19R3504_Attach_D_DD_Form_254_(amendment_4).pdf

Please wait...

If this message is not eventually replaced by the proper contents of the document, your PDF viewer may not be able to display this type of document.

You can upgrade to the latest version of Adobe Reader for Windows®, Mac, or Linux® by visiting http://www.adobe.com/go/reader_download.

For more assistance with Adobe Reader visit http://www.adobe.com/go/acrreader.

Windows is either a registered trademark or a trademark of Microsoft Corporation in the United States and/or other countries. Mac is a trademark of Apple Inc., registered in the United States and other countries. Linux is the registered trademark of Linus Torvalds in the U.S. and other countries.

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PREVIOUS EDITION IS OBSOLETE.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)

471 East C. St.

Norfolk, VA 23511 Security Manager: Adreienne O. Freeney, 757-443-2407

471 E. C St. Norfolk, VA 23511-2419

Block 10/11: The contractor shall be responsible for Controlled Cryptographic Instruments (CCI), such as a STE-III telephone, issued by the MSC operational or administrative Commander. The Contractor shall provide a secure space onboard the ship identified in Block 9 for use of CCI equipment and shall designate accountable personnel as specified by DODINST 5520.22 Series (National Industrial Security Program Operating Manual). The Contractor may also be issued COMSEC keying material which requires two-person integrity (TPI) be maintained onboard the ship as specified in DODINST 5520.22 Series. Any two ship's officers who hold a SECRET clearance granted by DISCO are acceptable as COMSEC keying material users. Physical safeguards for all classified material shall be provided by Contractor personnel as specified in DODINST 5220.22 Series. "The Contractor shall install, maintain, and operate COMSEC equipment for the U.S Government as well as electronically communicate classified national security-related information by COMSC protected means."

Block 13: Contractor performance requires that designated personnel employed onboard the ship have access to SECRET information regarding the operational employment and safe navigation of the ship. For operational matters, the Master, Chief Mate, and any additional officer (deck or engineering) shall have a completed National Agency Check and a SECRET clearance granted by DISCO. Only U.S. citizens have access to classified material. The Contractor shall, on a semi-annual basis, provide COMSC N15 an updated list of all crewmembers who are designated to have access to classified information. The Contractor shall ensure 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."

The MSC Operational Commander designated for the contract will be responsible for releasing classified information to the Contractor's shipboard personnel and will provide the Master with a Security Classification Guide (SCG).

Contracting office: Carley Orvin, MSC HQ/N10, 757-341-4628 Contracting Officer's Representative (COR): Recep Ugraskan, MSC HQ/N32. 757-443-2813

Personal Security. Avoid telephone discussions or face to face conversations that can be overheard by unauthorized personnel when discussing mission related information. Avoid discussing any aspect of operations or capabilities in and out of the work place particularly in view of the growing use of social media and networking. Watch for indications that strangers have focused on an individual or have a probing interest in ship operations. Where terrorism is a threat, instruct personnel to vary routines and predictable habits and travel in groups for safety.

Physical Security. Information concerning security, firearms onboard, custodial controls, emergency destruction procedures and capabilities, and threat reaction procedures and capabilities should remain closely held. Emergency action drills to practice responding to threats should not be observed by anyone other than authorized crewmembers.

Ship Arrivals in Port. The knowledge of a ship's scheduled port calls should be restricted to those members of the contractor's staff with a need to know. Arrange travel of port captains and port engineers, and shipment of supplies, so as to limit forewarning of a ship's actual arrival.

Norfolk, VA 23511 Address: Military Sealift Command 471 E. C St.

Norfolk, VA 23511