Att_1_BAA_Amend_3_N0002417IWS5A_Material_Request_Form_TOU_2018.pdf

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11.0.0.20130303.1.892433 N00024

IWS5A

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 daniel.kittrell@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 Prior ity Briefs and/or classification guidance] Company Name Unclassified Mailing Address Classified Mailing Address Classified Mailing POC Name: ______ Phone:

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) R equested Method of Delivery

Fed Ex CTR Fed Ex Account Number:

USPS

Contractor C ourier 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 Name: ______ Phone: ______ Email:

*Personnel verified by FSO Name: ______ Phone: ______ Email:

*Personnel verified by FSO Name: ______ Phone: ______ Email:

N00024

IWS5A

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

IWS5A

01, NAVSEA requires endorsement of this Terms of Use Agreement. Certification that your facility is suited for receipt and storage o f 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 reques ted 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.

M aterials 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 perso n 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 N0

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 Unit ed 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 term s of this agreement 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 m eghan.myers.ctr@navy.smil.mil. All questions shall be received, by NAVSEA, within 30 days of receipt of the requested documents . Note that White Papers shall not be accepted by email in accordance withBroad 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 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