ATTACHMENT 4 SECURITY CHARTS.doc

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INTERNET MONITORING AND ANALYSIS SUPPORT SERVICES Federal contract opportunity
Solicitation number
FDA-SOL-10-1068201-02
Issued by
Department of Health and Human Services Food and Drug Administration

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Security Charts

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ATTACHMENT 2 Past Performance Questionnare.doc DOC document
ATTACHMENT 5 NON DISCLOSURE STATEMENT.doc DOC document

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ATTACHMENT 4: PERSONNEL SECURTIY CHARTS

NON-PUBLIC DATA PROTECTION

The contractor shall protect the privacy of all information reported by or about contract employees and shall protect against unauthorized disclosure.

For clarification purposes and to facilitate the flow of all required security forms, the following matrix is provided:

CHART A

Mandatory for all on-site contract employees

NON-SENSITIVE POSITIONS - LEVEL 1

FORM NAME
OBTAIN

FROM

WHEN REQUIRED
SUBMIT

TO

DATE REQUIRED

FDA Form 3391 - FDA Security Card Access Request
COTR. Sponsorship must be provided by FDA COTR.
All positions on DHHS property or leased space
Food and Drug Administration

OSO/Office of Security Operations

Attn: Personnel Security Staff

10903 New Hampshire Ave, RM 1201

Silver Spring, MD 20993

**Form must be submitted by Security Rep.

Form must be received prior to making fingerprint appointment.

Contractor’s Commitment to Protect Non-Public Information (NPI) Agreement form
Contracting Officer
All positions with access to non-public privileged, proprietary, or trade secret information
Contracting Officer for retention

in contract file Ten (10) calendar days prior to commencement of work

Listing of all contractor employee names, social security #s, gender, dates of birth, former names, and a completed Fair Credit Reporting Act Release
Contractor generated
All positions, including intermittent, per diem or

temporary

* Food and Drug Administration

OSO/Office of Security Operations

Attn: Personnel Security Staff

10903 New Hampshire Ave, RM 1201

Silver Spring, MD 20993 Ten (10) calendar days prior to commencement of work

SF 85 - Questionnaire for Non-Sensitive Positions
Online via OPM’s e-QIP system
Non-Sensitive Positions - Level 1 Clearance
*Submit to OPM online via the e-QIP system
Ten (10) calendar days upon request of the Contracting Officer

FD 258 - Fingerprint Chart (2 Charts Required)

Fingerprinting services available by appointment only.

Call (301) 827-9527

Contracting Officer
Non-Sensitive Positions - Level 1 Clearance
* Food and Drug Administration

OSO/Office of Security Operations

Attn: Personnel Security Staff

10903 New Hampshire Ave, RM 1201

Silver Spring, MD 20993 Ten (10) calendar days prior to commencement of work

*In addition to the submission of these forms, the contractor shall provide a cover letter that includes: contractor’s name, contract number, contractor employees’ names, and name of Contracting Officer

*Upon favorable fingerprint return, contractor will be notified to respond to the badging office for their building pass.

Personnel Security Branch

5600 Fishers Lane

PKLN 12A-43, HFA 630

Rockville, MD 20857

Hours 8:00 a.m. -11: a.m. and

1:00 p.m.-3:00 p.m. Mon-Fri

No appointment necessary

(301) 827-9615

CHART B

Public Trust Positions - Levels 5 or 6

FORM NAME
OBTAIN

FROM

WHEN REQUIRED
SUBMIT

TO

DATE REQUIRED

SF 85P - Questionnaire for Public Trust Positions

Online via OPM’s e-QIP system

Public Trust Positions - Level 5 or 6 Clearance
*Submit to OPM online via the e-QIP system
Ten (10) calendar days prior to commencement

of work

FD 258 - Fingerprint Chart (2 Charts Required)

Fingerprinting services available by appointment only.

Call (301) 827-9527

Contracting Officer
Public Trust Positions - Level 5 or 6 Clearance
* Food and Drug Administration

OSO/Office of Security Operations

Attn: Personnel Security Staff

10903 New Hampshire Ave, RM 1201

Silver Spring, MD 20993 Ten (10) calendar days prior to commencement of work

FDA Form 3391 - FDA Security Card Access Request
COTR. Sponsorship must be provided by FDA COTR.
All positions on DHHS property or leased space
Food and Drug Administration

OSO/Office of Security Operations

Attn: Personnel Security Staff

10903 New Hampshire Ave, RM 1201

**Form must be submitted by Security Rep.

Form must be received prior to making fingerprinting appointment.

Contractor’s Commitment to Protect Non-Public Information (NPI) Agreement form
Contracting Officer
All positions with access to non-public privileged, proprietary, or trade secret information
Contracting Officer for retention

in contract file Ten (10) calendar days prior to commencement of work

Listing of all contractor employee names, social security #s, gender, dates of birth, former names, and a completed Fair Credit Reporting Act Release
Contractor generated
All positions, including intermittent, per diem or temporary
* Food and Drug Administration

OSO/Office of Security Operations

Attn: Personnel Security Staff

10903 New Hampshire Ave, RM 1201

Ten (10) calendar days prior to commencement of work

*In addition to the submission of these forms, the contractor shall provide a cover letter that includes: contractor’s name, contract number, contractor employees’ names, and name of Contracting Officer.

*Upon favorable fingerprint return, contractor will be notified to respond to the badging office for their building pass.

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