J-0200000-08 DD254 Dahlgren.pdf

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Attached to
Regional 8(a) Janitorial Services
Solicitation number
N40080-25-R-2233
Issued by

About this file

This is a DD Form 254 (Contract Security Classification Specification) dated March 8, 2018, establishing security requirements for a custodial services contract at Naval Support Facility Dahlgren in Dahlgren, Virginia. The contract is identified as BIDDING xxx-18 and is classified as unclassified, with a Secret facility security clearance (FCL) required. The contractor will perform custodial services in buildings that process classified information but will not receive, generate, or have custody of classified material at its facility.

The contracting activity is NAVFAC Washington (Activity Address Code N40080), with Roxanne Lacidonia serving as the point of contact (202-685-3024, roxanne.lacidonia@navy.mil). The certifying official is Latrice Rucker, CMD Security Officer, also at NAVFAC Washington (202-685-9616, latrice.moore@navy.mil). Key security requirements include: the contractor must maintain a Secret facility clearance; specifically designated personnel must possess favorably adjudicated SECRET personnel security clearances; contractors with interim clearances may only work on unclassified tasks in unclassified areas; all proposed subcontractor DD254s require advance certifying official approval; foreign nationals are prohibited from working on the contract; and all personnel must submit visit requests. The National Industrial Security Program Operating Manual (NISPOM) dated March 2013 applies to this effort. No additional security requirements beyond NISPOM are established. Distribution of the form is required to the contractor, cognizant security office for prime and subcontractor, and the administrative contracting officer.

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DEPARTMENT OF DEFENSE

CONTRACT SECURITY CLASSIFICATION SPECIFICATION

(Please read Instructions BEFORE completing this application.) (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 October 31, 2020

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

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

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

b. LEVEL OF SAFEGUARDING FOR CLASSIFIED INFORMATION/MATERIAL

REQUIRED AT CONTRACTOR FACILITY

Secret None (See instructions)

DUE DATE (YYYYMMDD)c. SOLICITATION OR OTHER NUMBER

b. SUBCONTRACT NUMBER BIDDING xxx-18

a. PRIME CONTRACT NUMBER (See instructions.)

DATE (YYYYMMDD)

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

DATE (YYYYMMDD)REVISION NO.b. REVISED (Supersedes all previous specifications.)

20180209

DATE (YYYYMMDD)

a. ORIGINAL (Complete date in all cases.)✖

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

YES. If Yes, complete the following:✖ NO4. IS THIS A FOLLOW-ON CONTRACT?

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

YES. If Yes, complete the following:✖ NO5. IS THIS A FINAL DD FORM 254?

c. COGNIZANT SECURITY OFFICE (CSO) (Name, Address, ZIP Code, Telephone)b. CAGE CODEa. NAME, ADDRESS, AND ZIP CODE

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

c. COGNIZANT SECURITY OFFICE(S) (CSOs) (Name, Address, ZIP Code, Telephone)

b. CAGE CODEa. NAME, ADDRESS, AND ZIP CODE

7. SUBCONTRACTOR(S) (Click button to add more subcontractors.)

c. COGNIZANT SECURITY OFFICE(S) (CSOs) (Name, Address, ZIP Code, Telephone) (If applicable, see instructions.)

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

NAVAL SUPPORT FACILITY DAHLGREN

18329 THOMPSON ROAD

DAHLGREN, VA 22448

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

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

PERFORM CUSTODIAL SERVICES

9. GENERAL UNCLASSIFIED DESCRIPTION OF THIS PROCUREMENT (Click here if more space is needed.)

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

d. FORMERLY RESTRICTED DATA

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

b. RESTRICTED DATA

e. NATIONAL INTELLIGENCE INFORMATION:

f. SPECIAL ACCESS PROGRAM (SAP) INFORMATION

k. OTHER (Specify) (See instructions.)

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

i. ALTERNATIVE COMPENSATORY CONTROL MEASURES (ACCM)

INFORMATION

h. FOREIGN GOVERMENT INFORMATION

g. NORTH ATLANTIC TREATY ORGANIZATION (NATO) INFORMATION

DD FORM 254, NOV 2017 PREVIOUS EDITION IS OBSOLETE. Adobe LiveCycle Designer ES4

Add More Items

Add More Items

Add Page

CLASSIFICATION (When filled in):

UNCLASSIFIEDCLASSIFICATION (When filled in):

UNCLASSIFIED

(1) Sensitive Compartmented Information (SCI)

(2) Non-SCI

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.)

h. REQUIRE A COMSEC ACCOUNT

k. BE AUTHORIZED TO USE THE DEFENSE COURIER SERVICE (DCS)

j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS

i. HAVE A TEMPEST REQUIREMENT

b. RECEIVE AND STORE CLASSIFIED DOCUMENTS ONLY

c. RECEIVE, STORE, AND GENERATE CLASSIFIED INFORMATION OR

MATERIAL

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

e. PERFORM SERVICES ONLY✖

d. FABRICATE, MODIFY, OR STORE CLASSIFIED HARDWARE 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

NONE AUTHORIZED

THROUGH (Specify) 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. Click button to add additional pages as needed to provide complete guidance.)

1. National Industrial Security Program Operating Manual (NISPOM) dated March 2013, applies to this contract.

2. Contractor will NOT be required to receive, generate, or have custody of classified material at the contractor's facility. This contract is for custodial services in buildings which process classified information at Naval Support Facility Dahlgren. Actual knowledge of, generation, or production of classified information is not required in the performance of this contract.

3. All information involved in security incidents shall be provided to the certifying official in Item 17a for classification review.

4. All security related issues, incidents, or requests pertaining to this contract shall be presented in writing to the certifying official in Item 17a below. The contractor shall abide by other reporting requirements outlined in the NISPOM.

14. ADDITIONAL SECURITY REQUIREMENTS. Requirements, in addition to NISPOM requirements for classified information, are established for this contract.

Yes✖ No (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. Use Item 13 or click button if additional space is needed.)

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

(If Yes, explain and identify specific areas and government activity responsible for inspections. Click button or use Item 13 if additional space is needed.)

YesNo✖

202-685-3024

e. POC TELEPHONE (Include Area Code.)

roxanne.lacidonia@navy.mil

f. EMAIL ADDRESS (See instructions.)

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

d. AAC OF THE CONTRACTING OFFICE (See instructions.)

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

Roxanne Lacidonia

d. POC NAME (See instructions.)

NAVFAC WASHINGTON

1314 HARWOOD STREET, SE

WASHINGTON NAVY YARD, DC 20374

c. ADDRESS (Include ZIP Code.)

NAVFAC WASHINGTON

a. GCA NAME

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

18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL

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.

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

Latrice Rucker

202-685-9616

f. TELEPHONE (Include Area Code.)

latrice.moore@navy.mil

g. EMAIL ADDRESS (See instructions.) h. SIGNATUREh. DATE

CMD SECURITY OFFICER

b. TITLE

NAVFAC WASHINGTON

1314 HARWOOD STREET, SE

WASHINGTON NAVY YARD, DC 20374

c. ADDRESS (Include ZIP Code.)

2018-03-08

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

e. ADMINISTRATIVE CONTRACTING OFFICER✖

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

c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR✖

b. SUBCONTRACTOR

a. CONTRACTOR✖

DD FORM 254 (BACK), NOV 2017

Add Page

Add Page

Add Page

N40080

N40080

UNCLASSIFIEDCLASSIFICATION (When filled in):

UNCLASSIFIEDCLASSIFICATION (When filled in):

15. INSPECTIONS (Continued)

14. ADDITIONAL SECURITY REQUIREMENTS (Continued)

5. Contractor is required to maintain a Secret facility clearance and the specifically designated contractor personnel assigned to this contract must possess a favorably adjudicated investigation and a final DoD granted SECRET personnel security clearance. The number of clearances requested must be limited to that which is operationally required to fulfill the requirements of the contract. The contractor will ensure that all periodic reinvestigations and other legal and regulatory requirements are completed. It is the contractor's responsibility to ensure continuity of cleared personnel due to planned or unplanned turnover or reassignment.

6. Contractors issued a DoD interim security clearance may ONLY work on unclassified tasks in unclassified areas in accordance with this contract SOW.

No classified access will be authorized.

7. Prime contractor will forward all DD254s for proposed subcontractors to the certifying official in Item 17a for advance approval.

8. Foreign nationals are not authorized to work on this contract. A visit request is required by all personnel assigned to this contract, to include full name, SSN, and contract number, and will be submitted to the official shown in Item 17a.

NSWC Concurrence:________________________________ (signature)

________________________________ (printed name and date)

13. SECURITY GUIDANCE (Continued)

PagesofContinuation PageDD FORM 254, NOV 2017 New Page

UNCLASSIFIED

CLASSIFICATION (When filled in): UNCLASSIFIED

CLASSIFICATION (When filled in):

Additional persons assisting with completion of form (signatures and titles)

DEPARTMENT OF DEFENSE

CONTRACT SECURITY CLASSIFICATION SPECIFICATION

(Please read Instructions BEFORE completing this application.) (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 October 31, 2020 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

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

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

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

b. LEVEL OF SAFEGUARDING FOR CLASSIFIED INFORMATION/MATERIAL REQUIRED AT CONTRACTOR FACILITY

DUE DATE (YYYYMMDD)

c. SOLICITATION OR OTHER NUMBER

b. SUBCONTRACT NUMBER

a. PRIME CONTRACT NUMBER (See instructions.)

DATE (YYYYMMDD)

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

DATE (YYYYMMDD)

REVISION NO.

b. REVISED (Supersedes all previous specifications.)

DATE (YYYYMMDD)

a. ORIGINAL (Complete date in all cases.)

(Preceding Contract Number) is transferred to this follow-on contract.

Classified material received or generated under YES. If Yes, complete the following:

NO

4. IS THIS A FOLLOW-ON CONTRACT?

, retention of the classified material is authorized for the period of:

In response to the contractor's request dated YES. If Yes, complete the following:

NO

5. IS THIS A FINAL DD FORM 254?

c. COGNIZANT SECURITY OFFICE (CSO) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

a. NAME, ADDRESS, AND ZIP CODE

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

c. COGNIZANT SECURITY OFFICE(S) (CSOs) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

a. NAME, ADDRESS, AND ZIP CODE

7. SUBCONTRACTOR(S) (Click button to add more subcontractors.)

c. COGNIZANT SECURITY OFFICE(S) (CSOs) (Name, Address, ZIP Code, Telephone) (If applicable, see instructions.)

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

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

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

9. GENERAL UNCLASSIFIED DESCRIPTION OF THIS PROCUREMENT (Click here if more space is needed.)

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

d. FORMERLY RESTRICTED DATA

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

b. RESTRICTED DATA

e. NATIONAL INTELLIGENCE INFORMATION:

f. SPECIAL ACCESS PROGRAM (SAP) INFORMATION

k. OTHER (Specify) (See instructions.)

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

i. ALTERNATIVE COMPENSATORY CONTROL MEASURES (ACCM) INFORMATION

h. FOREIGN GOVERMENT INFORMATION

g. NORTH ATLANTIC TREATY ORGANIZATION (NATO) INFORMATION

DD FORM 254, NOV 2017

PREVIOUS EDITION IS OBSOLETE.

Adobe LiveCycle Designer ES4 CLASSIFICATION (When filled in):

CLASSIFICATION (When filled in):

(1) Sensitive Compartmented Information (SCI)

(2) Non-SCI

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.)

h. REQUIRE A COMSEC ACCOUNT

k. BE AUTHORIZED TO USE THE DEFENSE COURIER SERVICE (DCS)

j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS

i. HAVE A TEMPEST REQUIREMENT

b. RECEIVE AND STORE CLASSIFIED DOCUMENTS ONLY

c. RECEIVE, STORE, AND GENERATE CLASSIFIED INFORMATION OR MATERIAL

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

e. PERFORM SERVICES ONLY

d. FABRICATE, MODIFY, OR STORE CLASSIFIED HARDWARE

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)

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. Click button to add additional pages as needed to provide complete guidance.)

14. ADDITIONAL SECURITY REQUIREMENTS. Requirements, in addition to NISPOM requirements for classified information, are established for this contract.

Yes No (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. Use Item 13 or click button if additional space is needed.)

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

(If Yes, explain and identify specific areas and government activity responsible for inspections. Click button or use Item 13 if additional space is needed.)

Yes No

e. POC TELEPHONE (Include Area Code.)

f. EMAIL ADDRESS (See instructions.)

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

d. AAC OF THE CONTRACTING OFFICE (See instructions.)

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

d. POC NAME (See instructions.)

c. ADDRESS (Include ZIP Code.)

a. GCA NAME

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

18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL

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.

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

f. TELEPHONE (Include Area Code.)

g. EMAIL ADDRESS (See instructions.)

h. SIGNATURE

h. DATE

b. TITLE

c. ADDRESS (Include ZIP Code.)

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

e. ADMINISTRATIVE CONTRACTING OFFICER

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

c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR

b. SUBCONTRACTOR

a. CONTRACTOR

DD FORM 254 (BACK), NOV 2017

CLASSIFICATION (When filled in):

CLASSIFICATION (When filled in):

c. COGNIZANT SECURITY OFFICE(S) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

a. NAME, ADDRESS, AND ZIP CODE

7. SUBCONTRACTOR(S) (Continued)

c. COGNIZANT SECURITY OFFICE(S) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

a. NAME, ADDRESS, AND ZIP CODE

c. COGNIZANT SECURITY OFFICE(S) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

a. NAME, ADDRESS, AND ZIP CODE

c. COGNIZANT SECURITY OFFICE(S) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

a. NAME, ADDRESS, AND ZIP CODE

c. COGNIZANT SECURITY OFFICE(S) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

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

c. COGNIZANT SECURITY OFFICE(S) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

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

c. COGNIZANT SECURITY OFFICE(S) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

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

c. COGNIZANT SECURITY OFFICE(S) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

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

8. ACTUAL PERFORMANCE (Continued)

9. GENERAL UNCLASSIFIED IDENTIFICATION OF THIS PROCUREMENT (Continued)

DD FORM 254, NOV 2017

Pages of Continuation Page CLASSIFICATION (When filled in):

CLASSIFICATION (When filled in):

15. INSPECTIONS (Continued)

14. ADDITIONAL SECURITY REQUIREMENTS (Continued)

13. SECURITY GUIDANCE (Continued) Pages of Continuation Page

DD FORM 254, NOV 2017

CLASSIFICATION (When filled in):

CLASSIFICATION (When filled in):

Additional persons assisting with completion of form (signatures and titles) 9.0.0.2.20120627.2.874785

WHS/ESD/DD

DD 254, Nov 2017, "DoD Contract Security Classification Specification" Orig No No Yes Yes

a. Facility clearance level. Select one.: 2
b. Level of safeguarding for classified information/material required at contractor facility. Select one.: 4
2.c. Due date (four digit year, two digit month, two digit day.:
2.c. Solicitation or other number.:
Mark X if solicitation or other number.: Off
2.b. Subcontract number.:
Mark X if Subcontract.: Off
2.a. Prime contract number.: BIDDING xxx-18
Date (4 digit year, 2 digit month, 2 digit day).:
Date (4 digit year, 2 digit month, 2 digit day).:
3.b. If revised, revision number.:
Date (Complete in all cases) (4 digit year, 2 digit month, 2 digit day).: 20180209.00000000
12. Public Release. Proposed public releases shall be submitted for approval prior to release: X first box if Direct, second box if Through.:
4. If yes: Classified material received or generated under. Enter the preceding contract number, (enter Preceding contract number) is transferred to this follow on contract.:
Retention of the classified material is authorized for the period of::
5. If yes, complete the following: In response to the contractors request dated::
6.c. Cognizant security office. (Name, address, and zip code).:
6.b. CAGE code.:
6. Contractor. a. Name, address, and zip code.:
c. Cognizant security office. (Name, address, and zip code).:
b. CAGE code.:
7. Subcontractor(s). a. Name, address, and zip code.:
8.c. Cognizant security office (Name, address, and zip code).:
8.b. CAGE code.:
8. Actual performance. a. Location.: NAVAL SUPPORT FACILITY DAHLGREN

18329 THOMPSON ROAD

DAHLGREN, VA 22448

9. General unclassified description of this procurement.: PERFORM CUSTODIAL SERVICES
10. Contractor will require access to: X if COMSEC information.: Off
X if restricted data.: Off
X if NATO information.: Off
X if other.: Off
X if CUI.: Off
X if alternative compensatory control measures (ACCM) information.: Off
X if foreign government information.: Off
X if formerly restricted data.: Off
X if formerly restricted data.: Off
X if formerly restricted data.: Off
X if special access program (SAP) information.: Off
X if CNWDI.: Off
Specify other require;ments (see instructions).:
Button1:
Button2:
Classification (when filled in).: UNCLASSIFIED
CheckBox1: 1
11. In performing this contract, the contractor will: X if have access to classified information only at another contractor's facility or a government activity.: Off
X if receive and store classified documents only.: Off
X if require a COMSEC account.: Off
X if be authorized to use the Defense Courier Service.: Off
X if have access to CUI.: Off
X if have OPSEC requirements.: Off
X if have a TEMPEST requirement.: Off
X if receive, store, and generate classified material.: Off
X if have access to U.S. classified information outside the U.S., Puerto Rico, U.S. possessions and trust territories.: Off
X if authorized to use the services of DTIC or other secondary distribution center.: Off
X if perform services only.: Yes
X if fabricate, modify, or store classified hardware.: Off
X if other.: Off
If through, specify.:

NONE AUTHORIZED

Public release authority::
13. Security guidance.: 1. National Industrial Security Program Operating Manual (NISPOM) dated March 2013, applies to this contract.

2. Contractor will NOT be required to receive, generate, or have custody of classified material at the contractor's facility. This contract is for custodial services in buildings which process classified information at Naval Support Facility Dahlgren. Actual knowledge of, generation, or production of classified information is not required in the performance of this contract.

3. All information involved in security incidents shall be provided to the certifying official in Item 17a for classification review.

4. All security related issues, incidents, or requests pertaining to this contract shall be presented in writing to the certifying official in Item 17a below. The contractor shall abide by other reporting requirements outlined in the NISPOM.

13. Security guidance.: 5. Contractor is required to maintain a Secret facility clearance and the specifically designated contractor personnel assigned to this contract must possess a favorably adjudicated investigation and a final DoD granted SECRET personnel security clearance. The number of clearances requested must be limited to that which is operationally required to fulfill the requirements of the contract. The contractor will ensure that all periodic reinvestigations and other legal and regulatory requirements are completed. It is the contractor's responsibility to ensure continuity of cleared personnel due to planned or unplanned turnover or reassignment.

6. Contractors issued a DoD interim security clearance may ONLY work on unclassified tasks in unclassified areas in accordance with this contract SOW. No classified access will be authorized.

7. Prime contractor will forward all DD254s for proposed subcontractors to the certifying official in Item 17a for advance approval.

8. Foreign nationals are not authorized to work on this contract. A visit request is required by all personnel assigned to this contract, to include full name, SSN, and contract number, and will be submitted to the official shown in Item 17a.

NSWC Concurrence:________________________________ (signature)

________________________________ (printed name and date)

15. Inspections. X first box if yes, second box if no.:
15. Inspections. X first box if yes, second box if no.:
15. Inspection. If yes is checked, explain and identify specific areas or elements carved out and the activity responsible for inspections.:
14. Additional security requirements. If yes, identify.:
e. POC telephone number (include area code).: 202-685-3024
f. Email address (see instructions).: roxanne.lacidonia@navy.mil
d. Activity address code of the contracting office.:
d. POC name (last, first, middle initial).: Roxanne Lacidonia
d. Cognizant security office. (Name, address, and zip code).: NAVFAC WASHINGTON

1314 HARWOOD STREET, SE

WASHINGTON NAVY YARD, DC 20374

16.a. Government contracting authority (GCA) name.: NAVFAC WASHINGTON
17.a. Typed name of government or contractor security official (last, first, middle initial).: Latrice Rucker
f. Telephone number (include area code).: 202-685-9616
g. Email address (see instructions).: latrice.moore@navy.mil
b. Title.: CMD SECURITY OFFICER
c. Address (include ZIP Code).: NAVFAC WASHINGTON

1314 HARWOOD STREET, SE

WASHINGTON NAVY YARD, DC 20374

h. Date signed.: 2018-03-08
i. Signature (click to sign).:
Specify other distribution.:
17.f. Mark X if others as necessary.: Off
17.e. Mark X if administrative contracting officer.: Yes
17.d. Mark X if U.S. activity responsible for overseas security administration.: Off
17.c. Mark X if Cognizant Security Office for prime and subcontractor.: Yes
17.b. Mark X if Subcontractor.: Off
17. Required distribution. a. Mark X if Contractor.: Yes
b. Activity address code of the contracting office.: N40080
e. CAGE code of the prime contractor.: N40080
9. General identification of this procurement.:
Total number of pages.:
Page number of this page.:
Button3:
Signature.:
Title.:
Title.:
Title.:
Title.:
Signature.:
Signature.:
Signature.:

File details come from the government source that posted it. Updated .