J.H-1_Contract_Security_Classification_Specification.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.

DEPARTMENT OF DEFENSE

CONTRACT SECURITY CLASSIFICATION SPECIFICATION

(Please read Instructions BEFORE completing this application.) (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. LEVEL OF FACILITY SECURITY CLEARANCE (FCL) REQUIRED (See instructions.)

b. LEVEL OF SAFEGUARDING FOR CLASSIFIED INFORMATION/MATERIAL REQUIRED AT CONTRACTOR FACILITY

DUE DATE (YYYYMMDD)

c. SOLICITATION OR OTHER NUMBER

b. SUBCONTRACT NUMBER

a. PRIME CONTRACT NUMBER (See instructions.)

DATE (YYYYMMDD)

c. FINAL (Complete Item 5 in all cases.)

DATE (YYYYMMDD)

REVISION NO.

b. REVISED (Supersedes all previous specifications.)

DATE (YYYYMMDD)

a. ORIGINAL (Complete date in all cases.)

(Preceding Contract Number) is transferred to this follow-on contract.

Classified material received or generated under YES. If Yes, complete the following:

NO

4. IS THIS A FOLLOW-ON CONTRACT?

, retention of the classified material is authorized for the period of:

In response to the contractor's request dated YES. If Yes, complete the following:

NO

5. IS THIS A FINAL DD FORM 254?

c. COGNIZANT SECURITY OFFICE (CSO) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

a. NAME, ADDRESS, AND ZIP CODE

6. CONTRACTOR (Include Commercial and Government Entity (CAGE) Code.)

c. COGNIZANT SECURITY OFFICE(S) (CSOs) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

a. NAME, ADDRESS, AND ZIP CODE

7. SUBCONTRACTOR(S) (Click button to add more subcontractors.)

c. COGNIZANT SECURITY OFFICE(S) (CSOs) (Name, Address, ZIP Code, Telephone) (If applicable, see instructions.)

b. CAGE CODE (If applicable, see instructions.)

a. LOCATION(S) (For actual performance, see instructions.)

8. ACTUAL PERFORMANCE (Click button to add more locations.)

9. GENERAL UNCLASSIFIED DESCRIPTION OF THIS PROCUREMENT (Click here if more space is needed.)

10. CONTRACTOR WILL REQUIRE ACCESS TO: (X all that apply. Provide details in Blocks 13 or 14 as set forth in the instructions.)

a. COMMUNICATIONS SECURITY (COMSEC) INFORMATION

d. FORMERLY RESTRICTED DATA

c. CRITICAL NUCLEAR WEAPON DESIGN INFORMATION (CNWDI) (If CNWDI applies, RESTRICTED DATA must also be marked.)

b. RESTRICTED DATA

e. NATIONAL INTELLIGENCE INFORMATION:

f. SPECIAL ACCESS PROGRAM (SAP) INFORMATION

k. OTHER (Specify) (See instructions.)

j. CONTROLLED UNCLASSIFIED INFORMATION (CUI) (See instructions.)

i. ALTERNATIVE COMPENSATORY CONTROL MEASURES (ACCM) INFORMATION

h. FOREIGN GOVERMENT INFORMATION

g. NORTH ATLANTIC TREATY ORGANIZATION (NATO) INFORMATION

DD FORM 254, NOV 2017

PREVIOUS EDITION IS OBSOLETE.

Adobe LiveCycle Designer ES4 CLASSIFICATION (When filled in):

CLASSIFICATION (When filled in):

(1) Sensitive Compartmented Information (SCI)

(2) Non-SCI

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.)

a. HAVE ACCESS TO CLASSIFIED INFORMATION ONLY AT ANOTHER CONTRACTOR'S FACILITY OR A GOVERNMENT ACTIVITY (Applicable only if there is no access or storage required at contractor facility. See instructions.)

h. REQUIRE A COMSEC ACCOUNT

k. BE AUTHORIZED TO USE THE DEFENSE COURIER SERVICE (DCS)

j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS

i. HAVE A TEMPEST REQUIREMENT

b. RECEIVE AND STORE CLASSIFIED DOCUMENTS ONLY

c. RECEIVE, STORE, AND GENERATE CLASSIFIED INFORMATION OR MATERIAL

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

e. PERFORM SERVICES ONLY

d. FABRICATE, MODIFY, OR STORE CLASSIFIED HARDWARE

l. RECEIVE, STORE, OR GENERATE CONTROLLED UNCLASSIFIED

INFORMATION (CUI).

(DoD Components: refer to DoDM 5200.01, Volume 4 only for specific CUI protection requirements. Non-DoD Components: see instructions.)

m. OTHER (Specify) (See 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)

DIRECT

THROUGH (Specify)

PUBLIC RELEASE AUTHORITY:

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. Click button to add additional pages as needed to provide complete guidance.)

14. ADDITIONAL SECURITY REQUIREMENTS. Requirements, in addition to NISPOM requirements for classified information, are established for this contract.

Yes No (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. Use Item 13 or click button if additional space is needed.)

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. Click button or use Item 13 if additional space is needed.)

Yes No

e. POC TELEPHONE (Include Area Code.)

f. EMAIL ADDRESS (See instructions.)

b. ACTIVITY ADDRESS CODE (AAC) OF THE CONTRACTING OFFICE (See instructions.)

d. AAC OF THE CONTRACTING OFFICE (See instructions.)

e. CAGE CODE OF THE PRIME CONTRACTOR (See instructions.)

d. POC NAME (See instructions.)

c. ADDRESS (Include ZIP Code.)

a. GCA NAME

16. GOVERNMENT CONTRACTING ACTIVITY (GCA) AND POINT OF CONTACT (POC)

18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL

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.

a. TYPED NAME OF CERTIFYING OFFICIAL (Last, First, Middle Initial) (See instructions.)

f. TELEPHONE (Include Area Code.)

g. EMAIL ADDRESS (See instructions.)

i. SIGNATURE

h. DATE

b. TITLE

c. ADDRESS (Include ZIP Code.)

f. OTHERS AS NECESSARY (If more room is needed, continue in Item 13 or on additional page if necessary.)

e. ADMINISTRATIVE CONTRACTING OFFICER

d. U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECURITY ADMINISTRATION

c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR

b. SUBCONTRACTOR

a. CONTRACTOR

DD FORM 254 (BACK), NOV 2017

CLASSIFICATION (When filled in):

CLASSIFICATION (When filled in):

c. COGNIZANT SECURITY OFFICE(S) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

a. NAME, ADDRESS, AND ZIP CODE

7. SUBCONTRACTOR(S) (Continued)

c. COGNIZANT SECURITY OFFICE(S) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

a. NAME, ADDRESS, AND ZIP CODE

c. COGNIZANT SECURITY OFFICE(S) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

a. NAME, ADDRESS, AND ZIP CODE

c. COGNIZANT SECURITY OFFICE(S) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

a. NAME, ADDRESS, AND ZIP CODE

c. COGNIZANT SECURITY OFFICE(S) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

a. LOCATION(S) (For actual performance, see instructions.)

c. COGNIZANT SECURITY OFFICE(S) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

a. LOCATION(S) (For actual performance, see instructions.)

c. COGNIZANT SECURITY OFFICE(S) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

a. LOCATION(S) (For actual performance, see instructions.)

c. COGNIZANT SECURITY OFFICE(S) (Name, Address, ZIP Code, Telephone)

b. CAGE CODE

a. LOCATION(S) (For actual performance, see instructions.)

8. ACTUAL PERFORMANCE (Continued)

9. GENERAL UNCLASSIFIED IDENTIFICATION OF THIS PROCUREMENT (Continued)

DD FORM 254, NOV 2017

Pages of Continuation Page CLASSIFICATION (When filled in):

CLASSIFICATION (When filled in):

15. INSPECTIONS (Continued)

14. ADDITIONAL SECURITY REQUIREMENTS (Continued)

13. SECURITY GUIDANCE (Continued) Pages of Continuation Page

DD FORM 254, NOV 2017

CLASSIFICATION (When filled in):

CLASSIFICATION (When filled in):

Additional persons assisting with completion of form (signatures and titles) 9.0.0.2.20120627.2.874785

WHS/ESD/DD

DD 254, Nov 2017, "DoD Contract Security Classification Specification" Orig No No No Yes Yes

1126 Pacific Ave. , 4th Floor Tacoma, WA 98402 Email: dss.san-francisco-fo@mail.mil

1126 Pacific Ave. , 4th Floor Tacoma, WA 98402 Email: dss.san-francisco-fo@mail.mil 8.c. Cognizant security office (Name, address, and zip code).: Defense Security Service (10FWT) 1126 Pacific Ave. , 4th Floor Tacoma, WA 98402 Email: dss.san-francisco-fo@mail.mil 8.c. Cognizant security office (Name, address, and zip code).: Defense Security Service (10FWT) 1126 Pacific Ave. , 4th Floor Tacoma, WA 98402 Email: dss.san-francisco-fo@mail.mil

1100 Hunley Rd.

Silverdale, WA 98315 (See additional page)

8. Actual performance. a. Location.: Naval Magazine Indian Island 100 Indian Island Road Port Hadlock, WA 98339

8. Actual performance. a. Location.: ARD Bayview 33964 North main Ave Bayview, Idaho 83830

9. General unclassified description of this procurement.:

Physical security guard services at Naval Base Kitsap, Bangor, Silverdale, WA, 98315, Naval Magazine Indian Island, Port Hadlock, WA, 98339, and ARD Bayview, Bayview, Idaho, 83830.

Require access to secured/restricted areas, classified correspondence, and involvement in various meetings where classified matters are discussed regarding ATFP plans and exercises.

Reference 8a and 11a. Contractor will be using classified source documents in the daily performance of their duties of guard services at Naval Base Kitsap, Bangor, Silverdale, WA, 98315, Naval Magazine Indian Island, Port Hadlock, WA, 98339, and ARD Bayview, Bayview, Idaho, 83830.

No classified hardware will be furnished to the contractor to perform his duties. Contractor may need to read classified instructions, messages in the performance of Anti-terrorism and Force Protection (ATFP) duties. Continuation - DD Form 254 item 13 below

13. Security guidance.: The Contractor shall ensure that personnel clearances and security responsibilities are implemented as follows:

Personnel with appropriate clearance levels shall be available to perform services during all shifts and emergent situations under this contract.

Personnel requiring clearances due to service performance or location shall be cleared to the applicable level, up to and including Secret.

Personnel directly supervising individuals requiring clearances shall, as a minimum, have the same clearance level required by the individual performing the work.

Clearances, up to and including Secret, are required for all personnel. The Contractor shall provide emergency accident procedures. Secret level work shall be accounted for on a classified material control log . Procedures shall be established to store Secret level material in the GOV Security Office safe until it is returned to the customer. Access to the safe shall be limited to those cleared individuals providing Security services. Procedures shall be established to check all equipment used in processing classified material.

Contractor will establish procedures to prevent unnecessary access to classified information, including procedures to establish need to know before access is authorized and to limit the number of persons granted access to classified information to the minimum consistent with operational needs and security requirements.

Contractor employees are subject to criminal penalties under applicable Federal Statutes, a well as administrative sanctions, if they knowingly, willfully or negligently violate the provisions of SECNAVINST 5510.36 Series. Classified discussions at conferences, training courses, or other gatherings (hereafter referred to as "meetings") are held only when disclosure of the information serves a specific U.S. Government purpose. Classified meetings may only be held at a U.S. Government agency with an appropriate facility security clearance (FCL) where adequate physical security and procedural controls have been approved.

Reference 10b and 10d: Access to RESTRICTED DATA requires a final U.S. Government clearance at the appropriate level.

Reference 11e. Contract is for maintenance services in classified processing areas. Actual knowledge, generation, or production of classified information is not required for performance on this contact. Cleared contractor personnel are required to perform theses services, because aural or visual access to classified information cannot be preclude by escorting personnel. Any classification guidance will be provided by the using activity.

1101 Tautog Circle Silverdale, WA 98315-1100

1101 Tautog Circle Silverdale, WA 98315-1100