Att.1_Field Maintenance Support 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PREVIOUS EDITION IS OBSOLETE.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)

Webster Field Annex, Saint Inigoes, MD 20684-4012 Location: Building 1559 Range Operations Division Twentynine Palms, CA 92278 Location: 151 O'Neill Street Building 151, Room 113 Yuma, AZ 85369 Location: Building 4048 HC83 Box 1 Bridgeport, CA 93517 Location: Marine Corps Air Station Tower Street Building 2399, Room 203 Camp Pendleton, CA 92055 Location: 25147 Montezuma Avenue Quantico, VA 22134 Location: 6th Avenue Building 4280 Cherry Point, NC 28533 Location: Range Control Division Duncan Road, Building 1047 Camp Lejeune, NC 28542 Location: Camp Hansen Kin-Cho Kin Kunigami-Gun Building 2466 Okinawa, Japan 9041201 Location: 9177 Highway 47 Townsend, GA 31331 Location: 601 Oceana Blvd.

Building 3030, NAS Oceana Virginia Beach, VA 23460 Location: NAS North Island Building 93A, Code 53 San Diego, CA 92135 Location: Ford Island Building 75 Pearl Harbor, HI 96860-5260 Location: Naval Air Warfare Center Aircraft Division Patuxent River, MD 20670

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.

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 https://fas.org/sgp/othergov/dod/index.html. 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.

10.k - Secret Internet Protocol Router 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, identified in Block 9, must modify the requirements for DD Form 254 revision. Contactor shall prepare and submit all required documentation as required by Command policy prior to receiving access. Written concurrence of the Contracting Officer Representative/Technical Point of Contact, identified in Block 9, is required prior to subcontracting.

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.

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 Block 16.d.

In accordance with the Department of Defense (DoD) Small Business Innovation Research (SBIR) Desk Reference guidance, Section VIII, Special Contract Provisions, the offerer should protect data, information, equipment, etc. as proprietary, including using Information Assurance (IA) protections to maintain United States Government (USG) interest. The offerer should place close attention as well to Section VIII, Para E, Export-Controlled Items, Information and Technology.In accordance with SECNAV M-5510.36 dated June 2006, Chapter 4, Paragraph16, page 4-9,& 4-10, the individual or contractor conducting an Independent Research and Development Information (IR&D)/Bid and Proposal (B&P) effort; and believing that information generated without prior access to classified information or current access to classified information associated with the specific information in question may require protection in the interest of national security; shall safeguard the information and submit it to an appropriate U.S. Government activity for a classification determination.

The information shall be marked with a "tentative" classification pending a classification determination.

11.f –The contractor shall require access at Okinawa, Japan in performance of this contract.

11.j – OPSEC: While performing aboard NAVAIR or other U.S. military 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 comply with any and all additional OPSEC security plans and requirements of the Hosting Command. All applicable OPSEC Plans will be provided by TPOC identified in Block 16. The prime contractor is responsible for subcontractor implementation of Operations Security.

If additional security classification assistance is required, please contact TPOC identified in Block 16.

Villa Road, Building 8270 Saint Inigoes, MD 20684 Address: Commander, Naval Air Warfare Center Aircraft Division Bldg. 2272, Rm. 074, Attn: 7.4.1 Security 47123 Buse Road Patuxent River, MD 20670