Attachment 2 - DD254.pdf

CLASSIFICATION (When filled in): Unclassified

NRL SER: 024-22

PREVIOUS EDITION IS OBSOLETE. Page 1 of 6DD 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 70 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)

Top Secret

b. LEVEL OF SAFEGUARDING FOR CLASSIFIED INFORMATION/

MATERIAL REQUIRED AT CONTRACTOR FACILITY

Secret

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

a. PRIME CONTRACT NUMBER (See instructions.)

b. SUBCONTRACT NUMBER

c. SOLICITATION OR OTHER NUMBER

57-1001-23

DUE DATE (YYYYMMDD)

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

a. ORIGINAL (Complete date in all cases.)

DATE (YYYYMMDD)

20240605

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.N00173-17-D-2002

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

FOR RFP PURPOSES ONLY; NOT VALID FOR

ACTUAL CONTRACT AWARD.

b. CAGE CODE

TBD

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

DEFENSE COUNTERINTELLIGENCE AND

SECURITY AGENCY

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.)

NAVAL RESEARCH LABORATORY

4555 OVERLOOK AVENUE, SW

WASHINGTON, DC 20375

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

N/A

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

N/A

a. LOCATION(S) (For actual performance, see instructions.)

VARIOUS U.S.NAVY SHIPS AND

U.S.GOVERNMENT FACILITES, CONUS AND

OCONUS, FOR PREPARATION, TESTING

AND MEETING PURPOSES ONLY.-SECRET ACCESS

ONLY.

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

N/A

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

N/A

NRL SER: 024-22

PREVIOUS EDITION IS OBSOLETE. Page 2 of 6DD FORM 254, APR 2018

a. LOCATION(S) (For actual performance, see instructions.)

CONTRACTOR FACILITY- TBD AFTER AWARD

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

ANALYSIS OF THREAT MISSILE SYSTEMS AND INTEGRATION OF ALL SOURCE DATA. EVALUATION OF THE PERFORMANCE AND PROJECTED PERFORMANCE OF NAVY ELECTRONIC COUNTERMEASURES. THE ACQUISITION OF FOREIGN TECHNOLOGY INFORMATION AND HARDWARE. THE DERIVATION OF REQUIREMENTS FOR NAVY ELECTRONIC

COUNTERMEAURES HARDWARE. PROGRAM MANAGEMENT SUPPORT.

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.)

SIPRNET and JWICS ACCESS REQUIRED

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.)

SECURE VOICE CAPABILITY

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) Public Release Authority:

PUBLIC RELEASE OF ANY INFORMATION, TO INCLUDE

SCI, CONCERNING THIS CONTRACT IS NOT AUTHORIZED.

13. SECURITY GUIDANCE

NRL SER: 024-22

PREVIOUS EDITION IS OBSOLETE. Page 3 of 6DD FORM 254, APR 2018

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.)

1. Contractor Sensitive Compartmented Information (SCI) work/access is granted at the U.S. Government facility only. Contractors requiring SCI access must be US citizens, possess a final DoD granted TOP SECRET security clearance, based on a DoD Tier 5 investigation; be lCD 704 eligible, and be indoctrinated for the applicable SCI compartments prior to access. Names of contractor personnel requiring SCI access will be submitted to the SCI POC named in para 14. Contractor personnel requiring access to non-SCI classified material at NRL must be a US citizen, have a favorably adjudicated DoD Tier 3 investigation and a final SECRET clearance with prior approval of the COR and security POC named in para 12 to work on this contract. Contractor personnel requiring access to unclassified information at NRL must have a favorably adjudicated DoD Tier 3 investigation or a DoD issued interim Secret clearance. See paragraph 12 concerning the investigation requirements for those performing IT duties. See paragraph 9 concerning access based on an interim secret clearance. The number of SCI billets are limited to 14. Coordination with the SSO, Code 1232, is required for additional billets.

2. NATO briefings required. NATO access authorized at SECRET level only. Initial NATO briefings must be within a 5 year scope of the completed investigation. Visit request and a copy of NATO indoctrination must be sent to Code 1231 prior to access. NATO briefing date must be within the current year. Annual refresher briefings for NATO access are required. A copy of the signed annual re-briefings must be forwarded to NRL Code 1231 annually. NATO access is authorized at cleared US Government/DoD facilities only.

3. Controlled Unclassified Information (CUI) associated with this contract must be handled/controlled IAW DoD 5200.48.

4. Foreign Nationals are only authorized to work on publicly releasable information.

5. The contractor will be required to generate, receive or store SECRET material at the contractor's facility during performance of this contract. Contractor must return all classified information generated in conjunction with this contract to the COR named below at the completion of this contract. All classified information transferred to contractor will be accounted for by the COR until returned or appropriate destruction certification is received.

6. COMSEC briefings required and processed through NRL COMSEC, Code 1222, (202) 767-7481.

7. All contractors (including subcontractors) identified in the Statement of Work shall supplement their current security practices by requiring any personnel involved in executing the contract to complete Operations Security (OPSEC) training via DCSA through their CDSE site: https://securityawareness.usalearning.gov/opsec/index.htm; and follow any OPSEC guidance that may pertain to the project.

8. Contractor personnel performing any function designated as a component of the Cyber Security Work Force (CSWF), and/or having privileged user access to NRL information systems and/or networks will require background investigations as specified in SECNAV M-5510.30. Contractors with privileged access shall meet the training and certification requirements specified in SECNAV M-5239.2. A submitted DoD Tier 5 Investigation is required for all with privileged access. Personnel performing these duties must be identified as such on all badge and visit request submissions.

9. Visit requests and Need-to-know certifications are required for all personnel on this contract. Visit requests must include full name, SSN, contract number, clearance level, date of closed investigation and should state if IT access is required. Visit requests for OTHER U.S.

Government/DoD contractor facilities will be processed through the contractor FSO. Authorized work locations for this contract are listed below.

10. The prime contractor will forward a copy of all proposed subcontracts and task orders to the COR named in paragraph 12, related to this contract, regardless of classification, for review, approval and coordination with the official named in block 16d below. All subcontracts must be approved in writing, by the official named in block 16d below prior to the start of work.

11. Contractors issued a DoD interim secret security clearance may ONLY work on unclassified tasks as outlined in the SOW .

Unclassified IA or IT positions are NOT authorized with a DoD issued interim secret clearance. Contract Facility Security Officers (FSOs), and/or NRL CORs, are required to report immediately to Code 1230 any derogatory information regarding a contractor holding an interim Secret clearance, either on- or off-site. FSOs and NRL CORs shall also notify Code 1230 when a contractor’s interim or final clearance has been declined or revoked.

12. The NRL COR for the contract is Jeffrey Shue; NRL Code 5715, (202) 404-2627. The SCI POC for this contract is Oscar Barrow, NRL Code 1232, (202) 279-5429. The NRL Security POC is Tara Burchick, NRL Code 1231, (202) 767-1380.

RRELEASE OF SENSITIVE COMPARTMENTED INFORMATION (SCI) INTELLIGENCE INFORMATION TO U.S.

CONTRACTORS

SCI NETWORK ACCESS REQUIRED: Yes

The Naval Research Laboratory (NRL) Cognizant Senior Intelligence Officer (SIO) has exclusive security responsibility for all Sensitive Compartmented Information (SCI) classified material released to or developed under the contract. Access to SCI Intelligence material requires adherence to the requirements set forth in the following: Department of Defense (DoD) Manual (DoDM) 5105.21, Volume 1, SCI Administrative Security Manual: Administration of Information and Information Systems Security; DoDM 5105.21, Volume 2, SCI Administrative Security Manual: Administration of Physical Security, Visitor Control, and Technical Security; DoDM 5105.21, Volume 3, NRL SER: 024-22

PREVIOUS EDITION IS OBSOLETE. Page 4 of 6DD FORM 254, APR 2018

SCI Administrative Security Manual: Administration of Personnel Security, Industrial Security, and Special Activities; ICD 403, Foreign Disclosure and Release of Classified National Intelligence; ICD 701, Security Policy Directive for Unauthorized Disclosures of Classified Information; ICD 703 Protection of Classified National Intelligence Including Sensitive Compartmented Information; ICS 703-02, Reporting Requirements for Individuals with Access to Sensitive Compartmented Information; ICS 703-03, Protection of Classified National Intelligence Including SCI Shared with Entities Outside the Intelligence Community; ICS 703-04, Foreign Ownership, Control, or Influence (FOCI); ICD 710, Classification Management and Control Markings Systems; ICPG 710.1, Application of Dissemination Controls: Originator Control (ORCON); 32 CFR Part 11, National Industrial Security Program Operating Manual (NISPOM); DoDM

5220.32 Volume 1 National Industrial Security Program: Industrial Security Procedures For Government Activities; DoDM 5200.01, Volumes 1-3, DoD Information Security Program; DoDI 5200.48, Controlled Unclassified Information; and Security Executive Agent Directive (SEAD) 3, Reporting Requirements for Personnel with Access to Classified Information or who hold a Sensitive Position.

Contractor’s will comply with all regulations/manuals/directives stated therein which provide the necessary security and classification guidance for personnel, information, physical, automated information security (AIS), and technical security measures and is a part of the SCI security specifications for the contract. Inquiries pertaining to SCI classification guidance or interpretations shall be directed to the Contracting Officer (KO)/Contracting Officer Representative (COR) identified on the attached DD Form 254.

1.Requirements for access to SCI:

a. All SCI will be handled in accordance with special security requirements, which will be furnished by the NRL Special Security Officer

(SSO).

b. SCI will not be released to contractor employees without specific release approval of the originator of the material as outlined in governing directives; based on prior approval and certification of "need-to-know" by the designated COR.

c. The contractor must restrict access to only those individuals who possess the necessary security clearance and who are actually providing services under the contract with a valid need to know. Further dissemination to other contractors, subcontractors, other government agencies, private individuals or organizations is prohibited unless authorized in writing by the originating agency through the COR.

d. Names of contractor personnel requiring access to SCI will be submitted to the COR for approval. (The COR is identified on the DD Form 254.) Upon receipt of written approval from the COR, the company security officer will submit request(s) for special background investigations, in accordance with the NISPOM, to the Defense Counterintelligence and Security Agency (DCSA).

e. SCI material must not be released to foreign nationals or immigrant aliens whether they are consultants, U.S. contractors, or employees of the contractor and regardless of the level of their security clearance, except with advance written permission from the originator.

Requests for release to foreign nationals shall be initially forwarded to the COR and shall include:

i. A copy of the proposed disclosure.

ii. Full justification reflecting the benefits to U.S. interests.

iii. Name, nationality, particulars of clearance, and current access authorization of each proposed foreign national recipient.

f. Contractor personnel must maintain accountability for all intelligence materials released o their custody.

g. SCI material will not be reproduced without prior approval of the originator of the material. All SCI material shall bear a prohibition against reproduction while in the contractor’s custody.

H. Inquiries pertaining to classification guidance on SCI will be directed through the CSSO to the responsible COR as indicated on the DD Form 254.

i. SCI released to cleared-DoD Contractors, all reproductions thereof, and all other information generated based on, or incorporating data from, in support of this contract, remains the property of the U.S. Government. Upon completion or cancellation of the contract, all SCI material furnished will be returned to the direct custody of the supporting SSO, or destroyed IAW instructions outlined by the COR.

j. SCI will be stored and maintained only in properly accredited facilities meeting the physical security requirements in ICD 705, SCI Facilities and ICS 705, Technical Specifications for Construction and Management of SCI Facilities.

K .The NRL SSO will recognize the above noted estimated completion date (ECD) as the completion date for the contract. The SSO will initiate action to debrief contractor personnel with access to this contract unless extensions or modifications to the contract are received by the SSO office no later than 30 days after the established completion date.

NRL SER: 024-22

PREVIOUS EDITION IS OBSOLETE. Page 5 of 6DD FORM 254, APR 2018

l. The contractor is governed by ICD 704, ‘Personnel Security Standards and Procedures Governing Eligibility for Access to Sensitive Compartmented Information (SCI) And Other Controlled Access Program Information’ and may be supplemented by SSO Navy.

Contractor personnel, assigned to this contract, that are eligible for access to SCI or currently possess an SCI personnel security clearance with another non-DoD agency must have their SCI eligibility adjudicated by the DCSA Consolidated Adjudication Services (CAS) prior to having access to SCI information retained by Naval Research Laboratory, unescorted access to Naval Research Laboratory spaces, and receipt of an Naval Research Laboratory issued contractor badge. The contractor will identify, in writing, contractor personnel assigned to this contract by NAME, SSN, Date and Place of Birth, and provide this documentation to the KO/COR identified on the DD 254. The KO/ COR will identify the SCI caveats for the contract and forward a copy of this documentation to the SSO for processing. This documentation will be marked and protected under the Privacy Act of 1974.

m. Electronic processing of SCI must be accomplished on equipment accredited in accordance with DoDM 5105.21 Volumes 1- 3, ICD 503, Information Technology System Security Risk Management, Certification and Accreditation, and the DoDIIS Joint Security Implementation Guide (DJSIG), Appendix D.

n. SCI security management issues shall be directed to Oscar A. Barrow, NRL Code 1232, (202) 279-5429.

o. In accordance with Director of National Intelligence Memorandum 5 May 2017, Access to North Atlantic Treaty Organization (NATO) Information by Intelligence Community (IC) Personnel and Naval Intelligence Security Policy Directive 17-008 Revision, Mandate for North Atlantic Treaty Organization (NATO) Information by Intelligence Community (IC) Personnel, all DoN Contractors with SCI access and access to JWICS or SIPRNet must be briefed into NATO Secret Information.

**NOTE**: ADDITIONAL SECURITY GUIDANCE SPECIFIC TO THE SCI CONTRACT WILL BE PROVIDED BY THE COR AND COMMAND SSO TO IDENTIFY SECURITY CLASSIFICATION GUIDES AND PROGRAM SPECIFIC SECURITY GUIDANCE THAT DEFINE TECHNICAL AND SAFEGUARDING REQUIREMENTS IDENTIFIED IN THE SOW/PWS/SOO.

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

Tara Burchick, NRL Security Specialist

SIGNATURE

NAME & TITLE OF REVIEWING OFFICIAL

Francheska Medina, NRL SSO

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.)

SEE BLOCK 13 PARAGRAPH 7. SCI ADDENDUM INCLUDED IN BLOCK 13.

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.)

NRL SIO HAS EXCLUSIVE SECURITY RESPONSIBILITY FOR SCI CLASSIFIED MATERIAL RELEASED OR DEVELOPED

UNDER THIS CONTRACT.

16. GOVERNMENT CONTRACTING ACTIVITY (GCA) AND POINT OF CONTACT (POC)

BURCHICK.TARA.

NICOLE.1544738980

Digitally signed by

BURCHICK.TARA.NICOLE.154

4738980 Date: 2024.06.05 10:09:08 -04'00'

MEDINA.FRANCHE

SKA.L.1117035430

Digitally signed by

MEDINA.FRANCHESKA.L.111

7035430 Date: 2024.07.03 13:44:38 -04'00'

NRL SER: 024-22

PREVIOUS EDITION IS OBSOLETE. Page 6 of 6DD FORM 254, APR 2018

a. GCA NAME

NAVAL RESEARCH LABORATORY

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

N00173

c. ADDRESS (Include ZIP Code)

4555 OVERLOOK AVENUE, SW

WASHINGTON, DC 20375

d. POC NAME

JASON CALANDRUCCIO

e. POC TELEPHONE (Include Area Code)

+1 (202) 924-1182

f. EMAIL ADDRESS (See Instructions)

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)

SHUE, JEFFERY

b. TITLE

HEAD, SURFACE ELECTRONIC PAYLOADS RESEARCH SEC.

c. ADDRESS (Include ZIP Code)

4555 OVERLOOK AVENUE, SW

WASHINGTON, DC 20375

d. AAC OF THE CONTRACTING OFFICE (See Instructions)

N00173

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

f. TELEPHONE (Include Area Code)

+1 (202) 404-2627

g. EMAIL ADDRESS (See Instructions) jeffrey.b.shue.civ@us.navy.mil

h. SIGNATURE

i. DATE SIGNED (See Instructions)

20240607

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.)

1222, 1231, 1232, 5702, 5715

SHUE.JE

FFREY.B

RIAN.12

44559634

Digitally signed by

SHUE.JEFFRE

Y.BRIAN.12445

59634 Date: 2024.06.07 11:51:16 -04'00'