Attachment 1 - DD254.pdf

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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PREVIOUS EDITION IS OBSOLETE.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)

NAVAIR FORM 5720.10 must be completed and attached.

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

All contracts with non-Sensitive Compartmented Information and Non-Compartmented work that may reveal mission-related information of a sensitive activity or sensitive operation should be routed to the NAVAIR STILO for approval.

All instances of loss, compromise and electronic spillage of classified or controlled unclassified information shall be reported to the COR, TPOC, and Government Security Office within 24 hours of the incident occurring.

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 identified in Block 16, or Contracting Officer Representative/Contracting Officer Representative for Security (as applicable) is required prior to subcontracting.

Block 10.e(2) –No contractor access to Non-SCI intelligence information or Foreign Intelligence Information required (Secret Internet Protocol Network (SIPRNet) access requirement only). If additional access via SIPRNet is required, the Technical Point of Contact/Contracting Officer Representative must modify/revise the requirements of DD254 for Scientific Technical Intelligence Liaison Officer (STILO) approval and signature.

Block 10.j – Controlled Unclassified Information including For Official Use Only and Covered Defense Information (meeting the definition of 48 CFR 252.204–7012(a)) 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 11-18) available at http://www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodm/520001-V4p.pdf. Any product containing Covered Defense Information shall be assigned the appropriate distribution statement using the criteria set forth in DoDI 5230.24 (Distribution Statements on Technical Documents); and have this statement displayed per DoDI 5230.24, Enclosure 3-4.

All For Official Use Only (FOUO), Covered Defense Information (CDI), and program Controlled Unclassified Information (CUI) data transmitted and safeguarded via electronic means shall use approved encryption. The Contractor shall ensure that when transmitting FOUO/CDI, over non-secure e-mail (e.g. not connected to the Navy Marine Corps Intranet through Broadband Unclassified Remote Access System / Virtual Private network), those transmissions are encrypted using Department of Defense Public Key Infrastructure (PKI), or an approved DoD External Certificate Authority, in accordance with Public Key Infrastructure & Public Key Enabling, DoDI 8520.02, 24 May 2011.

Block 10.k – Secret Internet Protocol Network (SIPRNet) access authorized. The contractor shall not access, download, or further disseminate any information or data that falls outside the scope and execution of the defined contract requirements. In the event any additional access is required, the Technical Point of Contact/Contracting Officer Representative must modify the requirements for DD Form 254 revision. Contractor shall prepare and submit all required documentation as required by Command policy prior to receiving access. Written concurrence of the Technical Point of Contact/Contracting Officer Representative identified in Block 16, or Contracting Officer Representative for Security (as applicable) is required prior to subcontracting.

Block 11.c – Information Systems (IS) shall be protected in accordance with DoDI 8510.01 and per guidance in the DoD 5220.22-M, National Industrial Security Operating Manual (NISPOM).

Block 11.d – Contractor shall provide adequate storage at their facility for classified hardware. Classified shipments are not to exceed two cubic feet. Larger size shipments require prior coordination with the Facility Security Officer (FSO) to confirm facility storage capacity. Preparation and transmission of material for shipment will be in accordance the DoD 5220.22-M, NISPOM, and the DoD 52001.01 V3, DoD Information Security Program Manual.

Block 11.i – TEMPEST information is not releasable to contractor employees who have not received a final security clearance at the appropriate level. The TEMPEST Requirements Questionnaire shall be submitted to the SPAWAR TEMPEST IPT in accordance with OPNAVINST C5510.93F, Navy Implementation of National Policy on Control of Compromising Emanations. Written concurrence of the Technical Point of Contact identified in block 16, or the Contracting Officer Representative/Contracting Officer Representative for Security (as applicable) is required prior to subcontracting.

Block 11.j – 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-81999) 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.

Specific Security Classification Guidance (SCGs), to include subsequent upgrades/revision(s), applying to classified performance on this contract, shall be provided by the Contracting Officer Representative or Technical Point of Contact, identified in Blk 16, as Government Furnished Information (GFI); and shall be executed by the Contractor without obligation to modify this DD Form 254. If additional security classification is required, contact the COR identified in Blk 16d.