Draft_DD254_PMRF_N00421-16-R-0011.doc

N00421-16-R-0011

1. CLEARANCE AND SAFEGUARDING

a. PRIME CONTRACT NUMBER

20160115

b. SUBCONTRACT NUMBER

all previous specs)

N00421-16-R-0011 Due Date (YYYYMMDD)

4. IS THIS A FOLLOW-ON CONTRACT?

N00421-12-D-0010

NO. If Yes, complete the following:

5. IS THIS A FINAL DD FORM 254?

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

TBD

b. CAGE CODE

TBD

c. COGNIZANT SECURITY OFFICE (Name, Address, and Zip Code)

TBD

TBD

8. ACTUAL PERFORMANCE

Pacific Missile Range Facility Barking Sands, Kuai, HI

9. GENERAL IDENTIFICATION OF THIS PROCUREMENT

Contractor will provide medium and heavy lift aircraft operations for Fleet Training and Research, Development, Test and Evaluation IPT Lead: Brian T. Alexander, PMA-226 (252) 466-5368, email:brian.t.alexander@navy.mil COR: Rhonda K. Link, PMA-226, (252) 466-5375, email: rhonda.link@navy.mil

a. COMMUNICATIONS SECURITY (COMSEC) INFORMATION

FACILITY OR A GOVERNMENT ACTIVITY

X

b. RESTRICTED DATA

X

c. CRITICAL NUCLEAR WEAPON DESIGN INFORMATION

c. RECEIVE AND GENERATE CLASSIFIED MATERIAL

X

d. FORMERLY RESTRICTED DATA

X

e. INTELLIGENCE INFORMATION:

(1) Sensitive Compartmented Information (SCI)

PUERTO RICO, U.S. POSSESSIONS AND TRUST TERRITORIES

X

(2) Non-SCI

CENTER (DTIC) OR OTHER SECONDARY DISTRIBUTION CENTER

X

f. SPECIAL ACCESS INFORMATION

X

i. HAVE TEMPEST REQUIREMENTS

X

h. FOREIGN GOVERNMENT INFORMATION

i. LIMITED DISSEMINATION INFORMATION

k. BE AUTHORIZED TO USE THE DEFENSE COURIER SERVICE

X

l. OTHER (Specify) IN ADDITIOM TO CMS ACCOUNT A STE ACCOUNT IS REQUIRED.

X

k. OTHER (Specify)

X

DD FORM 254, DEC 1999 PREVIOUS EDITION IS OBSOLETE.

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.

Transmissions by non-secure facsimile OR E-mail is NOT authorized (By Prime(s)or subcontractor Submit ALL Public Releases to:

PMA-226 Program Office/1.3 Competency Code.

NAVAIR FORM 5720.10 must be completed and attached 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 classification 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.)

Technical papers, briefings, presentations, either classified or unclassified to be presented at classified symposia must be submitted to AIR-7.4.1 for approval prior to presentation. Unclassified material submitted for public release (that is not to be presented at classified symposia) shall be forwarded for review prior to release as stated in item 12 above. All controlled unclassified and classified technical information shall be appropriately marked with distribution statements as specified in DoDI 5230.24 (Distribution Statements on Technical Documents) http://www.dtic.mil/whs/directives/corres/pdf/523024p.pdf.

Determination of need-to-know in connection with a classified visit is the responsibility of the individual/host who will disclose the classified information.

10e (2) –Access to Intelligence information required for performance. Non-SCI Intelligence information is not releasable to contractor employees who have not received a final security clearance at the appropriate level. Contractor shall comply with Naval Air Warfare Center Aircraft Division Scientific and Technical Intelligence Liaison Officer Memo of 03 MAR 09 (attached).

Reviewed by:___________________________________________________________________________

Senior Intelligence Officer, Stephen Hendricks 10g- To facilitate potential access to NATO classified information, all DoD military, civilian, and contractor personnel who are briefed on their responsibilities for protecting U.S. classified military information, shall also be briefed on the requirements for protecting NATO information, per Deputy Under Secretary of Defense Policy Security Memo of 5 Dec 01. Written concurrence of the Contracting Officer Representative (COR), identified in Block 9, required prior to subcontracting.

10j. For Official Use Only information generated and/or provided under this contract shall be marked and safeguarded as specified in DoDM 5200.01(DoD Information Security Program: Controlled Unclassified Information (CUI))Vol. 4 (enclosure 3 pages 11-17) available at http://www.dtic.mil/whs/directives/corres/pdf/520001 vol4.pdf and DoD 5400.7-R, Freedom of Information Program Chapter 3 (pages 31-42) available at http://www.dtic.mil/whs/directives/corres/pdf/540007r.pdf See page 3 (Additional Data Sheet for DD Form 254)

NO

(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.)

OPSEC CDRL in contract

15. 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.)

NONE

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.

Bldg. 2272, Rm. 074, Attn: AIR-7.4.1 Security 47123 Buse Road

Patuxent River, MD 20670

b. SUBCONTRACTOR

e. SIGNATURE

d. U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECURITY ADMINISTRATION

e. ADMINISTRATIVE CONTRACTING OFFICER

ADDITIONAL DATA SHEET FOR DD FORM 254

11b. Receive classified documents only: Contractor will receive classified information for reference purposes only. There will be no generation or derivative classified material at the contractor facility.

11j. – OPSEC: The contractor shall develop, implement, and maintain a facility level OPSEC Program to protect critical information to be used at the contractor facility during the performance of this contract. Contract data requirements list (CDRL) and data item description (DID-DI-MGMT-80934C) are a component of the contract. A draft OPSEC Plan must be submitted to: Commander, Naval Air Systems Command, ATTN: Program/User Agency mailing address, within 90 days of contract award. A final OPSEC Plan is due 45 days from the date that the draft OPSEC Plan is approved. The Contractor shall be responsible for subcontractor implementation of the OPSEC Program requirements for this contract. OPSEC: While performing aboard NAVAIR or NAVAIR sites, the contractor shall comply with the provisions of OPNAVINST 3432.1, the local Command/Facility 3432 Instruction series (OPSEC) as well as any procedures identified in Program Specific Operations Security Plans and Program Protection Plans (PPP) as applicable. The Contractor shall be responsible for subcontractor implementation of the OPSEC Program requirements for this contract.

The following security classification guide, and subsequent upgrades/revision(s), is required for performance of this contract. Classification guidance and all revisions/updates will be provided to the contractor by the Program Office. If additional classification guidance is required, contact COR identified in block 9.

DoD Defense Continuity Program (DCP) Security Classification Guide, dated 15 Dec 2005.

****************************END OF DD FORM 254 ADDITIONAL DATA SHEET*******************************

ADDITIONAL DATA SHEET FOR DD FORM 254

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