Attachment_1_DD_Form_254.pdf

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DRAFT

SAMPLE

PREVIOUS EDITION IS OBSOLETE.

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DD FORM 254, MAY 2019

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:

20220531 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 whs.mc-alex.esd.mbx.formswebmaster@mail.mil

WHS

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

3300 Russel Road Quantico Va 22134

Item 10g: NATO information will be handled and controlled as indicated in the NISPOM. Access requires a final U.S. Government clearance and special briefings as the appropriate level. Reproduction and destruction of this material, regardless of the classification, is prohibited without written approval from the COR, CG MCCDC (C 054) or higher authority. Prior approval form the COR and CG MCCDC (C054) is required for subcontracting.

Item 10j: Except where directed by the COR, Controlled Unclassified Information (CUI) includes for Official Use Only (FOUO) by definition, Information generated and/or provided under this contract shall be safeguarded and marked as specified in DODm 5200.01v1-v4. Additionally, non-government owned electronic storage media become the property of the U.S. government upon disposal, replacement, or turn-in per DON CIO message.

Item 11e: This is a service contract. Please see attached Performance Work Statement for all services to be performed under this contract.

Item 11f: The review/use of classified materials can be accessed outside the U.S., Puerto Rico, U.S. Possessions and Trust Territories under this contract. The Acces can/will be in support of OCONUS commanders located in the areas identified at the Task Order level.

Contractors will not release this information to any activity or person not directly engaged in providing services under the contract or to another contractor (including sub-contrators), government agencies, private individuals, or organizations without prior approval of the Director, Office of Naval Intelligence (ONO-5) via CG MCCDC (C054) and the SSO MCA.

TECOM (Attn:xxxx) 2300 Louis Rd Quantico Va, 22134-5001 And, The DSS, CSO identified in Item 6.c.

Or, The government organization identified in Item 15 as having inspection oversight carved out and the DSS, CSO identified in Item 6.c.

The GSA is responsible for ensuring (as a requirement) that all JPAS visits requests are submitted to each organization where classified information will be discussed or accessed. Visit requests to activities not listed in the contract, SOW/PWS or this DD-254 may be required and each instance will be approved by the COR or project officer. All requests shall contain the information required by the NISPOM and shall not exceed a 12 month visit period. Classified visits to CAOCL will be to SMO Code M300000 and MS3302 in order to be placed on the command access roster.

All Government CAC, access badges, and tokens issued under this contract will be returned immediately upon termination of the contract, or individual termination. When an individual contractor is terminated, for any reason, it is the responsibility of the Facility Security Officer to immediately notify the Command Security Manager, TECOM and to recover and turn in all government items issued.

Quantico, Va 22134