Atch-7_DD254_signed.pdf

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Attached to
MQ-1 and MQ-9 Sensor Support and Sustainment Federal contract opportunity
Solicitation number
FA8528-15-R-0104
Issued by
Department of the Air Force Materiel Command Lifecycle Management Center Robins Air Force Base

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Security Requirements

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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

fac_clear: TOP SECRET
safe_level: TOP SECRET
prime_no:
xprime: Off
sub_no:
xsub: Off
xsolic: Off
solic_no: FA8528-16-R-00104
due_date: 20150301
xspec3: Orig
orig_date: 20140327
rev_no:
rev_date:
final_date:
xfollowon: Yes
prec_no: FA8527-13-C-0031
xfinal: No
req_dated:
period:
ctr_name: Raytheon Company

2501 West University Drive McKinney, TX 75071-2813 972-952-3453

ctr_cage: 084T3
ctr_ofc: Defense Security Service (IOFSI)

5800 E. Campus Circle Drive, Suite 218A Irving, TX 75063 972-580-1200 X247 Fax: 972-580-1623

sub_name: N/A
sub_cage: N/A
sub_ofc: N/A
perf_loc: SEE CONTINUATION SHEET
perf_cage:
perf_ofc:
gen_id: Support and services effort involving sustainment activities for the multi-use electro-optical infrared and laser detecting-range-tracking set known as the Multi-Spectral Targeting System (MTS), Models A and B, and the Airborne Cueing and Exploitation System Hyper-Spectral (ACES HY) systems. Sustainment effort involves but is not limited to depot repair, technical order source data and software sustainment, on-site engineering, reliability/maintainability enhancements, and supply support, Field Service Representatives (FSRs) to provide on-site and resident support at CONUS and all OCONUS locations.
x10a: Yes
x10b: Yes
x10c: No
x10d: Yes
x10e1: Yes
x10e2: Yes
x10f: No
x10g: No
x10h: Yes
x10i: No
x10j: Yes
x10k: Yes
other10k: SCI AUTHORIZED - NUMBER OF BILLETS: 5
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:

VGSA required for on base performance.

xrelease: No
release_thru: 78 ABW/PA 78 ABW/IP AFLCMC/WIILR ***PUBLIC RELEASE OF SCI

620 Ninth St, Rm 215, Suite 230 455 Byron St., Suite 407 235 Byron St., Suite 19A IS NOT AUTHORIZED*** Robins AFB, GA 31098 Robins AFB, GA 31098 Robins AFB, GA 31098 guidance: USAF Program / Project Manager: USAF Program Office Representative: USAF Servicing Security Activity:

MARIE MILLER ANNA M WONG MELVESE HARRIS, DAFC

Program Manager Industrial Security Specialist Security Specialist AFLCMC/WIILR AFLCMC/HBG 78 ABW/IPD 235 Byron Street, Suite 19A 235 Byron Street 455 Byron Street, Suite 407 Robins AFB GA 31098 Robins AFB GA 31098 Robins AFB GA 31098

COMM: 478-926-8410 COMM: 478-926-8224 COMM: 478-222-1927

DSN: 468-8410 DSN: 468-8224 DSN: 472-1977

*****SEE INTELLIGENCE SECURITY ADDENDUM*****

*****SEE CONTINUATION SHEET*****

xaddlsec: Yes
addl_sec: Provide the information requested by the Notification of Government Security Activity and Visitor Group Security Agreements Clause, AFFARS

5352.204-9000, to the Servicing Security Activity (SSA) address where the work will be performed. Refer to the contract document for this clause.

xinsp: Yes
inspections: Industrial security reviews for long term visitor groups will be conducted by the SSA while operating on an Air Force Installation. The contractor

will comply with the visitor group security agreement provided by the USAF Program/Project Manager at the performance location.

cert_name: DALE E DALRYMPLE
cert_title: CONTRACTING OFFICER
cert_phone: (478) 926-8381
cert_addr: AFLCMC/WIKBA

235 Byron Street, Suite 19A Robins AFB GA 31098-2122

cert_sign:
x17a: Yes
x17b: Off
x17c: Yes
x17d: Yes
x17e: Yes
x17f: Yes
other_dist: SEE CONTINUATION SHEET
Reset:

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