Att_1_-_BAA_17IWS5A_Mat._Req_Form_TOU_2019.pdf

N00024-17-IWS5A-01

BROAD AGENCY ANNOUNCEMENT MATERIAL REQUEST FORM

Those companies who wish to receive the material relevant to the Broad Agency Announcement (BAA)

N00024-17-IWS5A-01 are to request such information from robert.j.mcneal@navy.mil and provide a copy to tracey.carothers@navy.mil, courtney.ryan@navy.mil, and IWS5BAA@cgifederal.com. Said companies should complete the “Material Request” below and return it via email to the aforementioned

Points of Contact.

MATERIAL REQUEST

Material Requested

[Specify which BAA Priority Briefs and/or classification guidance]

Company Name

Unclassified Mailing Address

Classified Mailing Address

Classified Mailing POC

Name: __________________________

Title: __________________________

Email: __________________________

Facility Security Officer (FSO)

Name: __________________________

Phone: __________________________

Email: __________________________

*Use an additional sheet if needed

Cage Code

Level of Facility Clearance

Level of Storage Capability/Level of

Safeguarding

(Please Select ONLY One) Requested Method of Delivery

Fed Ex

CTR Fed Ex Account Number:

mailto:robert.j.mcneal@navy.mil mailto:tracey.carothers@navy.mil mailto:IWS5BAA@cgifederal.com

USPS

Contractor Courier Pick Up

CTR Point of Contact:

Name: ______________________________________

Phone: ______________________________________

Email: ______________________________________

By signing, the FSO has verified the following people have sufficient security clearance to handle Secret

Classified Material

[FSO Signature Here]

*Personnel Verified by FSO

Name: ______________________________________

Phone: ______________________________________

Email: ______________________________________

*Personnel verified by FSO

N00024-17-IWS5A-01

BROAD AGENCY ANNOUNCEMENT TERMS OF USE AGREEMENT

1. In response to your interest in receiving materials provided in support of Broad Agency Announcement (BAA) N00024-17-IWS5A-01, NAVSEA requires endorsement of this Terms of Use Agreement. Certification that your facility is suited for receipt and storage of classified information, will permit NAVSEA to forward the classified information. In addition, upon receipt of this signed agreement, PEO IWS 5.0 will provide materials requested on Page 1 of the Material Request Form.

2. Please note that materials requested on Page 1 of the Material Request Form include the

Navy’s priority areas of interest including information up to SECRET and should be safeguarded in accordance with DoD 5220.22-M, National Industrial Security Program Operating Manual (NISPOM).

3. Materials requested on Page 1 of the Material Request Form are labeled as “Distribution

Statement F: Further dissemination only as directed by PEO IWS 5.0 or higher authority.”

Copies of the UNCLASSIFIED documents are limited to one (1) copy for each person identified on the BAA Material Request Form, excluding the Facilities Security Officer.

These copies will be property of the Government, must be controlled in accordance with the Distribution Statement F and the terms of your Company’s Defense Security Service (DSS) approved document handling procedures.

4. You may NOT:

a. Duplicate, transmit or post the above documents in a manner contrary to the guidance provided herein.

b. Disclose the above documents to anyone that was not identified on the NAVSEA BAA N00024-17-IWS5A-01 Material Request Form.

c. Disclose the above documents to foreign nationals (regardless of clearance, export licenses, or international agreement) or transmit said enclosures outside the geographical bound or custom territory of the United States of America.

5. You shall maintain records of disclosure of the requested documents and shall furnish these records upon demand of the Contracting Officer or other authorized Government security officials. Upon conclusion of your efforts, you shall destroy the requested documents or data in a manner approved for the destruction of classified material and shall maintain records of destruction available for inspection for a period of five (5) years.

6. You are required to acknowledge and accept the terms of this letter prior to receipt of requested documents. Such acknowledgement and acceptance must be made by the Facility Security Officer.

7. After review of requested documents, please send all questions to PEO IWS 5.0, through

CLASSIFIED mail (address below) or SIPRNET at robert.j.mcneal@navy.smil.mil and meghan.myers.ctr@navy.smil.mil. All questions shall be received within 30 days of the date of this letter. Note that White Papers shall not be accepted by email in accordance with Broad Agency Announcement (BAA) N00024-17-IWS5A-01.

CLASSIFIED Mailing Address:

Commander Naval Sea Systems Command ATTN: Code PEO IWS5A (Robert McNeal) 1333 Isaac Hull Avenue, SE, Stop 2040 Washington Navy Yard, DC 20376-2040

First Endorsement:

On behalf of _________________________________________, I do hereby accept the terms of the above letter.

Printed Name of Facility Security Officer / Facility Clearance Level (FCL)

Signature of Facility Security Officer / Date

11.0.0.20130303.1.892433