20140312_HCMO_HS0021-14-R-0044_DD254_Redacted.pdf

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

b. LEVEL OF SAFEGUARDING REQUIRED

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

a. CONTRACT NUMBER

b. SUBCONTRACT NUMBER

c. DUE DATE (YYYYMMDD)

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

a. (Complete date in all cases)

REVISION NO.

c. (Complete Item 5 in all cases)

DATE (YYYYMMDD)

b. REVISED (Supersedes all previous specs)

DATE (YYYYMMDD)

DATE (YYYYMMDD)

4. THIS A FOLLOW-ON CONTRACT? YES NO. Yes, complete the following:

Classified material received or generated under (Preceding Contract Number) is transferred to this follow-on contract.

5. THIS A FINAL DD FORM 254? YES NO. Yes, complete the following:

In response to the contractor's request dated , retention of the classified material is authorized for the period of

6. (Include Commercial and Government Entity (CAGE) Code)

a. ADDRESS, AND ZIP CODE b. CAGE CODE c. SECURITY OFFICE (Name, Address, and Zip Code)

7.

a. ADDRESS, AND ZIP CODE b. CAGE CODE c. SECURITY OFFICE (Name, Address, and Zip Code)

8. PERFORMANCE

a. b. CAGE CODE c. SECURITY OFFICE (Name, Address, and Zip Code)

9. 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.

g. NATO INFORMATION

h. FOREIGN GOVERNMENT INFORMATION

i. LIMITED DISSEMINATION INFORMATION

j. FOR OFFICIAL USE ONLY INFORMATION

k. (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. (Specify)

PRIME

SOLICITATION OR OTHER NUMBER

ORIGINAL

FINAL

IS If

IS If

CONTRACTOR

NAME, COGNIZANT

SUBCONTRACTOR

NAME, COGNIZANT

ACTUAL

LOCATION COGNIZANT

GENERAL

SPECIAL ACCESS INFORMATION

OTHER

OTHER

DD FORM 254, DEC 1999 PREVIOUS EDITION IS OBSOLETE.

FOR OFFICIAL USE ONLY

FOR OFFICIAL USE ONLY

a. FACILITY CLEARANCE REQUIRED

SECRET

None

HS0021-14-R-0044 2014/03/26

20140305

XYZ Company

STREET ADDRESS

CITY, STATE, ZIP

The Contractor shall conduct an analysis of an estimated 21% of the existing DSS workforce to ensure competency gaps are identified for critical skills competencies. An assessment shall also be conducted to project trends in the workforce that include losses due to retirement and other attrition. The contractor shall develop the appropriate career paths for the workforce identified in the PWS.

See Block 13. SECURITY GUIDANCE

(1) Information Technology

(2) Personnel Security

(3) Site Access

Reset

TBD

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 hall 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 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 refereced herin. Add additional pages as needed to provide com plete guiance.)

14. 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. 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. questions shall be referred to the official named below.

b. TITLE c. TELEPHONE (Include Area Code)

e. SIGNATURE

17. DISTRIBUTION

a. CONTRACTOR

b. SUBCONTRACTOR

e. ADMINISTRATIVE CONTRACTING OFFICER f.

ADDITIONAL SECURITY REQUIREMENTS.

INSPECTIONS.

All

REQUIRED

OTHERS AS NECESSARY

DD FORM 254 (BACK), DEC 1999

FOR OFFICIAL USE ONLY

FOR OFFICIAL USE ONLY

c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR.

d. U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECURITY ADMINISTRATION

Defense Security Service

Item 10 (j) - FOR OFFICIAL USE ONLY (FOUO):

- All contract documents generated are considered sensitive unless otherwise specified, and remain the property of the U. S.

Government. Public release of information by the contractor or subcontractor(s) is not authorized. The contractor is not authorized to use information developed or resulting from this contract in any advertising without prior review and written approval from the Directorate for Executive Services, Freedom of Information and Security Review Office, and the Defense Security Service.

- The contractor shall not release any information to any activity or person, including subcontractors, without the CO's written approval. Only with the expressed permission of the CO may the contractor reproduce any information/material pertaining to this contract. All requirements for control and accounting for original documentation and copies apply. All applicable provisions of the NISPOM and its supplements apply.

Item 11 (e)

- All information received or generated under this contract is the property of the U. S. Government. At the termination/completion of this contract, the U. S. Government shall provide disposition instructions. Actual knowledge of information may be required in the performance of this contract. Eligible personnel are required to perform this service as access to information cannot be precluded.

- The contractor shall not release any classified information to any activity or person, including sub-contractors, without the CO's written approval. Only with the expressed permission of the CO may the contractor reproduce any information/material pertaining to this contract. All requirements for control and accounting for original documentation and copies apply.

Defense Security Service Chief Security Officer, 27130 Telegraph Road Quantico, VA 22134

DSS Chief Security Officer

HARRISON.TIMOTHY.

W.

DD FORM 254 (CONTINUATION)

FOR OFFICIAL USE ONLY

FOR OFFICIAL USE ONLY

BLOCK 13. SECURITY GUIDANCE (Continued)

Item 11 l (l) Information Technology and Item 11l (3) Site Access

- Contractor personnel (including subcontractors) requiring access to DoD Information Systems in the performance of this contract will be granted IT access upon verification of the required personnel clearance for this contract. The Government shall provide a Common Access Card (CAC) to contractors as required by their position,

- Transmission of DSS or other Governmental information shall be protected through the use of DoD Public Key Infrastructure (PKI) encryption or DoD approved equivalent.

Item 11 l (2) Personnel Security

- The personnel security requirement for all Contractor personnel, to include any Subcontractors working on this project, is a final Secret clearance.

- Within 10 days of contract award, the Prime contractor shall send a Visit Authorization Request (VAR) to the DSS Security Office using the Joint Personnel Adjudication System (SMO Code: DSSHQSEC) for all management, supervisory, and design personnel validating eligibility for Secret level clearance. Change in contract personnel must be reported to the DSS Security Office via JPAS within three business days. Notification of new personnel must be forwarded to the DSS Security Office via JPAS three business days prior to a contractor's start date. Failure to provide security eligibility information shall delay and/or deny the individual access to DSS and DoD facilities and information.

Contractor personnel will have a Periodic Reinvestigation (PR) conducted every ten (10) years as defined by DoD 5200.2-R, Personnel Security Program. Selectees with an NACLC over ten years old must submit an e-QIP for an NACLC to their company Facility Security Officer (FSO) immediately upon hiring for initiation of an NACLC.

Vendor shall provide employees with a Level 1 Antiterrorism (AT) Awareness Briefing as part of the orientation process and will provide employees with any subsequent required briefings as outlined in DoD Instruction 2000.16 DoD Antiterrorism Standards, dated October 2, 2006, paragraph E3.25.1.2. or as required by DoD or DSS regulations.

Contractor personnel shall complete any briefings as required by the Defense Security Service.

DD FORM 254 (CONTINUATION)

FOR OFFICIAL USE ONLYDD FORM 254 (CONTINUATION)

REVIEWS/APPROVALS

PROJECT OFFICER:

COMMENTS

DEFENSE SECURITY SERVICE

CHIEF SECURITYOFFICER:

COMMENTS

HARRISON.TIMO

THY.W.