(FOUO)FD2399-18-00139_TBD_SP_Solicitation_DD254_(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

20171211

DUE DATE (YYYYMMDD)

FD2399-18-00139

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.)

20171201

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?

TBD

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

TBD

b. CAGE CODE

TBD

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.)

TBD

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

TBD

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

TBD

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

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

Telecommunications Electronics Material Protected fro Emanating Spurious Transmissions (TEMPEST) certified portable structure to be used as a Secure Software Development Room (SSDR). This structure is intended to beused for two (2) years during the development of software at Site.

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

AFLCMC/HBG

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

78 ABW/PA See block 13.

125 MLK Jr. Blvd, Robins AFB, GA 31098

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.)

Ref Blk 10j: See DoDM 5200.01 Volume 4, DoD Information Security Program: Controlled Unclassified Informatinon (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 11a: If any classified information is generated in the performance of this contract at the identified location, the contractor shall apply derivative classification and markings consistent with the source material.

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

Per AFI 10-254, all contractors will be Anit-terrorism Level 1 trained.

Ref Item 11i: See Contract Clause No. 252.239-7000 for additional EMSEC requirements.

Ref Item 11j: OPSEC requirements apply. See Statement of Work (SOW) for requriements.

478-926-8632

e. POC TELEPHONE (Include Area Code.)

brigitte.kneer@us.af.mil

f. EMAIL ADDRESS (See instructions.)

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

FA8555

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

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

Brigitte Kneer

d. POC NAME (See instructions.)

AFLCMC/HBKAA

235 Byron Street Suite 19A Robins AFB, GA 31098

c. ADDRESS (Include ZIP Code.)

Brian Layfield

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.)

Jason Morgan

478-222-6800

f. TELEPHONE (Include Area Code.)

jason.morgan.12@us.af.mil

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

Procurement Contracting Officer

b. TITLE

AFLCMC/HBKAA

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

c. ADDRESS (Include ZIP Code.)

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

FA8555

Unclassified // FOUOCLASSIFICATION (When filled in):

Unclassified // FOUOCLASSIFICATION (When filled in):

N/A

15. INSPECTIONS (Continued)

N/A

14. ADDITIONAL SECURITY REQUIREMENTS (Continued)

Ref Item 11f: Contract performance will occur at TBD sites overseas. HQ USAFE/IP will maintain security oversight at these locations.

Ref Item 12: Information requiring AF or DoD Level review will be forwarded by the entry-level public affairs office 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 DC 20330-1690.

Ref Item 18d/f: Ensure signatures and distribution is made to the following:

HQ USAFE/IP AFLCMC/HBG HQ Defense Security Service Unit 3050 Box 135 235 Byron Street, Suite 19A 27130 Telegraph Road APO AE, 09094-0135 Robins AFB, GA 31098 Quantico, VA 22134

USAF Program Manager Unit Security Manager USAF Servicing Security Activity

BRIGITTE KNEER ANNA M. WONG AFLCMC/IP

AFLCMC/HBGH AFLCMC/HBG 2145 MONAHAN WAY

235 BYRON STREET, SUITE 19A 235 BYRON STREET, SUITE 19A WPAFB, OH 45433-7629

ROBINS AFB, GA 31098 ROBINS AFB, GA 31098

478-926-8632 DSN 468 478-926-8224 DSN 468

13. SECURITY GUIDANCE (Continued)

Pages1of1Continuation 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)

LEE.ADRIAN.

E.1162883107

Digitally signed by

LEE.ADRIAN.E.1162883107

Date: 2017.12.07 08:57:33 -05'00'

WONG.ANNA.

M.1032473586

Digitally signed by

WONG.ANNA.M.1032473586

Date: 2017.12.07 08:38:03 -05'00'

CRONE.SEAN.D

AVID.1265845467

Digitally signed by

CRONE.SEAN.DAVID.12658454

Date: 2017.12.07 06:34:15 -05'00'