A23_Attachment_1_-_DD254.pdf

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Attached to
Mobility Modeling & Analysis Support for OSD CAPE Federal contract opportunity
Solicitation number
HQ0034-17-R-0083
Issued by
DOD Washington Headquarters Service

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A23 Attachment 1 - DD254

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HQ0034-17-R-0083-0001.pdf PDF
A23_Attachment_2_-_CAPE_Non_Disclosure_Agreement.docx DOCX document
A23_HQ0034-17-R-0083.pdf PDF

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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)

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.

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 classifiection 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

a_FACILITY_CLEARANCE_REQU: SECRET
b_LEVEL_OF_SAFEGUARDING_R: NONE
FillText1: Off
a_PRIME_CONTRACT_NUMBER: TBD
DATE_YYYYMMDD: 2017/02/01
FillText3: Off
b_SUBCONTRACT_NUMBER:
REVISION_NO:
DATE_YYYYMMDD1:
FillText5: Yes
c_SOLICITATION_OR_OTHER_N: HQ0034-17-R-0083
DUE_DATE_YYYYMMDD: 20170509
DATE_YYYYMMDD2:
YES1:
FillText12:
FillText11:
a_NAME_ADDRESS_AND_ZIP_CO: TBD
b_CAGE_CODE: TBD
c_COGNIZANT_SECURITY_OFFI: TBD
a_NAME_ADDRESS_AND_ZIP_C1: N/A
b_CAGE_CODE1: N/A
c_COGNIZANT_SECURITY_OFF1: N/A
a_LOCATION: See Item 13
b_CAGE_CODE2:
c_COGNIZANT_SECURITY_OFF2:
9_GENERAL_IDENTIFICATION: Contractor will be doing modeling, simulation, data warehousing, operations research and software development
a_COMMUNICATIONS_SECURIT1: Off
a_COMMUNICATIONS_SECURIT2: Yes
b_RESTRICTED_DATA1: Yes
b_RESTRICTED_DATA2: Off
c_CRITICAL_NUCLEAR_WEAPO1: Off
c_CRITICAL_NUCLEAR_WEAPO2: Yes
d_FORMERLY_RESTRICTED_DA1: Yes
d_FORMERLY_RESTRICTED_DA2: Off
1_Sensitive_Compartmente1: Off
1_Sensitive_Compartmente2: Yes
2_NonSCI1: Yes
2_NonSCI2: Off
f_SPECIAL_ACCESS_INFORMA1: Off
f_SPECIAL_ACCESS_INFORMA2: Yes
g_NATO_INFORMATION1: Yes
g_NATO_INFORMATION2: Off
h_FOREIGN_GOVERNMENT_INF1: Yes
h_FOREIGN_GOVERNMENT_INF2: Off
i_LIMITED_DISSEMINATION_1: Off
i_LIMITED_DISSEMINATION_2: Yes
j_FOR_OFFICIAL_USE_ONLY_I: Yes
j_FOR_OFFICIAL_USE_ONLY_1: Off
k_OTHER_Specify: Off
k_OTHER_Specify1: Yes
a_COMMUNICATIONS_SECURIT3: Yes
a_COMMUNICATIONS_SECURIT4: Off
b_RESTRICTED_DATA3: Off
b_RESTRICTED_DATA4: Yes
c_CRITICAL_NUCLEAR_WEAPO3: Off
c_CRITICAL_NUCLEAR_WEAPO4: Yes
d_FORMERLY_RESTRICTED_DA3: Off
d_FORMERLY_RESTRICTED_DA4: Yes
e_INTELLIGENCE_INFORMATI3: Yes
e_INTELLIGENCE_INFORMATI4: Off
1_Sensitive_Compartmente3: Off
1_Sensitive_Compartmente4: Yes
2_NonSCI3: Yes
2_NonSCI4: Off
f_SPECIAL_ACCESS_INFORMA3: Off
f_SPECIAL_ACCESS_INFORMA4: Yes
g_NATO_INFORMATION3: Off
g_NATO_INFORMATION4: Yes
h_FOREIGN_GOVERNMENT_INF3: Off
h_FOREIGN_GOVERNMENT_INF4: Yes
i_LIMITED_DISSEMINATION_3: Off
i_LIMITED_DISSEMINATION_4: Yes
1_OTHER_Specify: Classified ADP processing will be involved. All provisions of DoD Information Technology Security Certification and Accreditation Process (DITSCAP) apply.
FillText13: Yes
FillText14: Off
a_TYPED_NAME_OF_CERTIFYIN: Carl A. Lude
b_TITLE: Government Program Manager
c_TELEPHONE_Include_Area: 703-695-6732
d_ADDRESS_Include_Zip_Cod: OSD/CAPE Projection Forces Division

1800 DEFENSE PENTAGON

WASHINGTON, DC 20301-1800

2017-02-07T07:50:44-0500
LUDE.CARL.A.1175917469
FillText21: Yes
FillText22: Off
FillText23: Yes
FillText24: Off
FillText25: Yes
FillText26: Off
f_OTHERS_AS_NECESSARY:
FillText15:
FillText16:
other1:
release: Directorate for Freedom of Information and Security Review

Room 3A1066 1155 Defense Pentagon Washington, D.C. 20301-1155 security:

PFPA-SSD___________________________________ Government Program Manager_______________________________ All applicable provisions of DoD 5220.22M apply.

8a/11a. Using activity will furnish complete classification guidance for the service to be performed. Contract performance (all classified computer processing) is restricted to government areas occupied/controlled by the Director, Cost Assessment and Program Evaluation.

10.j. FOUO Information under this contract shall be safeguarded as specified in DoD 5400.7-R, Protecting For Official Use Only (FOUO) Information.

10.k. All contractor personnel who have access to classified information must possess a SECRET security clearance. Director, Cost Assessment and Program Evaluation will provide security classification guidance for performance of this contract.

11.e. Actual knowledge of, generation, or production of classified information is not required for performance of this contract. Cleared personnel are required because security measures enforcement does not preclude access to classified information. Prior approval of the contract monitor is required for subcontracting. Only with the expressed permission of the government contract monitor may the contractor reproduce any classified information/material. All requirements for control and accounting for original documentation and copies apply.

addit_sec:
Inspections:
Reset:
4_Yes: Off
4_No: No
5_Yes: Off
5_No: No
12_Public_Release_Direct: Off
12_Public_Release_Through: Through.
13_Rules:
13_2:
14_Yes: Off
14_No: No
15_Yes: Off
15_No: No
3_A: Original.
3_B: Off
3_C: Off
2017-02-16T09:33:17-0500
DELULLO.MARK.DEAN.1384822548
2017-02-07T07:44:56-0500
LUDE.CARL.A.1175917469

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