Att. (15) - DD Form 254 (2025.01.30) FINAL.pdf

CLASSIFICATION (When filled in): Unclassified

PREVIOUS EDITION IS OBSOLETE. Page 1 of 4DD 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:

June 30, 2025

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.)

b. SUBCONTRACT NUMBER

c. SOLICITATION OR OTHER NUMBER

N0001925R0003

DUE DATE (YYYYMMDD)

20250227

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

a. ORIGINAL (Complete date in all cases.)

DATE (YYYYMMDD)

20250130

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.N0001921D0004

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

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.)

TBD

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

TBD

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

TBD

9. GENERAL UNCLASSIFIED DESCRIPTION OF THIS PROCUREMENT

Contractor Logistics Support (CLS) for aircraft maintenance at Main Operating Bases for Navy C-40A Fleet. VR-51 Hawaii and VMR-1 Fort Worth, TX.

PREVIOUS EDITION IS OBSOLETE. Page 2 of 4DD 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 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)

Transmissions by non-secure facsimile or E-mail is NOT authorized (by Prime or Subcontractors)

Public Release Authority:

Submit ALL Public Releases to: PMA-207 NAVAIR FORM 5720.10 must be completed and attached.

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.)

Technical papers, briefings, presentations, either classified or unclassified to be presented at classified symposia must be submitted to A0N0000 for approval prior to presentation. Unclassified material submitted for public release (that is not to be presented at classified symposia) shall be forwarded for review prior to release as stated in item 12 above. All controlled unclassified and classified technical information shall be appropriately marked with distribution statements as specified in DoDI 5230.24 (Distribution Statements on Technical Documents).

Determination of need-to-know in connection with a classified visit is the responsibility of the individual/host who will disclose the classified information.

The COR, TPOC, and Government Security Office, concerning instances of possible loss, compromise, and electronic spillage of classified or controlled unclassified information shall be notified immediately upon discovery and/or no later than 72 hours of discovery.

3.b - Revision(s) made in blocks 6a and 6b: Contractor name/physical location/CAGE Code information changed. For further information, please contact the TPOC listed in block 16d.

Block 4-Follow-on Contract - there is no classified material/ information associated with this contract or the previous contract.

Block 10.a– Unclassified COMSEC material is not releasable to contractor employees who have not received a final security clearance at the appropriate level. Cryptologic

PREVIOUS EDITION IS OBSOLETE. Page 3 of 4DD FORM 254, APR 2018 keying materials and Controlled Cryptographic Items (CCI) are controlled by Department of the Navy, NISPOM, and National Security Agency (NSA) guidelines. The contractor shall be guided by NSA/CSS Policy Manual 3-16 in the control and protection of COMSEC material/information at their facilities. When access is required at Government facilities, contractor personnel will adhere to COMSEC rules and regulations as mandated by DoD National Industrial Security Program Operating Manual (NISPOM) codifying 32 Code of Federal Regulation Part 117, NISPOM Rule, 24 February 2021, Department of the Navy Communications Materials System (CMS-1A) and Command policy and procedures. Written concurrence of the Technical Point of Contact identified in Block 16, or Contracting Officer Representative/Industrial Security Representative is required prior to subcontracting.

Block 10.j/11.l – Controlled Unclassified Information including Legacy FOUO and Covered Defense Information (meeting the definition of DFARS Clause 252.204–7012 Safeguarding covered defense information and cyber incident reporting) generated and/or provided under this contract shall be marked and safeguarded as specified in DoD Instruction 5200.48 (Controlled Unclassified Information) (CUI)) available at https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodi/520048p.PDF. Any product containing Covered Defense Information shall be assigned the appropriate distribution statement using the criteria set forth in DoDI 5230.24 (Distribution Statements on DoD Technical Information); and have this statement displayed per DoDI 5230.24, Enclosure 3-4.

All Covered Defense Information (CDI), Legacy FOUO, and program Controlled Unclassified Information (CUI) data transmitted and safeguarded via electronic means shall use approved encryption. The Contractor shall ensure that when transmitting CUI/Legacy FOUO/CDI over non-secure e-mail (e.g. not connected to the Navy Marine Corps Intranet through Broadband Unclassified Remote Access System/Virtual Private network), those transmissions are encrypted using Department of Defense Public Key Infrastructure (PKI), or an approved DoD External Certificate Authority, in accordance with Public Key Infrastructure & Public Key Enabling, DoDI 8520.02, 18 May 2023.

The following Security Classification Guide(s) apply to classified performance on this contract. Subsequent updates shall be provided by the Technical Point of Contact/ Contracting Officer Representative/Contracting Officer Security Representative (as applicable) as Government Furnished Information (GFI) and shall be executed by the Contractor without obligation to modify this DD Form 254.

(08-100.02) - ELECTRONIC PROTECTION (EP) RADIO, AN/ARC-210(V) - dated 12 January 2017

User agency will provide security classification guidance for performance of this contract. Any classified information generated in performance of this contract shall be classified in accordance to the marking shown on the source material.

Block 11.j – OPSEC: While performing aboard NAVAIR or other U.S. military sites, the contractor shall comply with the provisions of SECNAVINST 3070.2A, the local Command/Facility 3070.2A Instruction Series (OPSEC), as well as any procedures identified in Program-Specific Operations Security Plans and Program Protection Plans (PPP) as applicable. The contractor shall comply with any and all additional OPSEC security plans and requirements of the Hosting Command. All applicable OPSEC Plans will be provided by TPOC identified in Block 16. The prime contractor is responsible for subcontractor implementation of Operations Security.

If additional security classification assistance is required, please contact the COR listed in block 16d.

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.)

OPSEC in contract

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 Air Systems Command

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

N00019

c. ADDRESS (Include ZIP Code) 46990 Hinkle Cir Patuxent River, MD 20670 20670-1627

d. POC NAME

Pedro Besinaiz

e. POC TELEPHONE (Include Area Code)

+1 (443) 889-8826

f. EMAIL ADDRESS (See Instructions) pedro.besinaiz.civ@us.navy.mil

PREVIOUS EDITION IS OBSOLETE. Page 4 of 4DD FORM 254, APR 2018

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)

Rachel Richards

b. TITLE

Industrial Security Representative

c. ADDRESS (Include ZIP Code) Commander, Naval Air Warfare Center Aircraft Division Attn: Industrial Security 21983 Bundy Rd, Bldg. 441, Patuxent River, MD 20670

d. AAC OF THE CONTRACTING OFFICE (See Instructions)

N00019

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

f. TELEPHONE (Include Area Code)

g. EMAIL ADDRESS (See Instructions) rachel.e.richards3.civ@us.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.)

RICHARD

S.RACHE

L.ELIZAB

ETH.10340

13132

Digitally signed by

RICHARDS.RA

CHEL.ELIZABE

TH.1034013132

Date: 2025.01.30 12:39:15 -05'00'