AFLCMC_IP_Signed_FD2060-18-Q-0002_dd254_signed_(003).pdf

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

Secret Secret

20180315

DUE DATE (YYYYMMDD)

FD2060-18-Q-0002

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.)

20180220

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:NO4. 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:NO5. IS THIS A FINAL DD FORM 254?

San Antonio Field Office (IOFSS) 1777 North East Loop 410, Suite 801 San Antonio, TX 78217

c. COGNIZANT SECURITY OFFICE (CSO) (Name, Address, ZIP Code, Telephone)

26401

b. CAGE CODE

Southwest Research Institute 6220 Culebra Rd, Bldg 61 San Antonio TX 78238-5166

a. NAME, ADDRESS, AND ZIP CODE

6. CONTRACTOR (Include Commercial and Government Entity (CAGE) Code.)

N/A

c. COGNIZANT SECURITY OFFICE(S) (CSOs) (Name, Address, ZIP Code, Telephone)

N/A

b. CAGE CODE

N/A

a. NAME, ADDRESS, AND ZIP CODE

7. SUBCONTRACTOR(S) (Click button to add more subcontractors.)

Atlanta Field Office (IOFSA) 1899 Powers Ferry Rd SE Ste 330 Atlanta, GA 30339

c. COGNIZANT SECURITY OFFICE(S) (CSOs) (Name, Address, ZIP Code, Telephone) (If applicable, see instructions.)

00JW9

b. CAGE CODE (If applicable, see instructions.)

Southwest Research Institute 609 Richard B. Russell Pkwy Warner Robins, GA 31088-6031

a. LOCATION(S) (For actual performance, see instructions.)

8. ACTUAL PERFORMANCE (Click button to add more locations.)

SwRI will provide Developmental Testing engineering services for the AC/MC-130-J Radio Frequency Countermeasures (RFCM) System. SwRi will perform analysis of RFCM electronic countermeasure data/techniques and provide a test report.

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

CLASSIFICATION (When filled in):

UNCLASSIFIED//FOUOCLASSIFICATION (When filled in):

UNCLASSIFIED//FOUO

(1) Sensitive Compartmented Information (SCI)

(2) Non-SCI

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 THE DEFENSE COURIER SERVICE (DCS)

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

SEE CONTINUATION SHEET.

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.)

The Radio Frequencies Countermeasure (RFCM) Security Classification Guide (dated 4 Aug 14) applies to classified performance on this contract.

Subsequent updates shall be provided by the Technical Point of Contact/Contracting Officer Representative/Contracting Officer or Security Representative (as applicable) as Government Furnished Information (GFI) and shall be executed by the Contractor without obligation to modify this DD Form 254. The National Industrial Security Program Operating Manual (NISPOM), February 2006, Incorporating Change 2 May 18, 2016 applies. The Contractor will notify the Government Contracting Activity and the Government Security Manager within 48 hours of any incident involving the actual or suspected compromise/loss of classified information to enable the Government to conduct immediate assessment of potential impact pending formal inquiry/ investigation. Actual or suspected compromise of Covered Defense Information will be reported IAW DFARS Clause 252.204-7012.

14. ADDITIONAL SECURITY REQUIREMENTS. Requirements, in addition to NISPOM requirements for classified information, are established for this contract.

YesNo (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.)

YesNo

Ref Blk 11j: OPSEC requirements apply. See Statement of Work (PWS) for requirements.

(478) 327-5259

e. POC TELEPHONE (Include Area Code.)

broam.hart@us.af.mil

f. EMAIL ADDRESS (See instructions.)

b. ACTIVITY ADDRESS CODE (AAC) OF THE CONTRACTING OFFICE (See instructions.)

FA8523

d. AAC OF THE CONTRACTING OFFICE (See instructions.)

e. CAGE CODE OF THE PRIME CONTRACTOR (See instructions.)

Broam Hart, Lt, USAF

d. POC NAME (See instructions.)

235 Byron Street, Suite 19A Robins Air Force Base, Georgia 31098-1670

c. ADDRESS (Include ZIP Code.)

AFLCMC/WNY EW Program Office 235 Byron Street, Suite 19A Robins Air Force Base, Georgia 31098-1670

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.)

Ethridge, Melissa, G.

(478) 926-1748

f. TELEPHONE (Include Area Code.)

melissa.ethridge@us.af.mil

g. EMAIL ADDRESS (See instructions.) h. SIGNATUREh. DATE

Contracting Officer

b. TITLE

AFLCMC/WNKD

235 Byron Street, Suite 19A Robins Air Force Base, Georgia 31098-1670

c. ADDRESS (Include ZIP Code.)

WPAFB SSO: 21 IS/INS, SSO WPAFB, 2450 D Street, Bldg 20, Area B, WPAFB OH 45433- 7629, WPAFBSpecialSecurityOffice.Mailbox@us.af.mil

AFLCMC SIO: 21 IS/INI, Bldg 20, 2450 D Street, WPAFB OH 45433-7629, aflcmc.21is.21is254workflow@us.af.mil

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

FA8523

26401

UNCLASSIFIED//FOUOCLASSIFICATION (When filled in):

UNCLASSIFIED//FOUOCLASSIFICATION (When filled in):

15. INSPECTIONS (Continued)

The Contractor will notify the Government Contracting Activity and the Government Security Manager within 48 hours of any incident involving the actual or suspected compromise/loss of classified information to enable the Government to conduct immediate assessment of potential impact pending formal inquiry/investigation. Actual or suspected compromise of Covered Defense Information will be reported IAW DFARS Clause 252.204-7012.

14. ADDITIONAL SECURITY REQUIREMENTS (Continued)

The National Industrial Security Program Operating Manual (NISPOM), February 2006, Incorporating Change 2 May 18, 2016 applies.

Security Classification Guide:

The USSOCOM Security Classification Guide for AC/MC-130J Commando II Radio Frequency Countermeasures (RFCM) dated 4 Aug 2014 applies to classified performance on this contract. Subsequent updates shall be provided by the Technical Point of Contact/Contracting Officer Representative/ Contracting Officer or Security Representative (as applicable) as Government Furnished Information (GFI) and shall be executed by the Contractor without obligation to modify this DD Form 254.

Ref Blks 10e (2): Contractor will require access to intelligence information and must comply with directions provided by the Contracting Officer’s Representative (COR). 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. In accordance with para 8.9.2.2 of AFMAN 14-304, the COR will identify what intelligence information is required for the contractor to satisfy the contract and will submit that information to the Servicing Senior Intelligence Officer (SIO) for approval prior to granting access.

Ref Blk 10j: See DoDM 5200.01, Volume 4, DoD Information Security Program: Controlled Unclassified Information (CUI), Enclosures 3 & 4 and DoDM 5400.07/Air Force Manual 33‑302, DoD Freedom of Information Act (FOIA) Program, and AFI 16-1404, Air Force Information Security Program, for requirements.

Ref Blk 11c: Any classified information generated in the performance of this contract shall require the contractor to apply derivative classification and markings consistent with the source material or be governed by the current version of the USSOCOM Security Classification Guide for AC/MC-130J Commando II Radio Frequency Countermeasures (RFCM) dated 4 Aug 2014 OPR: (USSOCOM, Special Operations Research, Development and Acquisition Center, Program Executive Officer, Fixed Wing, 7701 Tampa Point Blvd., MacDill AFB, 33621-5323). SCG will be provided under separate cover.

Ref Blk 11d: The contractor is required to provide adequate and approved storage for classified hardware or material to the level of (SECRET) which because of size or quantity cannot be safeguarded in an approved storage container.

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

Ref Blk 12: Information requiring AF or DoD-level review will be forwarded by the entry-level public affairs office through the AFIMSC 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 DC 20330-1690. MAJCOM/DRUs will send information requiring AF or DoD-level review directly to SAF/PAX. Public release requests for non-SAR related material should go to AFLCMC/WNY EW Program Office, 235 Byron Street, Ste. 19A, Robins AFB, GA 31098.

Program Manager/Quality Assurance Personnel/Contracting Officer’s Representative: Lt Broam Hart, AFLCMC/WNY, (478) 327-5259, broam.hart@us.af.mil

13. SECURITY GUIDANCE (Continued)

PagesofContinuation PageDD FORM 254, NOV 2017

UNCLASSIFIED//FOUO

CLASSIFICATION (When filled in): UNCLASSIFIED//FOUO

CLASSIFICATION (When filled in):

Additional persons assisting with completion of form (signatures and titles)

Lt. Broam Hart

AFLCMC/WNY

Jucal Higgs-Bradford

AFLCMC/WNE-IP

Sean D. Crone

AFLCMC/EZSP