ALEP_RFP_DD254.pdf

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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

DUE DATE (YYYYMMDD)

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.)

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:

NO

4. 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:

NO

5. IS THIS A FINAL DD FORM 254?

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

b. CAGE CODE

a. NAME, ADDRESS, AND ZIP CODE

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

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

b. CAGE CODE

a. NAME, ADDRESS, AND ZIP CODE

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

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

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

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

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

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

(1) Sensitive Compartmented Information (SCI)

(2) Non-SCI CLASSIFICATION (When filled in):

CLASSIFICATION (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

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.)

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

Yes No (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.)

Yes No

e. POC TELEPHONE (Include Area Code.)

f. EMAIL ADDRESS (See instructions.)

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

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

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

d. POC NAME (See instructions.)

c. ADDRESS (Include ZIP Code.)

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.)

f. TELEPHONE (Include Area Code.)

g. EMAIL ADDRESS (See instructions.)

i. SIGNATURE

h. DATE

b. TITLE

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

CLASSIFICATION (When filled in):

CLASSIFICATION (When filled in):

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

b. CAGE CODE

a. NAME, ADDRESS, AND ZIP CODE

7. SUBCONTRACTOR(S) (Continued)

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

b. CAGE CODE

a. NAME, ADDRESS, AND ZIP CODE

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

b. CAGE CODE

a. NAME, ADDRESS, AND ZIP CODE

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

b. CAGE CODE

a. NAME, ADDRESS, AND ZIP CODE

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

b. CAGE CODE

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

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

b. CAGE CODE

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

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

b. CAGE CODE

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

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

b. CAGE CODE

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

8. ACTUAL PERFORMANCE (Continued)

9. GENERAL UNCLASSIFIED IDENTIFICATION OF THIS PROCUREMENT (Continued)

DD FORM 254, NOV 2017

Pages of Continuation Page CLASSIFICATION (When filled in):

CLASSIFICATION (When filled in):

15. INSPECTIONS (Continued)

14. ADDITIONAL SECURITY REQUIREMENTS (Continued)

13. SECURITY GUIDANCE (Continued) Pages of Continuation Page

DD FORM 254, NOV 2017

Additional persons assisting with completion of form (signatures and titles) CLASSIFICATION (When filled in):

CLASSIFICATION (When filled in):

9.0.0.2.20120627.2.874785

WHS/ESD/DD

DD 254, Nov 2017, "DoD Contract Security Classification Specification" Orig No No No No Yes

*****DRAFT*****

Provide necessary personnel, material, and facilities to support the AFLCMC/WNUV Aircrew Laser Eye Protection (ALEP) program.

****** DRAFT*******

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

a) 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.

b) 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.

c) 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 Aircrew Laser Eye Protection (ALEP) Security Classification Guide (SCG), Original date 22 Dec 05 OPR: 711 Human Performance Wing, WPAFB, OH, all other applicable SCDGs will be provided under separate cover.

d) Ref Blk 11g: Access to DTIC can be requested through the DD Form 1540, Registration for Scientific and Technical Information Services or online at: http://www.dtic.mil/dtic/registration/registration.html.

e) Ref Blk 12: a. Air Force Lifecycle Management Center (AFLCMC) Agile Combat Support Simulators Division (WNS) , 2300 D Street, Building 32, Area B, (Wright-Patterson Air Force Base, Ohio) WPAFB OH 45433, for non-SAR related material. Transmission of public release request via e-mail is not authorized. 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,

13. Security guidance.:

****** DRAFT *****

f) Ref Item 18e (Administrative Contracting Officer): DCMA Dayton, Attn: Boyd E. Long, Jr., 1725 Van Patton Drive, (Wright-Patterson Air Force Base, Ohio) WPAFB OH 45433-5302; phone (937) 656-3023, boyd.long@dcma.mil.

g). Program Manager: Maj Tyler N. Tritz / AFLCMC/WNU / tyler.tritz.1@us.af.mil / (937) 938-3665 h). Security POC: Penny A. Watson, AFLCMC/WNE-IP, (937) 938-4784, penny.watson@us.af.mil.

i). Ref Item 18f (Distribution):

• 88 ABW/IPD, 1801 Tenth Street, (Wright-Patterson Air Force Base, Ohio) WPAFB OH 45433-7625, 88ABW.IPD.Industrial.security@us.af.mil

• 21 IS/INI, 2450 D Street, Building 20, Wright Patterson AFB OH 45433-7629, aflcmc.21is.21is254workflow@us.af.mil

• AFLCMC/WNE-IP Security Manager, 1981 Monahan Way, WPAFB OH 45433; penny.watson@us.af.mil

• HQ Defense Security Service, 27130 Telegraph Road, Quantico, VA 22134 *Distribution includes all Servicing Security Activities (SSA) listed in Items 8c, Continuation Pages 1-3; as well as ACCM Oversight Office (contact Program Manager for more information ref ACCM).

Ref Blk 11j: OPSEC requirements apply. See ALEP (22DEC2005) SCG Section II Paragraph 5 for requirements and see ALEP PPP (1AUG2010) Table 2. OPSEC countermeasures/practices are required to mitigate risk to ALEP organic Critical Program Info.

1981 Monahan Way, Bldg 12

WPAFB OH 45433

16.a. Government contracting authority (GCA) name.: Contracting, Simulators Program Office

(AFLCMC/WNU)

Agile Combat Support Directorate (AFLCMC/WN)

Wright-Patterson AFB, OH 45433