24_DD_FORM_254_CONTRACT_SECURITY_CLASSIFICATION.pdf

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Shipboard Automated Maintenance Management (SAMM)
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N32205-18-R-1000
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24 DD FORM 254 Contract Security Classification

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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:
xprime: Off
sub_no:
xsub: Off
xsolic: Yes
solic_no: N32205-18-R-1000
due_date:
xspec3: Orig
orig_date:
rev_no:
rev_date:
final_date:
xfollowon: Yes
prec_no: N00033-14-D-8005
xfinal: No
req_dated:
period:
ctr_name: TBD
ctr_cage: TBD
ctr_ofc: TBD
sub_name:
sub_cage:
sub_ofc:
perf_loc: Worldwide, as required.
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: This contract will provide services to the Engineering Directorate of Military Sealift Command (MSC) and other Government agencies in the areas of maintenance system engineering services, engineering and technical services, and shipboard testing and inspection survey services.
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:
xrelease: No
release_thru: Military Sealift Command, Public Affairs Office, Code N00P

471 E. C St. BLDG SP-47 Norfolk, VA 23511 guidance: A. The Contractor will be able to derive classified information concerning MSC vessel movements by combining information from separate unclassified sources. Performance of work will not require unescorted access to classified ship spaces that cannot be sanitized.

B. All contractor personnel performing ship checks on-board Military Sealift Command ships must be U.S. citizens and possess at least a Confidential clearance based on National Agency check with the Defense Industrial Security Clearance Office (DISCO). All contractor personnel responsible for scheduling support visits to Military Sealift Command ships must be U.S. citizens and possess at least a Secret clearance based on a National Agency check with the Defense Industrial Security Clearance Office (DISCO).

C. Visits to Navy and commercial shipyards and to Navy ships, whether commissioned or under construction, will be subject to any security requirements that may be imposed by the shipyard, the Supervisor of shipbuilding, or the Commanding Officer.

D. See DoD 5220.22-M, National Industrial Security Operating Manual (NISPOM) for industrial security guidance, DoD Manual 5200.01, Volumes 1-4, DoD Information Security Program for guidance on handling FOUO, SECNAV M-5510.36 Information Security Program, and SECNAV M-5510.30 Personnel Security Program.

E. 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.

F. The Contractor shall ensure that any classified information disclosed to its employees is not further released or made available to other employees, or any other person who does not have a comparable clearance and a "Need to Know."

G. 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: The Contractor shall provide annually to the COR an updated list of all crew-members who are designated to have access to classified information.
xinsp: No
inspections:
cert_name: Adrienne O. Freeney
cert_title: MSC Security Officer
cert_phone: (757) 443-2407
cert_addr: Military Sealift Command, Security Office, Code N021

471 E. C St. BLDG SP-47 Norfolk VA 23511

cert_sign: signed 3/9/18
x17a: Yes
x17b: Off
x17c: Yes
x17d: Off
x17e: Yes
x17f: Off
other_dist:
Reset:

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