DD254.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

20180918

DUE DATE (YYYYMMDD)

FD2060-18-31300

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.)

20180313

DATE (YYYYMMDD)

a. ORIGINAL (Complete date in all cases.)

(Preceding Contract Number) is transferred to this follow-on contract.SEE CONTINUATION SHEET 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?

Defense Security Service (IOFCCI) 13873 Park Center Road, Suite 225 Herndon, VA, 20171 (571)-373-5205

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

9M715

b. CAGE CODE

Peraton Inc 12975 Worldgate Dr. Ste 2143 Herndon, VA 20170-6008

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.)

N/A

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

N/A

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

See attached Continuation Sheet

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

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

Scope includes (1) engineering support services for the AN/ALM-280, commonly referred to as the Enhanced Automated Special Test Equipment (EASTE); (2) engineering support for the AN/ALQ-161A system software qualification and test for all ongoing and future AN/ALQ-161A deficiency analyses, technical inquiries, Preprocessor Flight Software (PFS) block cycle change programs, and laboratory maintenance/upgrade efforts (3) engineering and configuration management support for the B-1 B Defensive Avionics Subsystem (DAS) sustainment efforts.

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

See attached Continuation Sheet

DD FORM 254, NOV 2017 PREVIOUS EDITION IS OBSOLETE. Adobe LiveCycle Designer ES4

(1) Sensitive Compartmented Information (SCI)

(2) Non-SCI

UNCLASSIFIED/FOUOCLASSIFICATION (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

See attached Continuation Sheet 235 Byron Street Suite 19A Robins AFB, Georgia 31098 AFLCMC/WNY

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.)

B-1 Security Classification Guide (SCG), Revision 4, dated 10 Oct 2017

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

While performing intermittently at Military Service-owned and/or operated locations/facilities, the contractor will adhere to the respective Military Service: Information Security Program, ADP Programs, Physical Security Program, and Industrial Security Program. Appropriate local service/ component command security directives, regulations, and standard operating procedures will be provided by the requiring agency (as needed) at these locations/facilities. Prior approval of the contracting activity is required for subcontracting.

478-926-7337

e. POC TELEPHONE (Include Area Code.)

Brittany.White.18@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.)

Brittany White

d. POC NAME (See instructions.)

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

c. ADDRESS (Include ZIP Code.)

Air Force Life Cycle Management Center Electronic Warfare Contracting Branch

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.)

Taylor, Erin B.

478-926-2719

f. TELEPHONE (Include Area Code.)

Erin.Taylor.1@us.af.mil

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

Procuring Contract Officer

b. TITLE 235 Byron Street, Suite 19A Robins, AFB GA, 31098

c. ADDRESS (Include ZIP Code.)

2018-02-08

SSO-AFLCMC/INGS SEE CONT. SHEET

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

9M715

UNCLASSIFIED/FOUOCLASSIFICATION (When filled in):

SIGNATURE

B-1B SCG_REV4_10 OCT 2017.pdf Continuation_Sheet.docx

15. INSPECTIONS (Continued)

14. ADDITIONAL SECURITY REQUIREMENTS (Continued)

PagesofContinuation PageDD FORM 254, NOV 2017

13. SECURITY GUIDANCE (Continued)

Tyro Jackson Program Manager

AFLCMC/WNY

235 Byron Street Ste 19A Robins AFB GA. 31098

Jucal Higgs-Bradford Security Specialist

AFLCMC/WNE

235 Byron Street Ste 19A Robins AFB GA. 31098

Sean Crone, SFPC Industrial/Information Security Protection

AFLCMC/EZSP

2145 Monahan Way, Bldg 28

WPAFB, OH 45433

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