A23_Attachment_No._02__DRAFT_DD_254.pdf

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Attached to
DSB Summer Study Federal contract opportunity
Solicitation number
HQ0034-17-R-0276
Issued by
DOD Washington Headquarters Service

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A23 Attachment No. 02 DRAFT DD 254

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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.

DRAFT

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

DRAFT

a_FACILITY_CLEARANCE_REQU: TOP SECRET
b_LEVEL_OF_SAFEGUARDING_R: TOP SECRET
FillText1: Yes
a_PRIME_CONTRACT_NUMBER: HQ0034-17-R-0226
DATE_YYYYMMDD:
FillText3: Off
b_SUBCONTRACT_NUMBER:
REVISION_NO:
DATE_YYYYMMDD1:
FillText5: Off
c_SOLICITATION_OR_OTHER_N:
DUE_DATE_YYYYMMDD:
DATE_YYYYMMDD2:
YES1:
FillText12:
FillText11:
a_NAME_ADDRESS_AND_ZIP_CO:
b_CAGE_CODE:
c_COGNIZANT_SECURITY_OFFI:
a_NAME_ADDRESS_AND_ZIP_C1:
b_CAGE_CODE1:
c_COGNIZANT_SECURITY_OFF1:
a_LOCATION:
b_CAGE_CODE2:
c_COGNIZANT_SECURITY_OFF2:

9_GENERAL_IDENTIFICATION:

Provide analytical, technical and administrative support to the Defense Science Board.

a_COMMUNICATIONS_SECURIT1: Off
a_COMMUNICATIONS_SECURIT2: Yes
b_RESTRICTED_DATA1: Yes
b_RESTRICTED_DATA2: Off
c_CRITICAL_NUCLEAR_WEAPO1: Yes
c_CRITICAL_NUCLEAR_WEAPO2: Off
d_FORMERLY_RESTRICTED_DA1: Yes
d_FORMERLY_RESTRICTED_DA2: Off
1_Sensitive_Compartmente1: Yes
1_Sensitive_Compartmente2: Off
2_NonSCI1: Yes
2_NonSCI2: Off
f_SPECIAL_ACCESS_INFORMA1: Yes
f_SPECIAL_ACCESS_INFORMA2: Off
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: Yes
k_OTHER_Specify1: Off
a_COMMUNICATIONS_SECURIT3: Off
a_COMMUNICATIONS_SECURIT4: Yes
b_RESTRICTED_DATA3: Off
b_RESTRICTED_DATA4: Yes
c_CRITICAL_NUCLEAR_WEAPO3: Yes
c_CRITICAL_NUCLEAR_WEAPO4: Off
d_FORMERLY_RESTRICTED_DA3: Yes
d_FORMERLY_RESTRICTED_DA4: Off
e_INTELLIGENCE_INFORMATI3: Off
e_INTELLIGENCE_INFORMATI4: Yes
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: Yes
h_FOREIGN_GOVERNMENT_INF4: Off
i_LIMITED_DISSEMINATION_3: Yes
i_LIMITED_DISSEMINATION_4: Off
1_OTHER_Specify: SEE ATTACHMENT 1
FillText13: Yes
FillText14: Off
a_TYPED_NAME_OF_CERTIFYIN:
b_TITLE:
c_TELEPHONE_Include_Area:
d_ADDRESS_Include_Zip_Cod: Defense Science Board

3140 Defense Pentagon Washington D.C. 20301-3140

e_SIGNATURE:
FillText21: Yes
FillText22: Off
FillText23: Yes
FillText24: Off
FillText25: Yes
FillText26: Off
f_OTHERS_AS_NECESSARY:
FillText15:
FillText16:
other1: SEE ATTACHMENT 1
release: Director Freedom of Information & Security Review, 3100 Defense Pentagon, Room 2C757, Washington, DC 20301.

Public release of SCI/Non-SCI information is not authorized unless granted by written approval from the OUSD(I). SSO DIA, Bolling AFB, Washington, DC 20330 and OUSD(I). Public release of SAP portions of the contract are not authorized.

security:

Defense Science Board, 3140 Defense Pentagon, Rm. 3B888A, Washington, DC 20301 SSO DIA 3100 Clarendon Blvd., Arlington, VA 22201-5300 Directorate for Executive Services Freedom of Information & Security Review Office - 1155 Defense Pentagon, Washington, DC 20301

Contractor will have access to classified source data up to and including Top Secret SCI. Access to Top Secret SCI data will occur at the contractor facility as well as government facility as directed by the COR. Any extracts or use of Secret data will require the contractor to apply derivative classification and marking consistent with the source from extracts were made.

Contractor will have retention authority for all classified material from previous contracts as part of the contract and FOIA requirements.

Courier authorization is granted to contractor based on appropriate clearance level to Top Secret/SCI.

Contractor will be required to process classified information using Automated Information Systems (AIS)

(SEE ATTACHMENT 1)

addit_sec: SEE ATTACHED. SCI/Non-SCI Release of Intelligence for additional security requirements. Access to intelligence information requires special briefings and a U. S. Government clearance at appropriate level TS/SCI as designated by government program manager. Prior approval by contracting activity is required for subcontracting.
Inspections: SEE ATTACHED. SSO DIA has exclusive responsibility for all SCI classified material released to or developed under this contract. DSS is relieved of security inspection responsibility for all such material. DIA is responsible for reviewing all the contract's SCIF documentation to ensure compliance with SCIF regulations. DSS retains oversight responsibility for collateral information.
Reset:
4_Yes: Yes
4_No: Off
5_Yes: Off
5_No: No
12_Public_Release_Direct: Off
12_Public_Release_Through: Through.
13_Rules:
13_2:
14_Yes: Yes
14_No: Off
15_Yes: Yes
15_No: Off
3_A: Off
3_B: Off
3_C: Off

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