I. 10_DD254.pdf

CLASSIFICATION (When filled in): Unclassified

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AEM LiveCycle Designer

DD FORM 254, APR 2018

DEPARTMENT OF DEFENSE

CONTRACT SECURITY CLASSIFICATION SPECIFICATION

(The requirements of the National Industrial Security Program (NISP) apply to all security aspects of this effort involving classified information.)

OMB No. 0704-0567 OMB approval expires:

May 31, 2022

The public reporting burden for this collection of information, 0704-0567, is estimated to average 70 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Washington Headquarters Services, at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

RETURN COMPLETED FORM AS DIRECTED IN THE INSTRUCTIONS.

1. CLEARANCE AND SAFEGUARDING

a. LEVEL OF FACILITY SECURITY CLEARANCE (FCL) REQUIRED (See Instructions)

Secret

b. LEVEL OF SAFEGUARDING FOR CLASSIFIED INFORMATION/

MATERIAL REQUIRED AT CONTRACTOR FACILITY

None (See instructions)

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

a. PRIME CONTRACT NUMBER (See instructions.)

b. SUBCONTRACT NUMBER

c. SOLICITATION OR OTHER NUMBER

1300854603

DUE DATE (YYYYMMDD)

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

a. ORIGINAL (Complete date in all cases.)

DATE (YYYYMMDD)

20200522

b. REVISED (Supersedes all previous specifications.)

REVISION NO. DATE (YYYYMMDD)

c. FINAL (Complete Item 5 in all cases.) DATE (YYYYMMDD)

4. IS THIS A FOLLOW-ON CONTRACT? No Yes 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? No Yes 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

SyQwest Inc.

30 Kenney Drive Cranston RI 02920

b. CAGE CODE

33642

c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional)

DSS Boston Field Office - IOFNB 3 Edgewater Drive, Suite 204 Norwood, MA 02062 781-680-0180

7. SUBCONTRACTOR(S) (Click button if you choose to add or list the subcontractors -- but will still require a separate DD Form 254 issued by a prime contractor to each subcontractor)

a. NAME, ADDRESS, AND ZIP CODE b. CAGE CODE c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional)

8. ACTUAL PERFORMANCE (Click button to add more locations.)

a. LOCATION(S) (For actual performance, see instructions.)

NUWCDIVNWPT

1176 Howell Street Newport, RI 02841

b. CAGE CODE (If applicable, see Instructions.)

c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional)

9. GENERAL UNCLASSIFIED DESCRIPTION OF THIS PROCUREMENT

The Contractor shall provide engineering services to design the beamformer for the conceptual ADM sonar array.

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DD FORM 254, APR 2018

10. CONTRACTOR WILL REQUIRE ACCESS TO: (X all that apply. Provide details in Blocks 13 or 14 as set forth in the instructions.)

a. COMMUNICATIONS SECURITY (COMSEC) INFORMATION f. SPECIAL ACCESS PROGRAM (SAP) INFORMATION

b. RESTRICTED DATA

g. NORTH ATLANTIC TREATY ORGANIZATION

(NATO) INFORMATION

c. CRITICAL NUCLEAR WEAPON DESIGN INFORMATION (CNWDI) (If CNWDI applies, RESTRICTED DATA must also be marked.)

h. FOREIGN GOVERMENT INFORMATION

d. FORMERLY RESTRICTED DATA

i. ALTERNATIVE COMPENSATORY CONTROL MEASURES

(ACCM) INFORMATION

e. NATIONAL INTELLIGENCE INFORMATION:

(1) Sensitive Compartmented Information (SCI)

(2) Non-SCI

j. CONTROLLED UNCLASSIFIED INFORMATION (CUI) (See instructions.)

k. OTHER (Specify) (See instructions.)

11. IN PERFORMING THIS CONTRACT, THE CONTRACTOR WILL: (X all that apply. See instructions. Provide details in Blocks 13 or 14 as set forth in the instructions.)

a. HAVE ACCESS TO CLASSIFIED INFORMATION ONLY AT

ANOTHER CONTRACTOR'S FACILITY OR A GOVERNMENT

ACTIVITY

(Applicable only if there is no access or storage required at contractor facility.

See instructions.)

b. RECEIVE AND STORE CLASSIFIED DOCUMENTS ONLY

c. RECEIVE, STORE, AND GENERATE CLASSIFIED

INFORMATION OR 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 A TEMPEST REQUIREMENT

j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS

k. BE AUTHORIZED TO USE DEFENSE COURIER SERVICE

l. RECEIVE, STORE, OR GENERATE CONTROLLED UNCLASSIFIED

INFORMATION (CUI).

(DoD Components: refer to DoDM 5200.01, Volume 4 only for specific CUI protection requirements. Non-DoD Components: see instructions.)

m. OTHER (Specify) (See instructions.)

12. PUBLIC RELEASE

Any information (classified or unclassified) pertaining to this contract shall not be released for public dissemination except as provided by the National Industrial Security Program Operating Manual (NISPOM) or unless it has been approved for public release by appropriate U.S. Government authority.

Proposed public releases shall be submitted for review and approval prior to release to the appropriate government approval authority identified here with at least office and phone contact information and if available, an e-mail address. (See instructions)

DIRECT THROUGH (Specify below)

Commander, Naval Undersea Warfare Center, Division Newport

Public Release Authority:

13. SECURITY GUIDANCE

The security classification guidance for classified information needed for this 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. The field will expand as text is added. When removing any expanded text area, use delete key or backspace key, then click out of the text field for it to shrink after the text has been deleted. Also allows for up to 6 internal reviewers to digitally sign. See instructions for additional guidance or use of the fillable PDF.)

------------------------------------------NAVAL UNDERSEA WARFARE CENTER INFORMATION--------------------------

“This is to advise you that the following information is current verification information for the facility under this Solicitation or Contract.

The following mailing addresses are authorized under the cage codes identified on this DD254””

Cage Code: 33642

Physical Location: (this information is typically identified in section 6a, 7a and 8a)

Classified Mailing Address:

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DD FORM 254, APR 2018

SyQwest Inc.

30 Kenney Drive Cranston RI 02920

Classified Hardware Mailing Address:N/A

Classified Overnight Address:N/A AAll classified data and hardware shall be protected I.A.W. DOD 5220.22-M, National Industrial Security Program Operating Manual.

Classified or unclassified technical papers to be presented at a classified symposium shall be approved by the NUWCDIVNPT Contracting Officer's Representative (COR) prior to the presentation.

Security classification guides and controlled unclassified information (CUI) (e.g., FOUO, distribution statement controlled) is not authorized for public release; therefore, they cannot be posted on a publicly accessible web-server or transmitted over the internet unless appropriately encrypted. Request for public release cannot be transmitted via the internet until the contractor receives final approval from NUWCDIVNPT Code 00.

All reports of contractor security violations associated with this contract shall be sent by the DCSA field office directly to NUWCDIVNPT Industrial Security Team at nuwc_npt_indsec3.fct@navy.mil.

All security related issues, requests, or incidents, pertaining to this contract, shall be submitted in writing by the contractor’s Facility Security Officer (FSO) to NUWCDIVNPT Industrial Security Team at nuwc_npt_indsec3.fct@navy.mil.. The contractor shall abide by other reporting requirements outlined in the NISPOM.

The Contractor shall submit a request for sharing of classified and other sensitive information between prime contracts in writing to the NUWCDIVNPT Information, Industrial Security Code 1051 at nuwc_npt_indsec3.fct@navy.mil. Each request shall reference contract number XXXXXX-XX-X-XXXX identify the specific information for which approval is being sought, a justification for needing to share the information, the name of other contractor and its contract number under which the requested information will be shared.

Personnel designated as derivative classifiers shall receive derivative classification training prior to access from the contractor's Facility Security Officer (FSO). The FSO shall ensure personnel receive initial and biennial training during the life of this contract. Evidence of completion, training certificates or equivalent, shall be provided to the Information Assurance Manager no later than the individual's due date.

All classified documents shall be destroyed using a National Security Agency (NSA) approved high security crosscut shredder listed on the NSA/CSS evaluated products list(EPL) for high security crosscut paper shredders, or other approved method for destroying classified information.

All classified information involved in security incidents shall be retained and provided for classification review to the NUWCDIVNPT Industrial Security Team at nuwc_npt_indsec3.fct@navy.mil.

The contractor shall provide a copy of subcontractor DD 254s issued under this contract to NUWCDIVNPT Industrial Security Team at nuwc_npt_indsec3.fct@navy.mil.

------------------------------------------------------------Sections 10 and 11 Statements---------------------------------------------------------------------

10(j) DoD M-5200.01 Volume 4, DoD Information Security Program: Controlled Unclassified Information (CUI) of 2/24/2012

11(j): The Contractor shall protect critical information associated with this contract to prevent unauthorized disclosure. The NUWC Division Newport (NUWCDIVNPT) Critical Information List, Ser 105/090 of April 05, 2019 (FOUO) is identified under separate cover.

11(j) Continued: Performance under this contract requires the contractor to adhere to OPSEC requirements. OPSEC requirements are additional to the requirements of DoD 5220.22-M, National Industrial Security Program Operating Manual, therefore, the Contractor may not impose OPSEC requirements on its subcontractors unless NUWCDIVNPT approves the OPSEC requirements. The contractor shall assign an OPSEC point of contact for this contract at no additional cost to the Government. This individual may be the Facility Security Officer (FSO).

11(j) Continued: During the period of this contract, the Contractor may be exposed to, use, or produce, NUWCDIVNPT Critical Information (CI) and/or observables and indicators which may lead to discovery of CI. NUWCDIVNPT’s CI will not be distributed to

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DD FORM 254, APR 2018

unauthorized third parties, including foreign governments, or companies under Foreign Ownership, Control, or Influence (FOCI).

11(j) Continued: CUI correspondence transmitted internally on the contractor's unclassified networks or information systems, and externally, shall be protected per NIST SP-800-171, Protecting Controlled Unclassified Information in Non-federal Systems and Organizations.

11(j) Continued: Assembled large components/systems being transported to and from testing areas, other production or government facilities (whether or not on public roadways) shall be in an enclosed van trailer or covered flatbed trailer. Component/System outside storage, staging, and test areas shall be shielded/obscured from public view wherever physically possible.

11(j) Continued: NUWCDIVNPT's CI shall not be publicized in corporate wide newsletters, trade magazines, displays, intranet pages or public facing websites. Media requests related to this project shall be directed to NAVSEA/NUWCDIVNPT Public Release Authority listed in Item 12 of this DD Form 254.

11(j) Continued: Any attempt by unauthorized third parties to solicit, obtain, photograph, or record, or; incidents of loss/compromise of government Classified or CI, Business Sensitive, Company Proprietary information related to this or other program must be immediately reported to the Facility Security Officer and Defense Security Service and/or the Naval Criminal Investigative Service, and the NUWCDIVNPT Information, Industrial, and Operations Security POCs identified on this DD-254. Questions concerning these requirements shall be directed to the NUWCDIVNPT Information, Industrial, and Operations Security POCs.

11(l): DoD M-5200.01 Volume 4, DoD Information Security Program: Controlled Unclassified Information (CUI) of 2/24/2012

List of Attachments (All Files Must be attached Prior to Signing, i.e., for any digital signature on the form)

Operations Security (OPSEC) requirements are imposed for this contract under section 11(j) and are reflected in Item 13 of this DD Form 254.

NAME & TITLE OF REVIEWING OFFICIAL

Charles Morrison NUWCDIVNPT OPSEC Program Manager

SIGNATURE

14. ADDITIONAL SECURITY REQUIREMENTS

Requirements, in addition to NISPOM requirements for classified information, are established for this contract.

No Yes 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 CSO. The field will expand as text is added or you can also use item 13. When removing any expanded text area, use delete key or backspace key, then click out of the text field for it to shrink after the text has been deleted.

(See instructions for additional guidance or use of the fillable PDF.)

Operations Security (OPSEC) requirements are imposed for this contract under section 11(j) and are reflected in Item 13 of this DD Form

254. The contractor shall not impose additional security requirements including OPSEC on its subcontractor without written approval from the NUWCDIVNPT OPSEC Program Manager identified on this DD Form 254. These additional security requirements shall not be at an additional cost to the government.

15. INSPECTIONS

Elements of this contract are outside the inspection responsibility of the CSO.

No Yes If Yes, explain and identify specific areas and government activity responsible for inspections. The field will expand as text is added or you can also use item

13. When removing any expanded text area, use delete key or backspace key, then click out of the text field for it to shrink after the text has been deleted.

(See instructions for additional guidance or use of the fillable PDF.)

16. GOVERNMENT CONTRACTING ACTIVITY (GCA) AND POINT OF CONTACT (POC)

a. GCA NAME

Naval Undersea Warfare Center, Newport

b. ACTIVITY ADDRESS CODE (AAC) OF THE CONTRACTING OFFICE (See Instructions)

N66604

c. ADDRESS (Include ZIP Code)

NUWC

1176 Howell Street Newport, RI 02841

d. POC NAME

COR identified in section G

e. POC TELEPHONE (Include Area Code)

f. EMAIL ADDRESS (See Instructions)

17. CERTIFICATION AND SIGNATURES

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. Upon digitally signing Item 17h, no changes can be made as the form will be locked.

a. TYPED NAME OF CERTIFYING OFFICIAL (Last, First, Middle Initial) (See Instructions)

Jones, Gwen, L.

b. TITLE

Security Contracting Officer

MORRISON.CHARLE

S.ALFRED.JR.1060062

Digitally signed by

MORRISON.CHARLES.ALFRE

D.JR.1060062141

Date: 2020.05.26 09:13:24 -04'00'

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c. ADDRESS (Include ZIP Code)

NUWCDIVNWPT

1176 Howell Street Newport, RI 02841

d. AAC OF THE CONTRACTING OFFICE (See Instructions)

N66604

e. CAGE CODE OF THE PRIME CONTRACTOR (See Instructions.)

f. TELEPHONE (Include Area Code)

+1 (401) 832-8274

g. EMAIL ADDRESS (See Instructions) nuwc_npt_indec3.fct@navy.mil

h. SIGNATURE

i. DATE SIGNED (See Instructions)

18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL

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. OTHER AS NECESSARY (If more room is needed, continue in Item 13 or on additional page if necessary.)

COR

JONES.

GWEN.L

.1012571

Digitally signed by

JONES.GWEN.

L.1012571662 Date: 2020.05.27 05:55:08 -04'00'