Attachment_IV_-_DD_Form_254.pdf

DEPARTMENT OF DEFENSE

CONTRACT SECURITY CLASSIFICATION SPECIFICATION

(The requirements of the DoD Industrial Security Manual apply to all security aspects of this effort.)

1. CLEARANCE AND SAFEGUARDING

a. FACILITY CLEARANCE REQUIRED

b. LEVEL OF SAFEGUARDING REQUIRED

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

a. PRIME CONTRACT NUMBER

b. SUBCONTRACT NUMBER

c. SOLICITATION OR OTHER NUMBER DUE DATE (YYYYMMDD)

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

a. ORIGINAL (Complete date in all cases)

REVISION NO.

c. FINAL (Complete Item 5 in all cases)

DATE (YYYYMMDD)

b. REVISED (Supersedes all previous specs)

DATE (YYYYMMDD)

DATE (YYYYMMDD)

4. IS THIS A FOLLOW-ON CONTRACT? YES NO. If Yes, complete the following:

Classified material received or generated under (Preceding Contract Number) is transferred to this follow-on contract.

5. IS THIS A FINAL DD FORM 254? YES NO. 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 b. CAGE CODE c. COGNIZANT SECURITY OFFICE (Name, Address, and Zip Code)

7. SUBCONTRACTOR

a. NAME, ADDRESS, AND ZIP CODE b. CAGE CODE c. COGNIZANT SECURITY OFFICE (Name, Address, and Zip Code)

8. ACTUAL PERFORMANCE

a. LOCATION b. CAGE CODE c. COGNIZANT SECURITY OFFICE (Name, Address, and Zip Code)

9. GENERAL IDENTIFICATION OF THIS PROCUREMENT

10. CONTRACTOR WILL REQUIRE ACCESS TO: 11. IN PERFORMING THIS CONTRACT, THE CONTRACTOR WILL:YES NO YES NO

a. COMMUNICATIONS SECURITY (COMSEC) INFORMATION

b. RESTRICTED DATA

c. CRITICAL NUCLEAR WEAPON DESIGN INFORMATION

d. FORMERLY RESTRICTED DATA

e. INTELLIGENCE INFORMATION

(1) Sensitive Compartmented Information (SCI)

(2) Non-SCI

f. SPECIAL ACCESS INFORMATION

g. NATO INFORMATION

h. FOREIGN GOVERNMENT INFORMATION

i. LIMITED DISSEMINATION INFORMATION

j. FOR OFFICIAL USE ONLY INFORMATION

k. OTHER (Specify)

a. HAVE ACCESS TO CLASSIFIED INFORMATION ONLY AT ANOTHER

CONTRACTOR'S FACILITY OR A GOVERNMENT ACTIVITY

b. RECEIVE CLASSIFIED DOCUMENTS ONLY

c. RECEIVE AND GENERATE CLASSIFIED 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 TEMPEST REQUIREMENTS

j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS

k. BE AUTHORIZED TO USE THE DEFENSE COURIER SERVICE

l. OTHER (Specify)

DD FORM 254, DEC 1999 PREVIOUS EDITION IS OBSOLETE.

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12. PUBLIC RELEASE. Any information (classified or unclassified) pertaining to this contract shall not be released for public dissemination except as provided by the Industrial Security Manual or unless it has been approved for public release by appropriate U.S. Government authority. Proposed public releases shall be submitted for approval prior to release

a. TYPED NAME OF CERTIFYING OFFICIAL

Direct Through (Specify)

d. ADDRESS (Include Zip Code)

Yes No to the Directorate for Freedom of Information and Security Review, Office of the Assistant Secretary of Defense (Public Affairs)* for review.

*In the case of non-DoD User Agencies, requests for disclosure shall be submitted to that agency.

13. SECURITY GUIDANCE. The security classifiection guidance needed for this classified 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. Add additional pages as needed to provide complete guidance.)

14. ADDITIONAL SECURITY REQUIREMENTS. Requirements, in addition to ISM requirements, are established for this contract.

(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 cognizant security office. Use Item 13 if additional space is needed.)

Yes No15. INSPECTIONS. Elements of this contract are outside the inspection responsibility of the cognizant security office.

(If Yes, explain and identify specific areas or elements carved out and the activity responsible for inspections. Use Item 13 if additional space is needed.)

16. CERTIFICATION AND SIGNATURE. 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.

b. TITLE c. TELEPHONE (Include Area Code)

e. SIGNATURE

17. REQUIRED DISTRIBUTION

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. OTHERS AS NECESSARY

DD FORM 254 (BACK), DEC 1999

Updated 06 16 2015

Block 13 Security continuation sheet

Contractors are required to follow all applicable COTF instructions that are available on the COTF KMS web page and the Department of the Navy (DON) Personnel Security Program (PSP), SECNAVINST 5510.36A; Department of the Navy Information Security Program, SECNAV M5510.36 , National Industrial Security Program Operating Manual, DOD 5520.22M

a. All Visit requests to activities other than those not listed in the statement of work or this DD 254 shall have "Need to Know" certified by the COMOPTEVFOR Security Department. The Contractor Company will not submit any visit request for their contractors working on this contract. All visit requests will be done by COMOPTEVFOR Security Department. Contract companies are not required to submit any visit request for their employees.

b. All contractors will be required to do a full check-in regardless if they work on-site or off-site. All contractors are required to show up to COMOPTEVFOR with their own Work Authorization Memo (WAM) on company letterhead with an original signature by their companies approving authority. Photo copies of WAMS will not be accepted.

c. Contractors are required to follow the COTF check in and out process in the following order. Checking in 1-8 and Checking out 8-1. If there is an extension to your contract you will only need to come to security and CIO office.

1. Admin

2. COR (contract verification)

3. A/B/section head (Access Level)

4. Facilities (parking sticker)

5. Trusted agent (CAC card)

6. Security (clearance verification and badge)

7. CIO (Account Access and computer)

8. Security (return check in sheet)

d. All Government Badges and Common Access Cards (CAC) issued under this contract will be returned to the COMOPTEVFOR security department upon termination of the contract, or an individual’s terminations from the company.

When the company terminates an employee’s employment it is the responsibility of the Facility Security Officer or principle manager to immediately notify the Command Security Manager, COMOPTEVFOR. All contractors are required to check in and check out. Failure to comply could result in negative reporting to DSS and the COR.

e. All Contractors are required to display their badges at all times on the outer most article of clothing while in the building.

f. When entering the building:

1. Only one person may be allowed to enter through any exterior entry door and it must be physically closed by that person entering (whether someone is behind you or not) before the next person can enter their pin and badge.

2. When exiting an interior door you must physically shut the door (there is no rule about multiple people exiting the door) only that the last person is responsible for ensuring the door is closed. This prevents the door staying open due to the over pressurization of air (the side exit door leading to the smoking area is notorious for being left open do to the air pressure).There is absolutely NO PIGGY BACKING

g. All contractors are required to remove their SIPR tokens from the card reader when more than an arm’s length away from their desk. It may be stored in the desk drawer or placed out of plain site. All Common Access Cards (CAC) will be on their persons while not at their desk.

7970 Diven Street, Bldg CA-10 Norfolk, VA 23505-1498

7970 Diven Street, Bldg CA-10 Norfolk, VA 23505-1498

7970 Diven Street, Bldg CA-10 Norfolk, VA 23505-1498

- Contractors requiring access to classified information under the performance of this contract must be a U.S. citizen and possess a DOD issued security clearance for the appropriate level. Access to classified material is limited to those with a valid need to know.

- The “For Official Use Only” information provided under this contract shall be safeguarded as specified in the Facilities Clearance Request that will be submitted by the contractor.

- Contractor personnel shall not discuss classified material or unclassified technical sensitive information on any non-secure telephone or disclose such information to any unauthorized personnel.

- The following provisions apply for the protection of Controlled Unclassified Information (CUI):

1. Foreign nationals (Non U.S. citizens) will be denied access to CUI unless expressly permitted by the COMOPTEVFOR Command Security Manager.

2. Compliance with COMOPTEVFOR Instruction 5239.7 Protection of Controlled Unclassified Information is required 10d. FORMERLY RESTRICTED DATA will be handled and controlled as indicated in the NISPOM. This contractor is permitted access to CNWDI in performance of the contract. The Government program manager or designated representative ensures the contractor security supervisor is briefed for access to CNWDI by a Government representative prior to granting access. Access requires a final U.S. Government clearance at the appropriate level. (COTF SSO OR CSM) cannot conduct read-ins for this.

Item 10e. – Access to NON-SCI intelligence information is authorized for preparation of operational testing materials under the following conditions:

-Contractors will not release intelligence material to any activity or person not directly engaged in providing services under the contract or to another contractor, government agency, private individual or organization without prior approval of the Office of Naval Intelligence (ONI) via COMOPTEVFOR.

-Contractors will not release intelligence material to foreign nationals or immigrant aliens who may be employed by the contractor, regardless of the level of their security clearance or access authorization except with specific permission of ONI via COMOPTEVFOR.

Item 11a. – Contract performance is restricted to Block 6a, 7a and 8a.until amended.

For further information contact the Special Security Officer / Security Manager Kevin Smith 757-282-5546 ext3603 or, Command COR: Timothy R. Burrows, (757) 282-5546 ext 3136, email: Timothy.Burrows@cotf.navy.mil