DD254_RFP.pdf

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Repair of ALQ-161 Band 5 TWT
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FA8522-16-R-0023
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Contract Security Classification Specification

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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.

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 classifiection 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

Untitled

a_FACILITY_CLEARANCE_REQU: SECRET
b_LEVEL_OF_SAFEGUARDING_R: SECRET
FillText1: Off
a_PRIME_CONTRACT_NUMBER:
DATE_YYYYMMDD: 20151023
FillText3: Off
b_SUBCONTRACT_NUMBER:
REVISION_NO:
DATE_YYYYMMDD1:
FillText5: Yes
c_SOLICITATION_OR_OTHER_N: FD2060-15-00941
DUE_DATE_YYYYMMDD:
DATE_YYYYMMDD2:
YES1: FA8522-12-D-0003
FillText12:
FillText11:
a_NAME_ADDRESS_AND_ZIP_CO: L-3 Communications Corporation, Electron Devices

960 Industrial Road San Carlos, CA 94070-4194

b_CAGE_CODE: 80080
c_COGNIZANT_SECURITY_OFFI: Defense Security Service (IOFWV)

333 W. El Camino Real, Suite 280 Sunnyvale, CA 94087-1969 Main: 408-830-9042

a_NAME_ADDRESS_AND_ZIP_C1: N/A
b_CAGE_CODE1: N/A
c_COGNIZANT_SECURITY_OFF1: N/A
a_LOCATION: See Ref Item 13
b_CAGE_CODE2: N/A
c_COGNIZANT_SECURITY_OFF2: N/A
9_GENERAL_IDENTIFICATION: Perform maintenance and repair of an ALQ-161 Traveling Wave Tube.
a_COMMUNICATIONS_SECURIT1: Off
a_COMMUNICATIONS_SECURIT2: Yes
b_RESTRICTED_DATA1: Off
b_RESTRICTED_DATA2: Yes
c_CRITICAL_NUCLEAR_WEAPO1: Off
c_CRITICAL_NUCLEAR_WEAPO2: Yes
d_FORMERLY_RESTRICTED_DA1: Off
d_FORMERLY_RESTRICTED_DA2: Yes
1_Sensitive_Compartmente1: Off
1_Sensitive_Compartmente2: Yes
2_NonSCI1: Off
2_NonSCI2: Yes
f_SPECIAL_ACCESS_INFORMA1: Off
f_SPECIAL_ACCESS_INFORMA2: Yes
g_NATO_INFORMATION1: Off
g_NATO_INFORMATION2: Yes
h_FOREIGN_GOVERNMENT_INF1: Off
h_FOREIGN_GOVERNMENT_INF2: Yes
i_LIMITED_DISSEMINATION_1: Off
i_LIMITED_DISSEMINATION_2: Yes
j_FOR_OFFICIAL_USE_ONLY_I: Yes
j_FOR_OFFICIAL_USE_ONLY_1: Off
k_OTHER_Specify: Off
k_OTHER_Specify1: Yes
a_COMMUNICATIONS_SECURIT3: Off
a_COMMUNICATIONS_SECURIT4: Yes
b_RESTRICTED_DATA3: Off
b_RESTRICTED_DATA4: Yes
c_CRITICAL_NUCLEAR_WEAPO3: Yes
c_CRITICAL_NUCLEAR_WEAPO4: Off
d_FORMERLY_RESTRICTED_DA3: Off
d_FORMERLY_RESTRICTED_DA4: Yes
e_INTELLIGENCE_INFORMATI3: Off
e_INTELLIGENCE_INFORMATI4: Yes
1_Sensitive_Compartmente3: Off
1_Sensitive_Compartmente4: Yes
2_NonSCI3: Off
2_NonSCI4: Yes
f_SPECIAL_ACCESS_INFORMA3: Off
f_SPECIAL_ACCESS_INFORMA4: Yes
g_NATO_INFORMATION3: Off
g_NATO_INFORMATION4: Yes
h_FOREIGN_GOVERNMENT_INF3: Yes
h_FOREIGN_GOVERNMENT_INF4: Off
i_LIMITED_DISSEMINATION_3: Off
i_LIMITED_DISSEMINATION_4: Yes
1_OTHER_Specify:
FillText13: Off
FillText14: Yes
a_TYPED_NAME_OF_CERTIFYIN: John Evans III
b_TITLE: Contracting Officer
c_TELEPHONE_Include_Area: (478) 926-7140
d_ADDRESS_Include_Zip_Cod: AFSC/PZAB

235 Byron Street, Suite 19-A Robins AFB, GA 31098

e_SIGNATURE:
FillText21: Yes
FillText22: Off
FillText23: Yes
FillText24: Off
FillText25: Yes
FillText26: Yes
f_OTHERS_AS_NECESSARY: 448 SCMW/OMO-R, 78 ABW/IPD
FillText15:
FillText16:
other1:
release: 78 ABW/PA

620 Ninth St. Rm 215, Suite 230 Robins AFB GA 31098 security: Ref 8.a. & 11.c.: Contractor performance will occur at the contractor's facility listed in block 6.a. B-1 Weapon System Program Security Classification Guide, dated 1 June 2011, with Change Letter 1, dated 15 Aug 2014, applies to this contract in protecting and safeguarding classified information.

Ref 10.j.: FOUO information provided under this contract shall be safeguarded as specified in DoDM 5200.01-V4, DoD Information Security Program: Controlled Unclassified Information.

Ref 11.j.: The contractor will be provided critical information under separate cover, if applicable.

USAF PROGRAM MANAGER UNIT SECURITY OFFICE USAF SERVICING SECURITY ACTIVITY

Melissa Carvin Leanne Langston Melvese M. Harris Program Manager Security Specialist Industrial Security Specialist

408 SCMS/GULB 448 SCMW/OMO-R 78 ABW/IP

235 Byron Street, Suite 19-A 235 Byron Street, Suite 19-A 985 Macon Street Robins AFB, GA 31098-1670 Robins AFB, GA 31098-1670 Robins AFB, GA 31098

(478) 926-6068 DSN 468-6068 (478) 926-3367 DSN 468-3367 (478) 222-1977 DSN 472-1977

addit_sec:
Inspections:
Reset:
4_Yes: Yes
4_No: Off
5_Yes: Off
5_No: No
12_Public_Release_Direct: Off
12_Public_Release_Through: Through.
13_Rules:
13_2:
14_Yes: Off
14_No: No
15_Yes: Off
15_No: No
3_A: Original.
3_B: Off
3_C: Off
2015-10-27T10:11:16-0400
CARVIN.MELISSA.R.1290209150
2015-10-27T11:45:52-0400
LANGSTON.LEANNE.1229988235
2015-10-28T16:10:48-0400
HARRIS.MELVESE.M.1229928453

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