Att. L-10 REV 1 Infocenter Account Request Form.pdf
PDF 362 KB Posted
- Attached to
- Navy Electronic Chart Display and Information System (ECDIS) Hardware and Software Production
- Solicitation number
- N00025-26-R-5246
About this file
This document is an account activation instruction form for the Portfolio Acquisition Executive (PAE) Mission Systems Information Center, hosted by Naval Surface Warfare Center Division Crane.
To request access to the PAE MS Information Center, applicants must provide personal and employment information including name, title, rank, employment status (civilian/military/contractor), current employer, contact details, work address, and the specific reason for data access. The form identifies Miss. Tania Adams as the PAE MS Program Office Point of Contact and indicates the access request is related to contract N00024-26-R-5246 ECDIS Offeror Library. Applicants must also complete a Non-Disclosure Agreement with digital or physical signatures and submit it to Austin Witt at william.a.witt19.civ@us.navy.mil. The certification statement requires acknowledgment of DoDI 8500.1 and SECNAVINST 5239.3C, binding users to protect classified information, maintain access identification security, follow security classification guidance from Product Directors, and use information systems only for official business. Questions regarding the process should be directed to Jennifer Flinn at Jennifer.m.flinn3.ctr@us.navy.mil or Austin Witt at the email address provided.
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Text version
Naval Surface Warfare Center Division Crane
Portfolio Acquisition Executive Mission Systems Information Center
Instructions for Portfolio Acquisition Executive (PAE) Mission Systems (MS) Information Center Account Activation
1. To request access, please provide the following information:
a) Last Name: _________________________________
b) First Name: _________________________________
c) Title/Rank: _________________________________
d) Position: ___________________________________
e) Civ/Mil/Contractor: __________________________
f) Current Employer/Activity: ___________________
g) Employer/Activity: ___________________________
h) Phone: ____________________________________
i) Email: ____________________________________
j) Work Address:______________________________
k) Work Address:______________________________
l) City, State, Zip: _____________________________
m) PAE MS Program Office POC: _____________________________
n) Reason/Data needed: ______________________________________
o) Certificate Info (CAC Users)____________________________
Miss. Tania Adams
N00024-26-R-5246 ECDIS Offeror Library
2. Complete the Non-Disclosure Agreement. Digital signatures are acceptable. If you are unable to do that, please print page two of this document; sign and email to Austin Witt at william.a.witt19.civ@us.navy.mil.
If you have any questions, you may contact Jennifer Flinn at Jennifer.m.flinn3.ctr@us.navy.mil or Austin Witt at william.a.witt19.civ@us.navy.mil.
mailto:william.a.witt19.civ@us.navy.mil mailto:Jennifer.m.flinn3.ctr@us.navy.mil mailto:william.a.witt19.civ@us.navy.mil
CERTIFICATION STATEMENT
PAE MS WEBSITE ACCESS REQUEST/NONDISCLOSURE OF PAE MS
GOVERNMENT INFORMATION
To: Mr. Austin Witt, NSWC Crane Task Lead
From:
Name and Organization
POC email address and phone number
Complete this form and email to william.a.witt19.civ@us.navy.mil
Subj: CERTIFICATION–NONDISCLOSURE OF PAE MS PROGRAM INFORMATION
Ref: (a) DoDI 8500.1 dated March 14, 2014 Ref: (b) SECNAVINST 5239.3C Department of the Navy Cybersecurity Policy
I acknowledge that I have read references (a) and (b). I understand my obligations and responsibilities, under applicable laws, regulations, directives and instructions not to discuss, divulge, or otherwise disclose via any means (e.g., paper, electronic mail, voice, facsimile, web site, diskette, etc.) any data, information, procedure, correspondence, documentation, computer code, evaluation, evaluation criteria, offer or proposal, photographic/video information or other For Official Use Only data except as approved by PAE MS, Command and Control Directorate.
To the best of my ability, I will protect my access identification from compromise and will notify security personnel immediately if I suspect that others have knowledge of it.
I agree to follow current security classification guidance provided by the Product Directors for each PAE MS product that I support. This includes official markings and encryption when emailed.
I understand that my signature on this document authorizes use of appropriate information systems, for official business only.
The Website office will maintain this Nondisclosure Form.
Signature and Date mailto:william.a.witt19.civ@us.navy.mil
| Naval Surface Warfare Center Division Crane |
| Portfolio Acquisition Executive Mission Systems |
| Information Center |
| CERTIFICATION STATEMENT |
| a Last Name: |
| b First Name: |
| c TitleRank: |
| d Position: |
| e CivMilContractor: |
| Current EmployerActivity: |
| g EmployerActivity: |
| h Phone: |
| Email: |
| Work Address: |
| k Work Address: |
| City State Zip: |
| o Certificate Info CAC Users: |
| Name and Organization: |
| POC email address and phone number: |
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