Attachment_J4_DD-254.pdf
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- Attached to
- AIR 4. 5. 3 Support Services
- Solicitation number
- N00421-18-R-0041
About this file
This document is a draft DD Form 254, which outlines the security requirements for a federal contract opportunity to provide AIR 4.5.3 Support Services. The contractor will be required to design, implement, test, manage and maintain laboratory and information systems and project-related software in support of AIR 4.5.3 at the Naval Air Warfare Center Aircraft Division in Patuxent River, Maryland. The contractor must have a facility security clearance level of Secret and will generate, receive and store classified information. The contractor will require access to communications security information and national intelligence information designated as sensitive compartmented information. The contract number is N00421-18-R-0041 and has a period of performance from April 2019 through April 2023. The Naval Air Systems Command is the contracting agency, and the contracting officer's representative and technical point of contact are identified.
Attachment J4 DD-254
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CLASSIFICATION (When filled in): Unclassified
PREVIOUS EDITION IS OBSOLETE. Page # of ##
AEM LiveCycle Designer DD FORM 254, APR 2018 PREVIOUS EDITION IS OBSOLETE. Page # of ##
AEM LiveCycle Designer
DD 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:
October 31, 2020
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
None (See instructions)
2. THIS SPECIFICATION IS FOR: (X and complete as applicable.)
a. PRIME CONTRACT NUMBER (See instructions.)
Request For Proposal, Not Valid For Performance
b. SUBCONTRACT NUMBER
c. SOLICITATION OR OTHER NUMBER
N00421-18-R-0041
DUE DATE (YYYYMMDD)
3. THIS SPECIFICATION IS: (X and complete as applicable.)
a. ORIGINAL (Complete date in all cases.)
DATE (YYYYMMDD)
20180716
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.N00178-14-D-7733-M801
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 N/A
b. CAGE CODE c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional)
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) Add Row Remove last Row Delete All Rows
a. NAME, ADDRESS, AND ZIP CODE N/A
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.) Add Row Remove last Row Delete All Rows
a. LOCATION(S) (For actual performance, see instructions.)
NAS Patuxent River Buildings 2805 & 2187 Patuxent River, MD 20670
b. CAGE CODE (If applicable, see Instructions.)
c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional)
9. GENERAL UNCLASSIFIED DESCRIPTION OF THIS PROCUREMENT
Contract is for requirement specification, design, implementation, test, management, and maintenance of laboratory/information system and project/program related software in support of AIR 4.5.3. Contract will provide engineering products for the development of facilities, systems and equipment, which are used for the integration, test, and evaluation of avionics systems or subsystem elements. It also involves the functions associated with coordinating with the systems engineering IPT for the complete aircraft system to ensure successful integration of the avionics systems.
COR: John Harris 301-342-9143 TPOC: Stan Zugay 301-342-9147 FAX: 301-342-9184
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AEM LiveCycle Designer
DD FORM 254, APR 2018
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.)
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 DoDM 5200.01, Volume 4 only for specific CUI protection requirements. Non-DoD Components: see instructions.)
m. OTHER (Specify) (See instructions.)
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)
Transmissions by non-secure facsimile or E-mail is NOT authorized (by Prime(s) or subcontractor(s)).
Public Release Authority:
PEO (A), Public Affairs Office, 47123 Buse Road, Suite 162, RADM William A. Moffett Building, Patuxent River, MD 20670
13. SECURITY GUIDANCE Add Signature Remove last Signature Delete All Signatures
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.)
Technical papers, briefings, presentations, either classified or unclassified to be presented at classified symposia shall be submitted for approval prior to presentation.
Determination of need-to-know in connection with a classified visit is the responsibility of the individual/host who will disclose the classified information.
Block 10.a: Classified COMSEC material is not releasable to contractor employees who have not received a final security clearance at the appropriate level. Cryptologic keying materials and Controlled Cryptographic Items (CCI) are controlled by Department of the Navy, NISPOM, and National Security Agency (NSA) guidelines. The contractor shall be guided by NSA/CSS Policy Manual 3-16 in the control and protection of COMSEC material/information at their facilities. When access is required at Government facilities, contractor personnel will adhere to COMSEC rules and regulations as mandated by DoD 5520.22-M, EKMS 1 (series) and Command policy and procedures.
Written concurrence of the Technical Point of Contact/Contracting Officer Representative/Contracting Officer Security Representative (as applicable) is required prior to subcontracting.
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AEM LiveCycle Designer DD FORM 254, APR 2018 PREVIOUS EDITION IS OBSOLETE. Page # of ##
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DD FORM 254, APR 2018
Block 10.j: For Official Use Only (FOUO) Information generated and/or provided under this contract shall be marked/safeguarded as specified in:
• DoDM 5200.01, Vol.4 can be found at the following website (enclosure 3 pages 11-18):
http://www.dtic.mil/whs/directives/corres/pdf/520001_vol4.pdf
• DoD 5400.7-R, Chapter 3 can be found at the following website (pages 31 thru 42):
http://www.dtic.mil/whs/directives/corres/pdf/540007r.pdf
Block 11.a: All classified information/material shall be provided by the contractor facility or Government Contracting Activity (GCA) and safeguarded at the approved actual performance site.
Block 11.j: 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 apply the following statement on the bottom of the front/cover page of all IN-SERVICE Technical Publications:
"Distribution Statement D: Distribution authorized to the Department of Defense and U.S. DoD contractors only (provide REASON here) (June 2014). Other requests shall be referred to the Presidential Helicopters Program Office (PMA-274), Patuxent River MD 20670.
WARNING- This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Administration Act of 1979 (Title 50, U.S. C., App. 2401 et seq.), as amended. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25."
The Contractor shall apply the following statement on the bottom of the front/cover page of ALL OTHER In-Service technical documents:
"DISTRIBUTION STATEMENT F: Further dissemination only as directed by the Presidential Helicopters Program Office (PMA-274), Patuxent River, MD 20670, (June 2014), or higher DoD authority.
WARNING- This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Administration Act of 1979 (Title 50, U.S. C., App. 2401 et seq.), as amended. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25."
The Contractor shall apply the following statement on the bottom of the front/cover page of ALL VH-92A program technical documents:
"DISTRIBUTION STATEMENT F: Further dissemination only as directed by the Presidential Helicopters Program Office (PMA-274), Patuxent River, MD 20670, (December 2015), or higher DoD authority.
WARNING- This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Administration Act of 1979 (Title 50, U.S. C., App. 2401 et seq.), as amended. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25."
The following Security Classification Guide(s) apply to classified performance on this contract. Subsequent updates shall be provided by the Contracting Officer Representative as Government Furnished Information (GFI) and shall be executed by the Contractor without obligation to modify this DD Form 254.
• OPNAVINST 5513.2C - SCG ID # 02-216.03 - VH-3D Executive Transport Security Classification Guide
• OPNAVINST 5513.2C - SCG ID # 02-161.03 - VH-60N Executive Transport Security Classification Guide
• OPNAVINST 5513.2C - SCG ID # 02-282.1 - VH-92A Presidential Vertical Lift Platform (PMA-274) Security Classification Guide
If additional security classification guidance is required, contact the Contracting Officer Representative identified in Block 9.
List of Attachments (All Files Must be Attached Prior to Signing, i.e., for any digital signature on the form)
Add Attachment View Selected Attachment Remove Selected Attachment
PREVIOUS EDITION IS OBSOLETE. Page # of ##
AEM LiveCycle Designer
DD FORM 254, APR 2018
NAME & TITLE OF REVIEWING OFFICIAL 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.)
OPSEC in contract.
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.)
16. GOVERNMENT CONTRACTING ACTIVITY (GCA) AND POINT OF CONTACT (POC)
a. GCA NAME
PMA-274
b. ACTIVITY ADDRESS CODE (AAC) OF THE CONTRACTING OFFICE (See Instructions)
N00421
c. ADDRESS (Include ZIP Code) Program Executive Office PMA-274 48202 Bronson Road, Bldg 2805 Patuxent River, MD 20670
d. POC NAME
Stan Zugay
e. POC TELEPHONE (Include Area Code)
+1 (301) 342-9147
f. EMAIL ADDRESS (See Instructions) stanley.zugay@navy.mil
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)
Rachel E Richards
b. TITLE
CONTRACTING OFFICER’S SECURITY REP
c. ADDRESS (Include ZIP Code) Naval Air Systems Command 48183 Shaw Road, Building 2806 Patuxent River, MD 20670
d. AAC OF THE CONTRACTING OFFICE (See Instructions)
N00421
e. CAGE CODE OF THE PRIME CONTRACTOR
(See Instructions.)
f. TELEPHONE (Include Area Code)
+1 (301) 995-1642
g. EMAIL ADDRESS (See Instructions) rachel.richards@navy.mil
h. SIGNATURE
i. DATE SIGNED (See Instructions)
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.)
COR, COSR
DRAFT
SAMPLE
PREVIOUS EDITION IS OBSOLETE.
Page of AEM LiveCycle Designer
DD FORM 254, APR 2018
NEEDS DD67
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:
October 31, 2020 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
2. THIS SPECIFICATION IS FOR: (X and complete as applicable.)
3. THIS SPECIFICATION IS: (X and complete as applicable.)
a. ORIGINAL (Complete date in all cases.)
b. REVISED (Supersedes all previous specifications.)
4. IS THIS A FOLLOW-ON CONTRACT?
If yes, complete the following:
Classified material received or generated under
5. IS THIS A FINAL DD FORM 254?
If yes, complete the following:
6. CONTRACTOR (Include Commercial and Government Entity (CAGE) Code)
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)
8. ACTUAL PERFORMANCE (Click button to add more locations.)
10. CONTRACTOR WILL REQUIRE ACCESS TO: (X all that apply. Provide details in Blocks 13 or 14 as set forth in the instructions.)
e. NATIONAL INTELLIGENCE INFORMATION:
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.)
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)
13. SECURITY GUIDANCE
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.)
14. ADDITIONAL SECURITY REQUIREMENTS
Requirements, in addition to NISPOM requirements for classified information, 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 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.)
15. INSPECTIONS
Elements of this contract are outside the inspection responsibility of the CSO.
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.)
16. GOVERNMENT CONTRACTING ACTIVITY (GCA) AND POINT OF CONTACT (POC)
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.
18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL
9.0.0.2.20120627.2.874785 DD 254, DoD Contract Security Classification Specification List of Attachments (All Files Must be Attached Prior to Signing, i.e., for any digital signature on the form)
| CurrentPage: |
| PageCount: |
| Classification: Unclassified |
| SerialNum: |
| a. Facility clearance level. Select one.: 1 |
| b. Level of safeguarding for classified information/material required at contractor facility. Select one.: 4 |
| Choose Yes or No: 0 |
| Choose Yes or No: 1 |
| Prime: Request For Proposal, Not Valid For Performance |
| Choose Yes or No: 0 |
| Choose Yes or No: 0 |
| Sub: |
| Choose Yes or No: 1 |
| Choose Yes or No: 0 |
| Soli: N00421-18-R-0041 |
| DueDate: |
| dateA: 2018-07-16 |
| RevisionNum: |
| dateB: |
| Final: |
| dateC: |
| No: 0 |
| No: 1 |
| No: 0 |
| No: 1 |
| Yes: 1 |
| Yes: 0 |
| Yes: 1 |
| Yes: 0 |
| Enter your name here.: N00178-14-D-7733-M801 |
| ReqDated: |
| Enter your name here.: |
| Name: N/A |
| Name: N/A |
| Name: Rachel E Richards |
| Cage: |
| CSO: |
| addrow: |
| Removerow: |
| Click to delete a row: |
| Location: NAS Patuxent River |
Buildings 2805 & 2187 Patuxent River, MD 20670 Block9: Contract is for requirement specification, design, implementation, test, management, and maintenance of laboratory/information system and project/program related software in support of AIR 4.5.3. Contract will provide engineering products for the development of facilities, systems and equipment, which are used for the integration, test, and evaluation of avionics systems or subsystem elements. It also involves the functions associated with coordinating with the systems engineering IPT for the complete aircraft system to ensure successful integration of the avionics systems.
COR: John Harris 301-342-9143 TPOC: Stan Zugay 301-342-9147 FAX: 301-342-9184
| a: 1 |
| a: 1 |
| a: 1 |
| f: 0 |
| f: 0 |
| f: 1 |
| b: 0 |
| b: 0 |
| b: 0 |
| g: 0 |
| g: 0 |
| c: 0 |
| c: 0 |
| c: 1 |
| h: 0 |
| h: 0 |
| d: 0 |
| d: 0 |
| d: 0 |
| i: 0 |
| i: 0 |
| SCI: 0 |
| NonSCI: 0 |
| j: 1 |
| j: 1 |
| k: 0 |
| k: 0 |
| Enter your name here.: COR, COSR |
| e: 0 |
| e: 1 |
| l: 0 |
| m: 0 |
| direct: 0 |
| thru: 1 |
| Enter your name here.: Transmissions by non-secure facsimile or E-mail is NOT authorized (by Prime(s) or subcontractor(s)). |
| PublicAuthority: PEO (A), Public Affairs Office, 47123 Buse Road, Suite 162, RADM William A. Moffett Building, Patuxent River, MD 20670 |
| AddSig: |
| RemoveSig: |
| text: Technical papers, briefings, presentations, either classified or unclassified to be presented at classified symposia shall be submitted for approval prior to presentation. |
Determination of need-to-know in connection with a classified visit is the responsibility of the individual/host who will disclose the classified information.
Block 10.a: Classified COMSEC material is not releasable to contractor employees who have not received a final security clearance at the appropriate level. Cryptologic keying materials and Controlled Cryptographic Items (CCI) are controlled by Department of the Navy, NISPOM, and National Security Agency (NSA) guidelines. The contractor shall be guided by NSA/CSS Policy Manual 3-16 in the control and protection of COMSEC material/information at their facilities. When access is required at Government facilities, contractor personnel will adhere to COMSEC rules and regulations as mandated by DoD 5520.22-M, EKMS 1 (series) and Command policy and procedures. Written concurrence of the Technical Point of Contact/Contracting Officer Representative/Contracting Officer Security Representative (as applicable) is required prior to subcontracting.
Block 10.j: For Official Use Only (FOUO) Information generated and/or provided under this contract shall be marked/safeguarded as specified in:
• DoDM 5200.01, Vol.4 can be found at the following website (enclosure 3 pages 11-18):
http://www.dtic.mil/whs/directives/corres/pdf/520001_vol4.pdf
• DoD 5400.7-R, Chapter 3 can be found at the following website (pages 31 thru 42):
http://www.dtic.mil/whs/directives/corres/pdf/540007r.pdf
Block 11.a: All classified information/material shall be provided by the contractor facility or Government Contracting Activity (GCA) and safeguarded at the approved actual performance site.
Block 11.j: 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 apply the following statement on the bottom of the front/cover page of all IN-SERVICE Technical Publications:
"Distribution Statement D: Distribution authorized to the Department of Defense and U.S. DoD contractors only (provide REASON here) (June 2014). Other requests shall be referred to the Presidential Helicopters Program Office (PMA-274), Patuxent River MD 20670.
WARNING- This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Administration Act of 1979 (Title 50, U.S. C., App. 2401 et seq.), as amended. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25."
The Contractor shall apply the following statement on the bottom of the front/cover page of ALL OTHER In-Service technical documents:
"DISTRIBUTION STATEMENT F: Further dissemination only as directed by the Presidential Helicopters Program Office (PMA-274), Patuxent River, MD 20670, (June 2014), or higher DoD authority.
WARNING- This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Administration Act of 1979 (Title 50, U.S. C., App. 2401 et seq.), as amended. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25."
The Contractor shall apply the following statement on the bottom of the front/cover page of ALL VH-92A program technical documents:
"DISTRIBUTION STATEMENT F: Further dissemination only as directed by the Presidential Helicopters Program Office (PMA-274), Patuxent River, MD 20670, (December 2015), or higher DoD authority.
WARNING- This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Administration Act of 1979 (Title 50, U.S. C., App. 2401 et seq.), as amended. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25."
The following Security Classification Guide(s) apply to classified performance on this contract. Subsequent updates shall be provided by the Contracting Officer Representative as Government Furnished Information (GFI) and shall be executed by the Contractor without obligation to modify this DD Form 254.
• OPNAVINST 5513.2C - SCG ID # 02-216.03 - VH-3D Executive Transport Security Classification Guide
• OPNAVINST 5513.2C - SCG ID # 02-161.03 - VH-60N Executive Transport Security Classification Guide
• OPNAVINST 5513.2C - SCG ID # 02-282.1 - VH-92A Presidential Vertical Lift Platform (PMA-274) Security Classification Guide
If additional security classification guidance is required, contact the Contracting Officer Representative identified in Block 9.
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| GCAName: PMA-274 |
| AAC: N00421 |
| AAC: N00421 |
| Address: Program Executive Office PMA-274 |
48202 Bronson Road, Bldg 2805 Patuxent River, MD 20670 Address: Naval Air Systems Command 48183 Shaw Road, Building 2806 Patuxent River, MD 20670
| POCName: Stan Zugay |
| Phone: 3013429147 |
| Phone: 3019951642 |
| Email: stanley.zugay@navy.mil |
| Email: rachel.richards@navy.mil |
| Title: CONTRACTING OFFICER’S SECURITY REP |
| Enter the date using the format DD-Mon-YYYY: |
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