Attachment_7_DD254_N3220519R2012.pdf
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- Attached to
- VERTREP DET A LANT Federal contract opportunity
- Solicitation number
- N32205-19-R-2012
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Attachment 7: DD254
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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PREVIOUS EDITION IS OBSOLETE.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.: 2 |
| 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: |
| Choose Yes or No: 0 |
| Choose Yes or No: 0 |
| Sub: |
| Choose Yes or No: 1 |
| Choose Yes or No: 0 |
| Soli: N3220519R2012 |
| DueDate: 20190618 |
| dateA: 20190516 |
| RevisionNum: |
| dateB: |
| Final: |
| dateC: |
| No: 1 |
| No: 1 |
| No: 1 |
| No: 0 |
| Yes: 0 |
| Yes: 0 |
| Yes: 0 |
| Yes: 1 |
| Enter your name here.: |
| ReqDated: |
| Enter your name here.: |
| Name: TBD |
| Name: Mary Bennett |
| Cage: TBD |
| CSO: TBD |
| CSO: Military Sealift Command, Security Office, Code N02 |
471 E. C Street Norfolk, VA 23511 Security Manager: Mary Bennett (757)443-2879
| addrow: |
| Removerow: |
| Click to delete a row: |
| Location: GOVERNMENT FACILITIES ONLY. CONTRACTOR PERSONNEL EMBEDDED AT MSC LOCATIONS AND NAVY VESSELS WORLDWIDE, AS REQUIRED. |
| Block9: The Contractor shall supply a Detachment comprised of aircrew and maintenance personnel and equipment (two (2) commercial helicopters and support items) to provide ship-based and/or shore-based vertical replenishment (VERTREP) and other rotary-wing logistics services as outlined in the solicitation/contract, without interruptions or degradation of service. The Contractor shall furnish its own support equipment and supplies necessary to perform the flight operations and required services unless indicated in the Performance Work Statement. |
| a: 1 |
| a: 1 |
| a: 1 |
| f: 0 |
| f: 1 |
| f: 0 |
| b: 0 |
| b: 0 |
| b: 0 |
| g: 0 |
| g: 0 |
| c: 0 |
| c: 0 |
| c: 0 |
| h: 0 |
| h: 1 |
| 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.: |
| e: 0 |
| e: 1 |
| l: 0 |
| m: 0 |
| direct: 0 |
| thru: 1 |
| Enter your name here.: |
| PublicAuthority: Military Sealift Command, Public Affairs Office, Code N00P |
471 E.C St, BLDG SP-64, Norfolk, VA 23511-3905 757-443-3936
| AddSig: |
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| text: A. All Detachment Personnel, Program Manager, and Contractor personnel handling classified information necessary to carry out their duties and responsibilities with respect to this contract shall have a SECRET security clearance. The individuals shall possess the SECRET security clearance prior to the commencement of the contract and maintain the clearance throughout the duration of the contract performance. |
B. Detachment will be a local user of the ship's CMS accounts in order to key KIT 1C in the aircraft. As such, the Detachment will comply with security requirements specified in SECNAV M-5510.36 and DoD 5520.22-M.
C. The Contractor shall comply with security regulations, DoD 5220.22-M, National Industrial Security Operating Manual (NISPOM) for industrial security guidance, SECNAV M-5510.36 Information Security Program for information security guidance and guidance on handling FOUO, and SECNAV M-5510.30 Personnel Security Program for personnel security guidance. Contractors performing duties under this Contract must adhere to all service/component command/local security directives, regulations, and standard operating procedures at all contract performance locations.
D. If subcontractors are used, this form must be modified to include subcontractor information. The Contractor will ensure all subcontractors follow security guidance.
E. The Contractor shall ensure that any classified information disclosed to its employees is no further released or made available to other employees, or any other person who does not have a comparable clearance and a "need to know".
F. The Contractor is governed by the DoD 5220.00-S, COMSEC Supplement to Industrial Security Manual for Safeguarding Classified Information, in the control and protection of COMSEC material and information.
G. Information Security Requirements (INFOSEC). The Contractor shall handle, store, and maintain classified material in compliance with requirements set by DoD 5220.22 (series), National Industrial Security Program Operating Manual, and the DD Form 254, DOD Contracts Security Classification Specification for classified contracts. All members who require access to classified information, sensitive information, controlled unclassified information (to include Privacy Act and Personally Identifiacle Information (PII) or access to the classified information network shall comply with DoD Manual 5200.01 Vol I - IV (DoD Information Security Program), SECNAV M5510.36 (SECNAV Information Security Program), and D0DD 5240.06 (Counterintelligence Awareness and Reporting - CIAR). The Contractor shall implement INFOSEC measures for its contractor furnished unclassified information technology systems(s) used in performance of this contract. INFOSEC measures shall be compliant with DFARS 252.204-7012, Safeguarding Covered Defense Information and Cyber Incident Reporting. At a minimum, the security standards extracted from the referenced National Institute of Standards and Technology (NIST) Special Publication 800-171, Protecting Controlled Unclassified Information in Nonfederal Information Systems and Organizations or accepted equivalents shall be incorporated into an INFOSEC program the Contractor establishes.
| attachmentsList: |
| AddAttachment: |
| ViewAttachment: |
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| rep: CDR Stephen Petras/MSC Commercial Helicopter Program Manager |
| Sig: |
| Enter your name here.: Military Sealift Command will retain security cognizance. |
| GCAName: Military Sealift Command |
| AAC: N32205 |
| Address: Military Sealift Command |
471 E. C Street, Building SP-64 Norfolk, VA 23511 Address: 471 E. C Street Norfolk, VA 23511
| POCName: Steven M. Parker |
| Phone: 7574432472 |
| Phone: 7574432879 |
| Email: steven.m.parker1@navy.mil |
| Email: mary.f.bennett@navy.mil |
| Title: Industrial Security Officer |
| Enter the date using the format DD-Mon-YYYY: |
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