ATCH J-4 - DD Form 254 Amend 1.pdf

(Updated 20250815) CLASSIFICATION (When filled in): Unclassified

CLASSIFICATION (When filled in): Unclassified PREVIOUS EDITION IS OBSOLETE. Page 1 of 3DD 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:

August 31, 2028

The public reporting burden for this collection of information, 0704-0567, is estimated to average 36 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.)

TBD (To be assigned at award)

b. SUBCONTRACT NUMBER

c. SOLICITATION OR OTHER NUMBER

M67004-26-R-0007

DUE DATE (YYYYMMDD)

20260710

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

a. ORIGINAL (Complete date in all cases.)

DATE (YYYYMMDD)

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.M67004-19-D-0001

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 TBD (To be assigned at award)

b. CAGE CODE

TBD

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

TBD

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.)

Blount Island, Jacksonville, FL MSC Ships in transit Norway Diego Garcia Guam Ashore Prepositioning Sites

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

Contract requirements include maintenance and maintenance management type activities across the globe and mostly focused in Jacksonville, FL, Norway, Philippines, Australia, Palau, Saipan, Diego Garcia, Guam, Ashore Prepositioning Sites and in-transit locations while aboard Military Sealift Command Vessels. For specific items relating to NSI, refer to paragraph 1.8.3 of the SOW.

PREVIOUS EDITION IS OBSOLETE. Page 2 of 3DD 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 GOVERNMENT 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 DoDI 5200.48, 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)

Blount Island Command Security Manager: (904) 696-5056 Blount Island Command Contracting Officer: (904) 696-5360

Public Release Authority:

Matthew Crabill, Deputy, Blount Island Command

(904) 696-5100

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.)

Reference 2a: Access to classified information is not required prior to awarding this contract.

Reference 10a: Contractor’s COMSEC access is at a location other than the contractor’s location.

Reference 10g: Actual knowledge of, generation, or production of NATO information is not required for performance on the contract.

However, a NATO awareness briefing is required for those personnel which must access SIPRNET in performance of the contract.

Reference 10j: Contractor may come in contact with or generate Controlled Unclassified Information (CUI) in performance of this contract.

CUI replaces the previous term of For Official Use Only (FOUO) and must contain appropriate markings to identify as CUI. See the National Archives CUI Marking Handbook for instruction.

Reference 11a: The contractor may access NSI but is not required to generate classified documents at any location.

Reference 11e: Contract is for equipment and network maintenance, monitoring, and operation. Actual knowledge, generation, or production of NSI is not required in performance of this contract. Aspects of this contract constitute services only, such as network operations and maintenance. Other aspects of this contract require deliverables in the form of executing a production schedule.

Reference 11f: Performance on this contract requires personnel to travel to/from and work in Jacksonville, FL, Norway, Philippines, PREVIOUS EDITION IS OBSOLETE. Page 3 of 3DD FORM 254, APR 2018

Australia, Palau, Saipan, Diego Garcia, Guam and myriad locations while transiting via MSC Vessels.

Reference 11j: Contractor may come in contact with or generate Controlled Unclassified Information (CUI) in performance of this contract.

CUI replaces the previous term of For Official Use Only (FOUO) and must contain appropriate markings to identify as CUI. See the National Archives CUI Marking Handbook for instruction.

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

NAME & TITLE OF REVIEWING OFFICIAL 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.)

Reference 11j: By default and in support of contract performance, contractor is privy to operational information concerning global operations. This information is sensitive and must only be shared with those direct support personnel with a need to know.

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

Blount Island Command

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

M67004

c. ADDRESS (Include ZIP Code) Blount Island Command 5880 Channel View Blvd Jacksonville, FL 32226-3404

d. POC NAME

Timothy L. Rivers

e. POC TELEPHONE (Include Area Code)

+1 (904) 696-5360

f. EMAIL ADDRESS (See Instructions) timothy.l.rivers@usmc.mil

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)

Williams, Derrick

b. TITLE

Contracting Officer Security Representative

c. ADDRESS (Include ZIP Code) Blount Island Command 5880 Channel View Blvd Jacksonville, FL 32226-3404

d. AAC OF THE CONTRACTING OFFICE (See Instructions)

M67004

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

TBD

f. TELEPHONE (Include Area Code)

+1 (904) 696-5056

g. EMAIL ADDRESS (See Instructions) derrick.williams2@usmc.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.)