Attachment_H_-Joint_Base_Hickam_Support_dd_254_(3).pdf
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- Attached to
- Personnel Transfer Vehicle-Pearl Harbor
- Solicitation number
- N32205-16-R-3500
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Copy of the DD 254
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Other files
| File | Type | Posted |
|---|---|---|
| PTV_AMENDMENT_0004.doc | DOC document | |
| N32205-16-R-3500_Amend3.docx | DOCX document | |
| Q_AND_A__2__PTV.docx | DOCX document | |
| PTV_AMENDMENT_0002.doc | DOC document | |
| N32205-16-R-3500_Amend1.docx | DOCX document | |
| N32205-16-R-3500.docx | DOCX document | |
| Attachment_G_-_WD_2010-0205_Rev_9.pdf | ||
| Attachment_F_-_Crew_Complement.doc | DOC document | |
| Attachment_C_-_PP_Questionnaire.docx | DOCX document | |
| Attachment_E_-_Technical_Submission_Checklist.xlsx | XLSX spreadsheet | |
| Attachment_D_-_PP_Data_Sheet.doc | DOC document | |
| Attachment_B_-_SF_LLL.pdf | ||
| N32205-16-R-3500.docx | DOCX document |
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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. Adobe Professional 7.0
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 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.)
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
| fac_clear: SECRET |
| safe_level: NONE |
| prime_no: TBD |
| xprime: Yes |
| sub_no: |
| xsub: Off |
| xsolic: Yes |
| solic_no: N32205-16-R-3500 |
| due_date: 20151130 |
| xspec3: Orig |
| orig_date: |
| rev_no: |
| rev_date: |
| final_date: |
| xfollowon: Yes |
| prec_no: N00033-12-C-2005 |
| xfinal: No |
| req_dated: |
| period: |
| ctr_name: |
| ctr_cage: |
| ctr_ofc: |
| sub_name: |
| sub_cage: |
| sub_ofc: |
| perf_loc: Joint Base Hickham |
Pearl Harbor, HI
| perf_cage: |
| perf_ofc: Military Sealift Command, Security Office, Code N021 |
471 E. C St. BLDG SP-47 Norfolk VA 23511 Security Manager: Adrienne O. Freeney, (757) 443-2407 Fax: (757) 443-2938
| gen_id: The services of one (1) Jones Act compliant, U.S. Flag vessel required to support the Joint Base Hickam, Pearl Harbor, HI. Responsible for a vessel to support in port and offshore personnel and supply transfers upt to a distance of fifty (50) nautical miles (NM) from Joint Baste Hickam. The Contractor shall be required to safely transfer personnel and supplies (up to 44 personnel and 10 pallets of supplies) to and from an SSBN/SSGN in the open ocean. The Contractor shall provide a vessel and all necessary management, supervision personnel, labor, materials, fuel, and equipment required to support the personnel and supply transfers. |
| x10a: No |
| x10b: No |
| x10c: No |
| x10d: No |
| x10e1: No |
| x10e2: No |
| x10f: No |
| x10g: No |
| x10h: No |
| x10i: No |
| x10j: Yes |
| x10k: No |
| other10k: |
| x11a: Yes |
| x11b: Yes |
| x11c: Yes |
| x11d: Yes |
| x11e: Yes |
| x11f: Yes |
| x11g: Yes |
| x11h: Yes |
| x11i: Yes |
| x11j: Yes |
| x11k: Yes |
| x11l: Yes |
| other11l: Contractor may be required to courier classified materials. |
| xrelease: No |
| release_thru: Military Sealift Command, Public Affairs Office, Code NOOP |
463 E C ST BLDG SP-48
Norfolk VA 23511-3905 guidance: A. Contractor will be provided classified information concerning US Navy vessel movements during scheduling meetings in order to provide support and services. Performance of work will not require unescorted access to classified ship spaces that cannot be sanitized. All contractor personnel involved with scheduling US Navy Ship visits must be US citizens and possess at least a National Agency Check with Law and Credit (NACLC). All designated personnel who maintain a security clearance and handle classified information must attend Counterintelligence Awareness and Reporting (CIAR) Training. See DoD Directive Number 5240.06 for guidance.
B. See DoD 5220.22-M National Industrial Security Operating Manual (NISPOM) for industrial security guidance, SECNAV M-5510.30 Personnel Security Program for personnel security guidance, and SECNAV M-5510.36 Information Security Program, for information security guidance and guidance on handling FOUO.
C. All classified documents, when no longer needed, shall be destroyed as classified waste in accordance with DoD 5220.22-M and SECNAV M-5510.36, Information Security Program.
D. Contractors performing duties under this contact must adhere to all service/component command/local security directives, regulations, and standard operating procedures at all contract performance locations.
E. If subcontractors are used, this form must be modified to include subcontractor information. The contractor will ensure all subcontractors follow security guidance.
| xaddlsec: Yes |
| addl_sec: Contractor to run quarterly security training and provide copy of report to Contracting Officer Representative and the Regional Port Operations |
Office. Contractor must notify the Port Operations Office upon the occasion of any employee terminated from the company who was employed under this contract.
| xinsp: No |
| inspections: |
| cert_name: William David Johnson |
| cert_title: Industrial Security Specialist |
| cert_phone: 202-685-5144 |
| cert_addr: Military Sealift Command |
463 E C ST BLDG SP-64
Norfolk VA 23511-3905
| cert_sign: |
| x17a: Yes |
| x17b: Off |
| x17c: Yes |
| x17d: Off |
| x17e: Yes |
| x17f: Off |
| other_dist: |
| Reset: |
File details come from the government source that posted it. Updated .