HSAM Appendix G STATION SEATTLE ARMORY IDS.pdf
PDF 299 KB Posted
- Attached to
- IDS Upgrade for USCG Station Seattle Armory
- Solicitation number
- USCG-SPS-0006
About this file
This document is an Individual or Class Checklist for Controlled Unclassified Information (CUI) related to a federal contract opportunity. The checklist is used to identify the types of CUI that may be accessed during the acquisition, the security and privacy requirements that must be included in the solicitation and resulting contract, and the continuous monitoring data requirements if federal information systems will be used to process CUI. The required signatures indicate the review and approval by various government stakeholders.
The related federal contract opportunity is for the upgrade of the Intrusion Detection System (IDS) at the U.S. Coast Guard Station Seattle Armory. The solicitation, issued as a Request for Quotation (RFQ), seeks commercial products or services to furnish and install a new IDS panel and sensors. The contract will be awarded to the small business offeror submitting the lowest priced, technically acceptable proposal. The associated NAICS code is XXXX with a small business size standard of $25M. Quotes are due by the offer due date and time specified in the solicitation.
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| File | Type | Posted |
|---|---|---|
| Statement of Work.pdf | ||
| SF1449 for Solicitation.pdf |
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Text version
October 2009 HSAM Appendix G
G-1 HSAM Notice 2023-10
APPENDIX G
INDIVIDUAL OR CLASS CHECKLIST FOR CONTROLLED UNCLASSIFIED
INFORMATION
INDIVIDUAL CHECKLIST FOR CONTROLLED UNCLASSIFIED INFORMATION
Procurement Title: ______________________ Requisition #: _______________________ Estimated Contract Value (incl. options): __________________________________________
Instructions: The requiring office shall complete this checklist for all acquisitions, including assisted acquisitions, regardless of dollar value. The requiring official shall ensure the Statement of Work, Statement of Objective, Performance Work Statement or specification is reviewed by the organizations identified at HSAM 3004.470(b) and obtain signatures, as applicable, on this checklist when the requiring official determines that (1) contractor and/or subcontractor employees require recurring access to government facilities or access to controlled unclassified information (CUI); (2) CUI will be collected or maintained on behalf of the agency; or (3) Federal information systems, which include contractor information systems operated on behalf of the agency, will be used to collect, process, store, or transmit CUI. If it is not clear to the requiring official if the contractor will have access to CUI and/or Federal information systems, which include contractor information systems operated on behalf of the agency, will be used to collect, process, store, or transmit CUI, the requirements official shall at a minimum consult with the Component Chief Information Officer (CIO), Chief Security Officer (CSO) and Privacy Officer. The requiring office shall submit the completed checklist as part of the procurement request package in accordance with HSAM 3004.7101. Failure to submit a completed checklist will result in the return of the procurement request package. The contracting officer is responsible for routing the checklist to the Head of Contracting Activity (HCA) or designee for signature and ensuring the solicitation and resultant contract reflect the requirements contained in the checklist.
A. Controlled Unclassified Information and Access Requirements (completed by the requiring office):
1. Will the contractor have access to any of the types of CUI (see CUI definition in HSAR 3002.101) listed below during the acquisition?
Yes No Chemical-terrorism Vulnerability Information (CVI) Yes No Homeland Security Agreement Information Yes No Homeland Security Enforcement Information Yes No Information Systems Vulnerability Information (ISVI) Yes No International Agreement Information Yes No Operations Security Information Yes No Personnel Security Information Yes No Physical Security Information Yes No Protected Critical Infrastructure Information (PCII) Yes No Personally Identifiable Information (PII) Yes No Sensitive PII (SPII)
USCG STA SEATTLE ARMORY IDS
G-2 HSAM Notice 2023-10
Yes No Sensitive Security Information (SSI) Other type of CUI _______________________________________
Note: If the answer is “Yes” to any of the information types listed above, the contracting officer shall include HSAR 3052.204-72 Safeguarding of Controlled Unclassified Information in the solicitation and resultant contract. If “Yes” is answered for PII and/or SPII, the contracting officer shall also include HSAR 3052.204-73 Notification and Credit Monitoring Requirements for Personally Identifiable Information Incidents in the solicitation and resultant contract.
2. Will contractor employees have access to DHS information systems? Yes No
3. Will contractor employees require recurring access to Government facilities?
Yes No
Note: If the answer is “No” to questions 1 through 3, proceed to the Signatures section of the checklist. When the answer is “No” to questions 1 through 3, the checklist shall, at a minimum, be signed by the requiring official and the HCA (or designee).
4. If the answer is “Yes” to any of questions 1 through 3, identify the information security, personnel security, and privacy clauses and provisions to be included in the solicitation and resultant contract:
Yes No FAR 52.224-3 Privacy Training – Alternate I (see FAR Class Deviation 17-03, Revision 1)
Yes No HSAR 3052.204-71 Contractor Employee Access Yes No HSAR 3052.204-71 Contractor Employee Access Alt I Yes No HSAR 3052.204-71 Contractor Employee Access Alt II Yes No HSAR 3052.204-72 Safeguarding of Controlled Unclassified
Information Yes No HSAR 3052.204-72 Safeguarding of Controlled Unclassified
Information Alt I Yes No HSAR 3052.204-73 Notification and Credit Monitoring
Requirements for Personally Identifiable Information Incidents Yes No Special Clause Information Technology Security Awareness Training
(see HSAR Class Deviation 15-01, Revision 1) Yes No Other: _____________________________________________________
5. If foreign end products or services are allowed under the contract, what additional security provisions are to be included in the solicitation to protect CUI and facilities from unauthorized access and disclosure? __________________________________________
G-3 HSAM Notice 2023-10
B. Authority to Operate (ATO) and Continuous Monitoring Data Requirements (completed by requiring office in coordination with Component CIO or designee):
1. Will Federal information systems, which include contractor information systems operated on behalf of the agency, be used to collect, process, store, or transmit CUI ?
Yes No
2. If “Yes” to #1, has the requiring office coordinated development of the Security
Requirements Traceability Matrix (SRTM) with the Component CIO or designee for inclusion in the solicitation? Yes N/A (only if “No” to #1)
3. If “Yes” to #1, will the solicitation require the submission of a draft security plan and instructions on how the draft security plan will be evaluated? Yes N/A (only if “No” to #1)
4. If “Yes” to #1, does the requirements document identify how the contractor should submit monthly continuous monitoring data to the Government? Yes N/A (only if “No” to #1)
5. If “Yes” to #1, identify and describe the continuous monitoring data requirements to be included in the solicitation.
Note: When Federal information systems, which include contractor information systems operated on behalf of the agency, will be used to collect, process, store, or transmit CUI , the SRTM shall be included in the solicitation. The SRTM is prepared by the Component CIO or designee in coordination with the requiring office and shall be included in the procurement request package as an attachment to the requirements document (i.e., Statement of Work, Statement of Objectives, Performance Work Statement). Contracting officers shall ensure the solicitation requires vendors to submit a draft security plan with their proposal/quotation as their response to the SRTM. Instructions on how the draft security plan will be evaluated shall be included in the solicitation.
C. Data Retention Requirements (completed by requiring office):
1. Will the contractor be required to retain CUI for the Government? Yes No
2. If “Yes” to #1, does the requirements document identify (a) retention requirements (e.g., length of time data must be retained before return and/or destruction) and (b) security requirements for the protection of retained data? Yes N/A (only if “No” to #1)
3. If “Yes” to #1, identify and describe the retention and security requirements to be included in the solicitation. _________________________________________________
G-4 HSAM Notice 2023-10
4. Does the Government have a plan to monitor and/or ensure contractor compliance with the retention and security requirements identified? Yes N/A (only if “No” to #1)
5. If “Yes” to #1, describe the Government’s plan to monitor and/or ensure contractor compliance with the retention and security requirements identified in the acquisition.
D. Additional Privacy Considerations (completed by requiring office in coordination with Component Privacy Officer or designee):
1. Is privacy compliance documentation (Privacy Threshold Analysis, Privacy Impact
Assessment, and/or System of Record Notice, as appropriate) required for this procurement? Yes No N/A
2. If “Yes” to #1, has any of the following privacy compliance documentation been completed?
Yes No N/A Privacy Threshold Analysis Yes No N/A Privacy Impact Assessment Yes No N/A System or Record Notice Yes No N/A Other: _____________________________________________
3. Is contractor support needed to complete privacy compliance documentation? Yes
No N/A
4. If contractor support is needed to complete the privacy compliance documentation, does the requirements document identify the activities and level of contractor support needed?
Yes N/A (only if “No” or “N/A” to #3)
5. If “Yes” to #3, identify and describe the activities and level of contractor support needed to complete the privacy compliance documentation.
Signatures:
Name Date Program Official (or official title) (DHS Component and Organization) (Telephone number)
G-5 HSAM Notice 2023-10
Component Chief Information Officer (CIO) or designee
Component Chief Security Officer (CSO) or designee
Component Privacy Officer or designee
TSA SSI Program Office, as applicable
CISA CVI Program Office, as applicable
CISA PCII Program Office, as applicable
Head of Contracting Activity or designee
G-6 HSAM Notice 2023-10
CLASS CHECKLIST FOR CONTROLLED UNCLASSIFIED INFORMATION
Title: ________________________________________________________________________
Class Description (Note: Each class Appendix G shall describe with reasonable specificity the class to which it applies. This description shall enable any objective reviewer to clearly determine the action reviewed falls within the scope of the class Appendix G.):
Estimated Value (including all actions anticipated): ___________________________________
Expiration Date (Note: The expiration date shall not exceed five years.) ___________________
Instructions: The requiring office may complete a class checklist when it is known that there will be multiple contract actions for the same or related supplies or services or other contract actions that require essentially identical justification (see HSAM 3004.470(d). The requiring official shall ensure the Statement of Work, Statement of Objective, Performance Work Statement or specification is reviewed by the organizations identified at HSAM 3004.470(b) and obtain signatures, as applicable, on this checklist when the requiring official determines that (1) contractor and/or subcontractor employees will require recurring access to government facilities or access to controlled unclassified information (CUI); (2) CUI will be collected or maintained on behalf of the agency; or (3) Federal information systems, which include contractor information systems operated on behalf of the agency, will be used to collect, process, store, or transmit CUI. If it is not clear to the requiring official if the contractor will have access to CUI and/or if Federal information systems, which include contractor information systems operated on behalf of the agency, will be used to collect, process, store, or transmit CUI, the requirements official shall at a minimum consult with the Component Chief Information Officer (CIO), Chief Security Officer (CSO) and Privacy Officer. The requiring office shall submit the completed checklist as part of the procurement request package in accordance with HSAM 3004.7101.
Failure to submit a completed checklist will result in the return of the procurement request package. The class checklist shall be approved at a level no lower than the Deputy Head of the Contracting Activity (HCA) or, for FLETC, the Deputy Chief of Procurement. The contracting officer is responsible for routing the checklist to the HCA or Deputy HCA/Deputy Chief of Procurement for signature and ensuring the solicitation and resultant contract reflect the requirements contained in the checklist.
A. Controlled Unclassified Information and Access Requirements (completed by the requiring office):
1. Will the contractor have access to any of the types of CUI listed below during the acquisition?
Yes No Chemical-terrorism Vulnerability Information (CVI) Yes No Homeland Security Agreement Information
USCG STA SEATTLE ARMORY IDS
G-7 HSAM Notice 2023-10
Yes No Homeland Security Enforcement Information Yes No Information Systems Vulnerability Information (ISVI) Yes No International Agreement Information Yes No Operations Security Information Yes No Personnel Security Information Yes No Physical Security Information Yes No Protected Critical Infrastructure Information (PCII) Yes No Personally Identifiable Information (PII) Yes No Sensitive PII (SPII) Yes No Sensitive Security Information (SSI) Other type of CUI _______________________________________
Note: If the answer is “Yes” to any of the information types listed above, the contracting officer shall include HSAR 3052.204-72 Safeguarding of Controlled Unclassified Information in the solicitation and resultant contract. If “Yes” is answered for PII and/or SPII, the contracting officer shall also include HSAR 3052.204-73 Notification and Credit Monitoring Requirements for Personally Identifiable Information Incidents in the solicitation and resultant contract.
2. Will contractor employees have access to DHS information systems? Yes No
3. Will contractor employees require recurring access to Government facilities?
Yes No
Note: If the answer is “No” to questions 1 through 3, proceed to the Signatures section of the checklist. When the answer is “No” to questions 1 through 3, the checklist shall, at a minimum, be signed by the requiring official and the HCA (or designee).
4. If the answer is “Yes” to any of questions 1 through 3, identify the information security, personnel security, and privacy clauses and provisions to be included in the solicitation and resultant contract:
Yes No FAR 52.224-3 Privacy Training – Alternate I (see FAR Class Deviation 17-03, Revision 1)
Yes No HSAR 3052.204-71 Contractor Employee Access Yes No HSAR 3052.204-71 Contractor Employee Access Alt I Yes No HSAR 3052.204-71 Contractor Employee Access Alt II Yes No HSAR 3052.204-72 Safeguarding of Controlled Unclassified
Information Yes No HSAR 3052.204-72 Safeguarding of Controlled Unclassified
Information Alt I Yes No HSAR 3052.204-73 Notification and Credit Monitoring
Requirements for Personally Identifiable Information Incidents Yes No Special Clause Information Technology Security Awareness Training
(see HSAR Class Deviation 15-01, Revision 1) Yes No Other: _____________________________________________________
G-8 HSAM Notice 2023-10
5. If foreign end products or services are allowed under the contract, what additional security provisions are to be included in the solicitation to protect CUI and facilities from unauthorized access and disclosure? __________________________________________
B. Authority to Operate (ATO) and Continuous Monitoring Data Requirements (completed by requiring office in coordination with Component CIO or designee):
1. Will Federal information systems, which include contractor information systems operated on behalf of the agency, be used to collect, process, store, or transmit CUI ?
Yes No
2. If “Yes” to #1, has the requiring office coordinated development of the Security Requirements Traceability Matrix (SRTM) with the Component CIO or designee for inclusion in the solicitation? Yes N/A (only if “No” to #1)
3. If “Yes” to #1, will the solicitation require the submission of a draft security plan and instructions on how the draft security plan will be evaluated? Yes N/A (only if “No” to #1)
4. If “Yes” to #1, does the requirements document identify how the contractor should submit monthly continuous monitoring data to the Government? Yes N/A (only if “No” to #1)
5. If “Yes” to #1, identify and describe the continuous monitoring data requirements to be included in the solicitation.
Note: When Federal information systems, which include contractor information systems operated on behalf of the agency, will be used to collect, process, store, or transmit CUI, the SRTM shall be included in the solicitation. The SRTM is prepared by the Component CIO or designee in coordination with the requiring office and shall be included in the procurement request package as an attachment to the requirements document (i.e., Statement of Work, Statement of Objectives, Performance Work Statement). Contracting officers shall ensure the solicitation requires vendors to submit a draft security plan with their proposal/quotation as their response to the SRTM. Instructions on how the draft security plan will be evaluated shall be included in the solicitation.
C. Data Retention Requirements (completed by requiring office):
1. Will the contractor be required to retain CUI for the Government? Yes No
G-9 HSAM Notice 2023-10
2. If “Yes” to #1, does the requirements document identify (a) retention requirements (e.g., length of time data must be retained before return and/or destruction) and (b) security requirements for the protection of retained data? Yes N/A (only if “No” to #1)
3. If “Yes” to #1, identify and describe the retention and security requirements to be included in the solicitation. _________________________________________________
4. Does the Government have a plan to monitor and/or ensure contractor compliance with the retention and security requirements identified? Yes N/A (only if “No” to #1)
5. If “Yes” to #1, describe the Government’s plan to monitor and/or ensure contractor compliance with the retention and security requirements identified in the acquisition.
D. Additional Privacy Considerations (completed by requiring office in coordination with Component Privacy Officer or designee):
1. Is privacy compliance documentation (Privacy Threshold Analysis, Privacy Impact
Assessment, and/or System of Record Notice, as appropriate) required for this procurement? Yes No N/A
2. If “Yes” to #1, has any of the following privacy compliance documentation been completed?
Yes No N/A Privacy Threshold Analysis Yes No N/A Privacy Impact Assessment Yes No N/A System or Record Notice Yes No N/A Other: _____________________________________________
3. Is contractor support needed to complete privacy compliance documentation? Yes
No N/A
4. If contractor support is needed to complete the privacy compliance documentation, does the requirements document identify the activities and level of contractor support needed?
Yes N/A (only if “No” or “N/A” to #3)
5. If “Yes” to #3, identify and describe the activities and level of contractor support needed to complete the privacy compliance documentation.
G-10 HSAM Notice 2023-10
Signatures:
Requiring Official (or official title)
Component Chief Information Officer (CIO) or designee
Component Chief Security Officer (CSO) or designee
Component Privacy Officer or designee
TSA SSI Program Office, as applicable
CISA CVI Program Office, as applicable
G-11 HSAM Notice 2023-10
CISA PCII Program Office, as applicable
Head of the Contracting Activity or Deputy HCA/Deputy Chief of Procurement
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