J23. 47QFHA24R0001_T10_09_OXD Seed Attachment 5_DD Form 254.pdf
PDF 65 KB Posted
- Attached to
- OUSD PRISM MATOC SOLICITATION Federal contract opportunity
- Solicitation number
- 47QFHA24R0001
- Issued by
- GSA Federal Acquisition Service
About this file
This document is a DD Form 254, which outlines security requirements for a federal contract to provide administrative assistance to the Office of the Undersecretary of Defense for Personnel and Readiness. The contractor will require access to classified information at the Secret level, including Special Access Programs, NATO and FGI materials, as well as controlled unclassified information. The work involves support to several offices within OUSD P&R on both classified and unclassified systems. The Performance Work Statement calls for services in areas like executive support, readiness programs, personnel management and health affairs. The contracting vehicle is a multiple award task order contract to be awarded by GSA, with separate pools for P&R and major defense systems. Questions are due by February 14, 2024 and proposals by March 6, 2024. The contracting office is GSA AAS APEX 3 Sector 1.
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DRAFT
SAMPLE
PREVIOUS EDITION IS OBSOLETE.
Page of AEM LiveCycle Designer
DD FORM 254, APR 2018
NEEDS DD67
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:
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. ORIGINAL (Complete date in all cases.)
b. REVISED (Supersedes all previous specifications.)
4. IS THIS A FOLLOW-ON CONTRACT?
If yes, complete the following:
Classified material received or generated under
5. IS THIS A FINAL DD FORM 254?
If yes, complete the following:
6. CONTRACTOR (Include Commercial and Government Entity (CAGE) Code)
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)
8. ACTUAL PERFORMANCE (Click button to add more locations.)
10. CONTRACTOR WILL REQUIRE ACCESS TO: (X all that apply. Provide details in Blocks 13 or 14 as set forth in the instructions.)
e. NATIONAL INTELLIGENCE INFORMATION:
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.)
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)
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.)
14. ADDITIONAL SECURITY REQUIREMENTS
Requirements, in addition to NISPOM requirements for classified information, 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 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.)
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. 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)
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.
18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL
9.0.0.2.20120627.2.874785 DD 254, DoD Contract Security Classification Specification List of Attachments (All Files Must be Attached Prior to Signing, i.e., for any digital signature on the form)
| CurrentPage: |
| PageCount: |
| Classification: Unclassified |
| SerialNum: |
| a. Facility clearance level. Select one.: 2 |
| b. Level of safeguarding for classified information/material required at contractor facility. Select one.: 4 |
| Choose Yes or No: 0 |
| Choose Yes or No: 1 |
| Prime: |
| Choose Yes or No: 0 |
| Choose Yes or No: 0 |
| Sub: |
| Choose Yes or No: 1 |
| Choose Yes or No: 0 |
| Soli: 47QFHA24R0001 |
| DueDate: 20240205 |
| dateA: |
| RevisionNum: |
| dateB: |
| Final: |
| dateC: |
| No: 1 |
| No: 1 |
| No: 1 |
| No: 1 |
| Yes: 0 |
| Yes: 0 |
| Yes: 0 |
| Yes: 0 |
| Enter your name here.: |
| ReqDated: |
| Enter your name here.: |
| Name: Johnson, Robert F. |
| Cage: |
| CSO: Office of the Undersecretary of Defense - Personnel and Readiness |
4000 Defense Pentagon Washington DC 20301-4000
| addrow: |
| Removerow: |
| Click to delete a row: |
| Location: 4000 Defense Pentagon |
Other CONUS and OCONUS locations will be approved by the GCA points of contact as needed. Also see statement listed in phrase 11.f.
| Block9: This contract will provide administrative assistance in support of the OUSD P&R mission in the following areas: Office of the Executive Director; the Office of the Assistant Secretary of Defense for Readiness (OASD R); the Office of the Assistant Secretary of Defense for Manpower and Reserve Affairs (OASD M&RA); the Office of the Assistant Secretary of Defense for Health Affairs (OASD HA); the Office of the Director for Force Resiliency (OFR); and the Office of the Chief Talent Management Officer (CTMO) – to include all subordinate offices and directorates of these P&R Components. This support will require NIPR, SIPR, and JWICS classified material access in support of OSD P&R actions. Contract personnel will require access to SCI, SAP, NATO, Foreign Government Information, and Controlled Unclassified Information (CUI) on a periodic basis in order to support on-going DoD actions. The contractor will have access on Government systems and Government locations only. The Contractor will be able to receive, store, and generate classified material and CUI at a Government facility. |
| a: 1 |
| a: 1 |
| a: 1 |
| f: 1 |
| f: 1 |
| f: 0 |
| b: 0 |
| b: 0 |
| b: 1 |
| g: 1 |
| g: 0 |
| c: 0 |
| c: 0 |
| c: 1 |
| h: 1 |
| h: 1 |
| d: 0 |
| d: 0 |
| d: 0 |
| i: 0 |
| i: 0 |
| SCI: 1 |
| NonSCI: 0 |
| j: 1 |
| j: 0 |
| k: 0 |
| k: 0 |
| Enter your name here.: NIPR and SIPR Access |
| e: 1 |
| e: 1 |
| l: 1 |
| m: 1 |
| direct: 0 |
| thru: 1 |
| Enter your name here.: Director, Office of the Executive Director, OUDS P&R |
| PublicAuthority: |
| AddSig: |
| RemoveSig: |
| text: P&R Security Guideline |
Information Assurance Training Administrative Instruction 26, " Information Security Supplement to DoD5200.1R"
| attachmentsList: |
| AddAttachment: |
| ViewAttachment: |
| RemoveAttachment: |
| rep: Robert Johnson |
Contracting Officer
| Sig: |
| Enter your name here.: |
| GCAName: GSA AAS APEX 3 Sector 1 |
| AAC: 47QFHA |
| AAC: 47QFHA |
| Address: 2300 Main Street |
Kansas City, MO 64108 Address: 2300 Main Street Kansas City, MO 64108
| POCName: Robert Johnson |
| Phone: 9132172291 |
| Phone: 9132172291 |
| Email: robert.f.johnson@gsa.gov |
| Email: robert.f.johnson@gsa.gov |
| Title: Contracting Officer |
| Enter the date using the format DD-Mon-YYYY: |
File details come from the government source that posted it. Updated .