markings consistent with the source material.

e. Ref Blk 10f/11a: SAP access requirements, personal access controls, SAP mandated Security Education Training, reporting, records retention, etc., associated with contractor SAP performance under this contract is the responsibility of the performance location. The contractor is responsible for maintenance of personnel security clearances necessary for SAP access eligibility IAW SAPNP and JAFAN 6/0.

f. Ref Blk 8a/11a: SAP performance will occur at AFLCMC/WWZP, Bldg 1083 7180 Reserve Rd. Tinker AFB, OK. 73145 and restricted to the government activity. SAP performance is not authorized at the contractor facility. Level of Classified performance at this Location: Collateral Secret

g. Ref Blk 13: Government Special Access Program Security Officer (GSSO): Kenneth J. Cybela, AFLCMC/WWZBAB, (405) 739-7855

h. Ref Blk 13: Program Security Officer (PSO): Geoffrey T. Olsen, AFOSI PJ Det2, B-2 PSO, (937) 255-7978

i. Ref Blk 10j: See DoDM 5200.01, Volume 4, DoD Information Security Program: Controlled Unclassified Information (CUI), Enclosures 3 & 4 and DoD 5400.7‑R/Air Force Manual 33‑302, DoD Freedom of Information Act (FOIA) Program, for requirements.

j. Ref Blk 11j: OPSEC requirements apply. See Performance of Work

k. Ref Blk 11l: Provide the information requested by the Notification of Government Security Activity and Visitor Group Security Agreements clause, Air Force Federal Acquisition Regulation Supplement (AFFARS) 5352.204-9000, to N/A

l. Ref Blk 17e: Administrative Contracting Officer: Rose Akeroyd, DLA DSCR/AOCB, Bldg 3001, Tinker AFB, OK 74145, (405) 739-9082

m. Ref Blk 13: Program Manager: Larry Steine, 424 SCMS/GUME Bld 3001, Tinker AFB, OK 73145, (405) 736-3388

n. Ref Blk 13: Security Manager / Facility Security Officer (FSO): Company FSO: B.J. Raji, 7400 Paul Horning Way, Green Bay, Wi. 23606, (757) 874-1067

o. Ref Blk 13: IT Level I duties require a favorably completed Single Scope Background Investigation. (SSBI) and a periodic reinvestigation every 5 years

p. Ref Blk 10e(2): Access to SIPRNET is required.

q. Ref Blk 10e(2): Contractor will require access to intelligence information and must comply with AFI 14-303/AFMC Supplement 1. The Program Manager has determined that disclosure does not create an unfair competitive advantage for the contractor or a conflict of interest with the contractor's obligation to protect the information and will submit the AFMC Form 210 to the servicing Senior Intelligence Officer (SIO) (AFLCMC-Tinker/INB) for approval prior to granting access.

r. Ref Blk 10a/11h: COMSEC is required. COMSEC/Cryptologic, Safeguarding requirements apply. See AFI 33-201 Volume 2, Communications Security (COMSEC) User Requirements.

s. Supersession of any of the above documents will not require an immediate revision to this DD Form 254. The updated document will be deemed to be on contract as of the date of supersession. Additional costs incurred due to updated guidance will be brought to the attention of the CGO immediately”.

Block #14: (continued)

Ref Blk 10f: All Special Access Programs (SAP) will comply with Air Force Special Access Program Nomination Process (AF SAPNP) memo dated 30 Sep 13, nominations must conform to revised AF SAPCO candidate process. Guidance for gaining access will be provided by the Government Special Access Program Security Officer (GSSO) within the government program office, or the AFOSI Office of Special Projects (PJ) Program Security Officer (PSO), Randolph Howson, AFOSI PJ Det 2, 937-255-7015.

Block #15: (continued)

Ref Blks 10a/11h: 624509T, Tinker AFB, OK has oversight for COMSEC.

ADDENDUM TO DD FORM 254 (Block 10j)

FOR OFFICIAL USE ONLY (FOUO)

(Reference DoD Regulation 5400.7/Air Force Supplement, 2 Jan 2008.)

1. GENERAL: FOUO is information that has not been given a security classification pursuant to the criteria of an Executive Order, but which may be withheld from the public because disclosure would cause a foreseeable harm to an interest protected by one or more of the Freedom of Information Act (FOIA) exemptions 2 through 9. Additional information on FOUO may be obtained by contacting the User Agency. FOUO is assigned to information at the time it is created in a DoD Agency or derivatively as instructed in a Security Classification Guide.

2. MARKING:

a. FOUO information received (released by a DoD component) should contain the following marking, when received:

UNCLASSIFED//FOR OFFICIAL USE ONLY

THIS DOCUMENT CONTAINS INFORMATION EXEMPT FROM MANDATORY DISCLOSURE UNDER FOIA.

b. Mark an unclassified document containing FOUO information “FOR OFFICIAL USE ONLY” at the bottom of each page containing FOUO information and on the bottom of the front or front cover (if any) and on the back of the last page and on the back cover (if any). Each paragraph containing FOUO information shall be marked as such.

c. Within a classified document, an individual page that contains both FOUO and classified information shall be marked at the top and bottom with the highest security classification of information appearing on the page. Individual paragraphs shall be marked at the appropriate classification level, as well as unclassified or FOUO, as appropriate. An individual page that contains FOUO information but no classified information shall be marked “FOR OFFICIAL USE ONLY” at the top and bottom of the page, as well as each paragraph that contains FOUO information. NOTE: For “production efficiency” the entire document may be marked top and bottom with the highest level of classification contained within it, as long as every paragraph is marked to reflect the specific classification of the information it contains.

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

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

3. DISSEMINATION: FOUO may be disseminated between officials of DoD Components, DoD contractors, consultants and grantees to conduct official business for DoD. Recipients shall be made aware of the status of such information and transmission shall be by means that preclude unauthorized public disclosure.

4. TRANSMISSION: FOUO information shall be transmitted in a manner that prevents disclosure of the contents. When commingled with classified information, it may be sent via first-class mail or parcel post. Bulky shipments, i.e. testing materials that otherwise qualify under postal regulations, may be sent by fourth-class mail. FOUO information may also be sent over facsimile equipment; however, when deciding whether to use this means, balance the sensitivity of the records against the risk of disclosure. Consider the location of sending and receiving machines and ensure authorized personnel are available to receive the FOUO information as soon as it is transmitted. Transmittal documents shall call attention to the presence of FOUO attachments. FOUO information may also be sent via e-mail, if it is sent via a system that will prevent unintentional or unauthorized disclosure.

5. STORAGE: To safeguard FOR OFFICIAL USE ONLY records during normal duty hours, place them in an out-of-sight location if your work area is accessible to persons who do not have a valid need for the information. After normal duty hours, store FOUO records to prevent unauthorized access. File them with other unclassified records in unlocked files or desks when normal internal building security is provided. When there is no internal building security, locked buildings or rooms normally provide adequate after-hours protection. If such protection is not considered adequate, FOUO material shall be stored in locked containers such as file cabinets, desks, or bookcases. Expenditure of funds for security containers or closed areas solely for the protection of FOUO date is prohibited.

6. DESTRUCTION: When no longer needed, FOUO information shall be disposed of by any method that will preclude its disclosure to unauthorized individuals.

(CLASSIFY AS APPROPRIATE WHEN FILLED IN)

SUBCONTRACTOR/SUPPLIER DATA SHEET (U)

1.( )Prime Contractor:( )Subcontractor/supplier:
( )Address:
( )City, State, Zip:
2.(U)Initial Meeting:
(U)Date:( )Attended By:
( )Location:
3.( )Type of Procurement:( )Sole Source?|_|Yes|_|No
4.( )Product:( )Classification:
5.(U)Subcontractor/Supplier Data:
DoD Facility Clearance Level:Date Granted:
DoD Storage Level:CAGE Code:
Other Contracts with Prime:
Approx Percentage of Firm’s Business:Unclassified Project Number/Name:
6.( )Cover Story
7.(U)Subcontractor/Supplier Points of Contact:( )Key Sterile Phone Numbers:
Program Management:
Technical:
Contracts:
Security:
8.( )Sterile Address:
( )Name:
( )Address:City:State:Zip:
9.( )Secure Communication:Voice:Fax:
10.( )Proposed Work Area/Location:
11.( )Proposed Personnel Program Accesses:
Level I:Level II:Level III:Level IV:
12.( )Proposed Program Classified Storage:|_|SECRET|_|Top SECRET|_|Other
Storage NOT Approved:Storage Containers:
Level Approved:Class VI:
13.( )Remarks

SAP Format 13, “Subcontractor/Supplier Data Sheet,” Jan 1998 PREVIOUS EDITIONS ARE OBSOLETE

(CLASSIFY AS APPROPRIATE WHEN FILLED IN)

SAP 13 notes….

As the Program Manager please make sure SAP 13s are completed for this contract if the contractor employs any subcontractors for this effort. If not, then we need to know that too. Sub-contracts can be for people, parts, or info. I cannot forward the 254 without the SAP 13s or statement from the contractor that they employ no sub-contractors.

Complete the following as a minimum on the SAP 13 form.

Classification at the top and bottom of the form.

Even on unclassified contracts it should be “UNCLASSIFED//FOR OFFICIAL USE ONLY” as a minimum.

Each “( )” prior to a heading / question is for the classification of that item.

Section 1, 3, 4, & 10 Entire Section, self-explanatory (please place the specific contract number under the contractor name in block 1)

Section 5

All items
For Unclassified Project Number/Name use contract number if unclassified.

Section 7

All items if applicable. (All companies should have a POC for these sections)
Put their contact phone number in the line across from their name, only check ‘key sterile phone numbers’ if it is a classified contract and they are sterile numbers. (In which case the form will be classified)

Section 13 In the remarks section, SPECIFY what products listed in section 4 are being provided specifically.

(ie- if ‘personnel / services’ then list how many people and for what type of work / if ‘parts’ then put how many parts, and what their classification is.)

Also list in this section what information (if any) is being provided to the sub-contractor and what the classification of that information is.

(ie – none, unclassified technical drawings, FOUO technical orders, etc…)

Complete any other sections if that information is applicable.

If the contractor has NO sub-contractors with this particular contract, then complete block 1 listing the contractor name (place the contract number below the name), and place the word “NONE” in block 2.

File details come from the government source that posted it. Updated .