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DD Form 254

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FA825119R0002.pdf PDF
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2628638_TRNSPDATA_REPORT.pdf PDF
Item_Decription.pdf PDF
2628723_ATTACH.pdf PDF
2614510_ATTACH.pdf PDF
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CDRL.pdf PDF
2614514_ATTACH.pdf PDF
Pre_Synopsis.docx DOCX document
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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 7.0

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

DD Form 254 Addendum

OPSEC

All contractors, subcontractors, their employees, associates, and consultants who have access to critical information must comply with the Air Force-sponsored Operations Security (OPSEC) program.

OPSEC is a systematic means of identifying and protecting information which an adversary could use to their advantage or to our disadvantage. Critical Information (CI) is generally unclassified but sensitive information which has been identified by the OPSEC program as requiring protection. OPSEC Measures (OM) are control standards with which all personnel must comply in order to protect critical information.

Responsibilities:

The 748 SCMG must provide / approve OPSEC training curriculum for use by the contractor. Training must provide listings of critical information that must be protected by all personnel, listings of OPSEC measures which must be used by all personnel to protect critical information, and current foreign intelligence and industrial espionage threats. The contractor must ensure all personnel working on the contract or having access to critical information attend initial and annually recurring refresher training and that the approved curriculum is presented. Training must be provided before personnel are allowed access to critical information. All personnel must comply with OPSEC standards and practices as trained. Additional training may be required based on updates to critical information, OPSEC measures, intelligence threat, or other fundamental changes to the OPSEC program.

The contractor must track OPSEC training statistics to include the personnel working on the contract, when each individual received the required OPSEC training, and when refresher training is due. Training statistics must be forwarded to the 748 SCMG OPSEC program coordinator, Mr. Samuel Ingram 801-775-6301 at the end of each calendar quarter and upon request.

Prior to seeking approval through Hill AFB Public Affairs, any information to be released outside of official U.S. Government channels, via any media, must be approved through an OPSEC review by the 748 SCMG OPSEC program coordinator. All personnel must promptly report OPSEC related incidents, issues, and concerns to the 748 SCMG OPSEC program coordinator Mr. Samuel Ingram at 801-775-6301.

Prime Contractor Solicitation #: FD2020-17-01019

Addendum template version: Oct 2010. Previous versions will be used.

fac_clear: SECRET
safe_level: SECRET
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: TBD
ctr_cage: TBD
ctr_ofc: TBD
sub_name: N/A
sub_cage: N/A
sub_ofc: N/A
perf_loc: TBD
perf_cage: TBD
perf_ofc: TBD
gen_id: This contract covers repair of Low Noise Assembly (LNA), used in the MLPRF of the APG-68 Radar system in the F16 C/D aircraft. Testing of this item requires test parameter data contained in Secret documents.
x10a: No
x10b: No
x10c: No
x10d: No
x10e1: No
x10e2: No
x10f: No
x10g: No
x10h: No
x10i: No
x10j: Yes
x10k: No
other10k:
x11a: Yes
x11b: Yes
x11c: Yes
x11d: Yes
x11e: Yes
x11f: Yes
x11g: Yes
x11h: Yes
x11i: Yes
x11j: Yes
x11k: Yes
x11l: Yes
other11l:
xrelease: No
release_thru: Information requiring AF or DoD–level review will be forwarded to 75 ABW Public Affairs Office, 7981 Georgia Street, Hill AFB, UT

84056, for distribution through the MAJCOM/DRU Public Affairs Office to the Secretary of the Air Force, Office of Public Affairs, Security and Review Division (SAF/PAX), 1690 Air Force Pentagon, Washington.

guidance: Ref. 10.j.: FOUO information provided under this contract shall be safeguarded as specified in DOD Manual 5200.01, Volume 4, DoD Information Security Program: Controlled Unclassified Information (CUI).

Ref 11.b: The contractor will receive classified documents up to and including SECRET for reference only; however, if any classified information is generated in performance of this contract, the contractor will be required to apply derivative classification markings consistent with the source documents/materials and Executive Order 13526, as amended. Security Classification Guide: F-16 Multi-mission fighter, dated 1 June 2006 (Revised 2 March 2016).

Ref 11.j: The contractor must comply with the U.S. Government, DOD, Air Force, AFMC, Hill AFB, and 749 SCMG Operation Security (OPSEC) Programs. The contractor must comply with any additional OPSEC requirements referenced.

*Below signatures are located on attached "Electronic Signatures.docx" form attached.

13a. Program Official 13b. Duty phone 13c. Five Year Review Date

Joe Refahiyat 801-775-4602 2022 06 28 416th SCMS/GUMAD Program Engineer

Security Manager Industrial Security

448 SCMW/OMO 75 ABW/IPD

xaddlsec: Yes
addl_sec: Ref 11.j. OPSEC requirements are referenced in the applicable OPSEC DD Form 254 addendum.
xinsp: No
inspections:
cert_name:
cert_title: Contracting Officer
cert_phone:
cert_addr: 6050 Gum Lane

Hill, AFB, UT 84056

cert_sign:
x17a: Yes
x17b: Off
x17c: Yes
x17d: Off
x17e: Yes
x17f: Yes
other_dist: 75 ABW/IPD (steven.nutt.2@us.af.mil)
Reset:

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