Attachment 8 J-H2 DD254 SECURITY CLASSIFICATION FORM 3.pdf

PDF 418 KB Posted

Attached to
Construction Management Technical Support Service Requirement (CMTSS)
Solicitation number
HQ0034-12-R-0002
Issued by

About this file

J-H2 DD-254 Security Classification Form

View the file

Other files

Show all 15

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

Text version

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)

a. PRIME CONTRACT NUMBER

b. SUBCONTRACT NUMBER

c. SOLICITATION OR OTHER NUMBER DUE DATE (YYYYMMDD)

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

a. ORIGINAL (Complete date in all cases)

REVISION NO.

c. FINAL (Complete Item 5 in all cases)

DATE (YYYYMMDD)

b. REVISED (Supersedes all previous specs)

DATE (YYYYMMDD)

DATE (YYYYMMDD)

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: 11. IN PERFORMING THIS CONTRACT, THE CONTRACTOR WILL:YES NO YES NO

a. COMMUNICATIONS SECURITY (COMSEC) INFORMATION

b. RESTRICTED DATA

c. CRITICAL NUCLEAR WEAPON DESIGN INFORMATION

d. FORMERLY RESTRICTED DATA

e. INTELLIGENCE INFORMATION

(1) Sensitive Compartmented Information (SCI)

(2) Non-SCI

f. SPECIAL ACCESS INFORMATION

g. NATO INFORMATION

h. FOREIGN GOVERNMENT INFORMATION

i. LIMITED DISSEMINATION INFORMATION

j. FOR OFFICIAL USE ONLY INFORMATION

k. OTHER (Specify)

a. HAVE ACCESS TO CLASSIFIED INFORMATION ONLY AT ANOTHER

CONTRACTOR'S FACILITY OR A GOVERNMENT ACTIVITY

b. RECEIVE CLASSIFIED DOCUMENTS ONLY

c. RECEIVE AND GENERATE CLASSIFIED MATERIAL

d. FABRICATE, MODIFY, OR STORE CLASSIFIED HARDWARE

e. PERFORM SERVICES ONLY

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

h. REQUIRE A COMSEC ACCOUNT

i. HAVE TEMPEST REQUIREMENTS

j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS

k. BE AUTHORIZED TO USE THE DEFENSE COURIER SERVICE

l. OTHER (Specify)

DD FORM 254, DEC 1999 PREVIOUS EDITION IS OBSOLETE. Adobe Professional 7.0

12. PUBLIC RELEASE. Any information (classified or unclassified) pertaining to this contract shall not be released for public dissemination except as provided by the Industrial 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

a. TYPED NAME OF CERTIFYING OFFICIAL

Direct Through (Specify)

d. ADDRESS (Include Zip Code)

Yes No to the Directorate for Freedom of Information and Security Review, Office of the Assistant Secretary of Defense (Public Affairs)* 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 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. Add additional pages as needed to provide complete guidance.)

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

(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 office. Use Item 13 if additional space is needed.)

Yes No15. INSPECTIONS. Elements of this contract are outside the inspection responsibility of the cognizant security office.

(If Yes, explain and identify specific areas or elements carved out and the activity responsible for inspections. Use Item 13 if 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 official named below.

b. TITLE c. TELEPHONE (Include Area Code)

e. SIGNATURE

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

DD FORM 254 (BACK), DEC 1999

fac_clear: SECRET
safe_level: None
prime_no:
xprime: Yes
sub_no:
xsub: Off
xsolic: Off
solic_no:
due_date:
xspec3: Orig
orig_date:
rev_no:
rev_date:
final_date:
xfollowon: No
prec_no:
xfinal: No
req_dated:
period:
ctr_name:
ctr_cage:
ctr_ofc:
sub_name:
sub_cage:
sub_ofc:
perf_loc: Pentagon Reservation, Arlington, VA, Mark Center, Alexandria, VA, and the Raven Rock Mountain Complex (RRMC) in Adams County, PA.
perf_cage:
perf_ofc: WHS/FSD/SEMO

1155 Defense Pentagon Washington, DC 20301-1155

gen_id: The contractor shall provide all personnel, equipment, tools, materials, supervision and non-personal services necessary to perform construction management technical support services for the Department of Defense (DoD), Washington Headquarters (WHS), Facilities Services Directorate (FSD) as defined in this Performance Work except for those items specified as government furnished property and services. The contractor shall perform to the standards in this contract.
x10a: No
x10b: No
x10c: No
x10d: No
x10e1: No
x10e2: No
x10f: No
x10g: No
x10h: No
x10i: No
x10j: Yes
x10k: Yes
other10k:
x11a: Yes
x11b: Yes
x11c: Yes
x11d: Yes
x11e: Yes
x11f: Yes
x11g: Yes
x11h: Yes
x11i: Yes
x11j: Yes
x11k: Yes
x11l: Yes
other11l:
xrelease: No
release_thru: Washington Headquarters Service (WHS) Acquisition Directorate (AD) Contracting Officer
guidance: In accordance with the DD254, the contractor shall submit with its proposal written verification of an ACTIVE Facility Security Clearance (FCL) at the SECRET Level. Failure to provide the required FCL will result in rejection of the proposal. All personnel working on this contract must have at a minimum a favorably adjudicated National Agency Check w/Inquires (NACI). Personnel working at the RRMC will require a SECRET clearance.

- Pentagon Building Pass The contractor shall submit completed DD Form 2249 (DoD building pass application) for each employee working on this contract. These forms shall be submitted to the FSD security office not later than five (5) calendar days after contract award and each time a new employee is hired. The government will issue a DoD identification badge to each contract employee directly supporting this contract upon completion of a favorable NCIC check. The contractor shall ensure that each of its employees displays the appropriate identification badge at all times while working at the various project locations. The contractor shall also ensure that identification badges for any employee who is terminated or resigns are returned to the contracting officer immediately following termination or resignation.

- Common Access Card (CAC) A CAC is issued primarily to those contractor personnel with a requirement for access to DoD information systems. The contractor shall provide a list of names to the contracting officer /government customer for verification. The contractor shall comply with instructions from the government customer and security office to complete this process. The contractor shall have a minimum of a favorably completed National Agency Check w/Inquires (NACI) for issuance of a CAC. Contractor shall return CACs to the contracting officer when expired or terminated from this contract. Lost CACs must be reported to the contracting officer immediately in writing.

xaddlsec: No
addl_sec:
xinsp: No
inspections:
cert_name:
cert_title:
cert_phone:
cert_addr:
cert_sign:
x17a: Off
x17b: Off
x17c: Off
x17d: Off
x17e: Off
x17f: Off
other_dist:
Reset:

File details come from the government source that posted it. Updated .