DD2542019-02-05-103222.pdf

CLASSIFICATION (When filled in): UNCLASSIFIED

DEPARTMENT OF DEFENSE 0MB No. 0704--0567 CONTRACT SECURITY CLASSIFICATION SPECIFICATION 0MB approval expires

(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.) October 31, 2020

The public reporting bl.W'den for this collection of information. 0704-0567, is estimated to ave:,: 70 minutes per response, including the time for reviewing instNctions. searching existing data SOl.re8S gathering and maintaining the data needed. and completing and reviewing the collection of infonnation, end comments regaroing 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 Se<Vices, at whs.mc-alex.esd.mbx.do-dod-infonnation-<:oltections@mail.mi, Re=::ts should be aware that notwithstanding any other provision of law. no person shall be subject to eny penalty for falling to comply with a collection of lnfonnation nit does not display a currently valid O B control number, RETURN COMPLETED FORM AS DIRECTED IN THE INSTRUCTIONS.

1. CLEARANCE AND SAFEGUARDING

a. LEVEL OF FACILITY SECURITY CLEARANCE (FCL) REQUIRED b. LEVEL OF SAFEGUARDING FOR CLASSIFIED INFORMATION/MATERIAL

(See instructions.) REQUIRED AT CONTRACTOR FACILITY

Secret None (See instructions)

2. THIS SPECIFICATION IS FOR: (X and complete as app5cable.) 3. THIS SPECIFICATION IS: (X and complete as applicable.)

a. PRIME CONTRACT NUMBER (See instructions.) DATE (YYYYMMDD)

X a. ORIGINAL (Complete date in all cases.) 20180413

b. SUBCONTRACT NUMBER

b. REVISED (Supersedes REVISION NO. DATE (YYYYMMDD)

X c. SOLICITATION OR OTHER NUMBER DUE DATE (YYYYMMDD) all previous specifications.)

H92239-19-R-0004

DATE (YYYYMMDD)

c. FINAL (Complete Item 5 in all cases.)

4. IS THIS A FOLLOW-ON CONTRACT? �NO LJ YES. 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? �NO LJ YES. If Yes. complete the following:

In response to the contractor's request date<! , retention of the classified material is authorize<! 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 (CSO) (Name, Address. ZIP Code, Telephone)!

TBD

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

a. NAME. ADDRESS. AND ZIP CODE b. CAGE CODE c. COGNIZANT SECURITY OFFICE(S) (CSOs) (Name, Address, ZIP Code, Te/ephOneJ

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

a. LOCATION(S) (For actual performance, see instructions.) b. CAGE CODE c. COGNIZANT SECURITY OFFICE(S) {CSOs) (Name, Address, ZIP Code, I st Special Warfare Training Group (SWTG) (A) (If applicable. Telephone) (If applicable, see instructions.)

Fort Bragg, NC 28310 see instructions./ HQUSASOC

AOIN-SOD

Fort Bragg, NC 283 I 0-9110

9. GENERAL UNCLASSIFIED DESCRIPTION OF THIS PROCUREMENT (C5ck here if more space is needed.)

FOR SOLICITATION PURPOSES ON LY

This contract shall provide Instructor support for the Survival, Evasion, Resistance and Escape Level "C" Training conducted during Phase II ofthc U.S.

Anny Special Forces Qualification Course. This training is conducted by C�arlie Company, 1st_ Battalion, 1st SWTG(A), U.S. Anny John F. Kennedy Special Warfare Center and School located on Camp Mackall, NC. The penod of performance 1s TBD.

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 f. SPECIAL ACCESS PROGRAM (SAP) INFORMATION

b. RESTRICTED DATA g. NORTH ATLANTIC TREATY ORGANIZATION (NATO) INFORMATION

c. CRITICAL NUCLEAR WEAPON DESIGN INFORMATION (CNWDI) h. FOREIGN GOVERMENT INFORMATION (lfCNWDI applies, RESTRICTED DATA must also be marked.) i. ALTERNATIVE COMPENSATORY CONTROL MEASURES (ACCM)

d. FORMERLY RESTRICTED DATA INFORMATION

e. NATIONAL INTELLIGENCE INFORMATION: X j. CONTROLLED UNCLASSIFIED INFORMATION (CUI) (See instructions.)

(1) Sensitive Compartmented Information (SCI) ,___

k. OTHER (Specify) (See instructions.)

(2) Non-SCI

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

CLASSIFICATION (When filled in): _UN_C_L_A_S_S_l_F _IE_D _______________ _