HC1047-16-R-4008_-_Attachment_7_-_DD254.pdf
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- Attached to
- Cost/Business Analysis and Financial Support Federal contract opportunity
- Solicitation number
- HC1047-16-R-4008
- Issued by
- Defense Information Systems Agency
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Attachment 7 - DD254
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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) 3. THIS SPECIFICATION IS: (X and complete as applicable)
a. PRIME CONTRACT NUMBER
a. ORIGINAL (Complete date in all cases)
DATE (YYYY MMDD)
b. SUBCONTRACT NUMBER b. REVISED (Supersedes all previous specs)
REVISION NO. DATE (YYYY MMDD)
c. SOLICITATION OR OTHER NUMBER DUE DATE (YYYY MMDD)
c. FINAL (Complete Item 5 in all cases)
DATE (YYYY MMDD)
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: YES NO 11. IN PERFORMING THIS CONTRACT, THE CONTRACTOR WILL: YES NO
a. COMMUNICATIONS SECURITY (COMSEC) INFORMATION a. HAVE ACCESS TO CLASSIFIED INFORMATION ONLY AT ANOTHER
CONTRACTOR'S FACILITY OR A GOVERNMENT ACTIVITY
b. RESTRICTED DATA b. RECEIVE CLASSIFIED DOCUMENTS ONLY
c. CRITICAL NUCLEAR WEAPON DESIGN INFORMATION c. RECEIVE AND GENERATE CLASSIFIED MATERIAL
d. FORMERLY RESTRICTED DATA d. FABRICATE, MODIFY, OR STORE CLASSIFIED HARDWARE
e. INTELLIGENCE INFORMATION e. PERFORM SERVICES ONLY
(1) Sensitive Compartmented Information (SCI) f. HAVE ACCESS TO U.S. CLASSIFIED INFORMATION OUTSIDE THE U.S., PUERTO RICO, U.S. POSSESSIONS AND TRUST TERRITORIES
(2) Non-SCI g. BE AUTHORIZED TO USE THE SERVICES OF DEFENSE TECHNICAL INFORMATION
CENTER (DTIC) OR OTHER SECONDARY DISTRIBUTION CENTER
f. SPECIAL ACCESS INFORMATION h. REQUIRE A COMSEC ACCOUNT
g. NATO INFORMATION i. HAVE TEMPEST REQUIREMENTS
h. FOREIGN GOVERNMENT INFORMATION j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS
i. LIMITED DISSEMINATION INFORMATION k. BE AUTHORIZED TO USE THE DEFENSE COURIER SERVICE
j. FOR OFFICIAL USE ONLY INFORMATION l. OTHER (Specify)
k. OTHER (Specify)
DD FORM 254, May 2010 PREVIOUS EDITION IS OBSOLETE.
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12. PUBLIC RELEASE. Any information (classified or unclassified) pertaining to this contract shall not be released for public dissemination except as provided by the Indus trial 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 Direct Through (Specify) to the Directorate for Freedom of Information and Security Review, Office of the Assistant Secretary of Defense (Public Affair)s* 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 fu rnished or generated under this contract;
and to submit any questions for interpretation of this guidance to the off icial 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 documen ts/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. 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 cognizant security off ice. Use Item 13 if additional space is needed.)
15. INSPECTIONS. Elements of this contract are outside the inspection responsibility of the cognizant security office. Yes No
(If Yes, explain and identify specific areas or elements carved out and the activity responsible for inspections. Use Item 1 3if 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 off icial named below.
a. TYPED NAME OF CERTIFYING OFFICIAL b. TITLE c. TELEPHONE (Include Area Code)
d. ADDRESS (Include Zip Code) 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
e. SIGNATURE
DD FORM 254 (BACK), May 2010
13. SECURITY GUIDANCE. (CON'T.)
Solicitation or Contract #__________________________________________ Page # ________ of _________
DD FORM 254 (13 CON'T.), MAY 2010
DD FORM 254, SECURITY SIGNATURE PAGE
Contract Number:
CERTIFICATION AND SIGNATURES: “Security requirement stated herein are completed and adequate for safeguarding the classified information to be release or generated under this classified effort. All questions shall be referred to the official named below.”
Security Office Approved Date
Name:
Title:
Security Office Approved Date
Name:
Title:
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| a FACILITY CLEARANCE REQUIRED: Secret |
| b LEVEL OF SAFEGUARDING REQUIRED: None |
| DATE YYYYMMDD: |
| REVISION NO: |
| DATE YYYYMMDD_2: |
| c SOLICITATION OR OTHER NUMBER: HC1047-16-R-4008 |
| DATE YYYYMMDD_3: |
| Classified material received or generated under: HC1028-10-F-2796 |
| undefined: N/A |
| a NAME ADDRESS AND ZIP CODE: TBD |
| b CAGE CODE: |
| c COGNIZANT SECURITY OFFICE Name Address and Zip Code: |
| a NAME ADDRESS AND ZIP CODE_2: |
| b CAGE CODE_2: |
| c COGNIZANT SECURITY OFFICE Name Address and Zip Code_2: |
| a LOCATION: DISA HQ Fort Meade |
6910 Cooper Ave Fort Meade, MD 20755 Resource Management Center (RMC) Development and Business Center (DBC)
| b CAGE CODE_3: |
| c COGNIZANT SECURITY OFFICE Name Address and Zip Code_3: |
| 9 GENERAL IDENTIFICATION OF THIS PROCUREMENT: DISA Cost/Business Analysis and Financial Management Support DDCM50020 |
| a TYPED NAME OF CERTIFYING OFFICIAL: Alexander R. Diaz |
| b TITLE: Contracting Officer Representative |
| c TELEPHONE Include Area Code: |
| 13 SECURITY GUIDANCECONT Solicitation or Contract Page of: Reference Block 10j: Contractor will be provided with and will abide by DoD Regulation 5400.7, DoD Freedom of Information Act Program, and DoD 5200.01-M, Information Security Program. |
Reference Block 11a: Contract performance and access to classified is limited to DISA HQ, Ft Meade MD. Contractor will require access to information up to the Secret level to develop PWS scope requirements, attend meetings and briefings, and access to data containing sensitive and/or classified information. The using contractor or Government activity will provide security classification guidance for the performance of this contract.
Reference block 11l: ADP/IT-II access required.
| Solicitation or Contract: Insert solicit number |
| Page: 3 |
| of: 4 |
| Contract Number: Insert solicitation # |
| Name: Dontia Costin |
| Title: |
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| Approved Date: |
| Approved Date_2: |
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| Text66: Public release is not authorized. |
| Text67: General Information: |
All classified visit request by contractors shall be forwarded to the Contracting Officer Representative (COR) for approval and need -to-know certification before being sent to the facility to be visited.
All visit access requests (VARs) by contractors shall be sent via the Joint Personnel Adjudication System (JPAS) to the DISA VAR Center (JPAS SMO:DKABAA10) or appropriate SMO for the effort. The COR/TM must approve the VAR prior to sending the request to the facility being visited. Contractors must also provide a copy of the VAR to the security manager.
The COR/TM must be notified and approve the receipt and/or generation of classified information under this contract.
All classified information received and/or generated under this contract is the property of the U.S. Government regardless of proprietary claims. Upon completion or termination of this contract, the U.S. Government will be contacted for destruction or disposition instructions.
Foreign Nationals will not perform on any area of the contract (classified or unclassified).
| Text68: |
| Text69: |
| Check Box70: Off |
| Check Box71: Yes |
| Check Box72: Off |
| Check Box73: Yes |
| Text74: DISA HQ |
PO Box 549 Ft Meade, MD 20755
| Check Box76: Yes |
| Check Box77: Off |
| Check Box78: Yes |
| Check Box79: Off |
| Check Box80: Yes |
| Check Box81: Off |
| Button84: |
| Button85: |
| Text4: |
| Text5: ADP/IT-Level II access Required. |
| retention of the classified material is authorized for the period of: N/A |
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