DD254-Rev1.pdf

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CVN-74 FY17 PIA Preservation
Solicitation number
N4523A-17-R-0001
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DD 254 (Rev 1)

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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. AND SAFEGUARDING

a. CLEARANCE REQUIRED

b. LEVEL OF SAFEGUARDING REQUIRED

2. IS FOR: (X and complete as applicable)

a. CONTRACT NUMBER

b. SUBCONTRACT NUMBER

c. DUE DATE (YYYYMMDD)

3. IS: (X and complete as applicable)

a. (Complete date in all cases)

REVISION NO.

c. (Complete Item 5 in all cases)

DATE (YYYYMMDD)

b. REVISED (Supersedes all previous specs)

DATE (YYYYMMDD)

DATE (YYYYMMDD)

4. THIS A FOLLOW-ON CONTRACT? YES NO. Yes, complete the following:

Classified material received or generated under (Preceding Contract Number) is transferred to this follow-on contract.

5. THIS A FINAL DD FORM 254? YES NO. Yes, complete the following:

In response to the contractor's request dated , retention of the classified material is authorized for the period of

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

a. ADDRESS, AND ZIP CODE b. CAGE CODE c. SECURITY OFFICE (Name, Address, and Zip Code)

7.

a. ADDRESS, AND ZIP CODE b. CAGE CODE c. SECURITY OFFICE (Name, Address, and Zip Code)

8. PERFORMANCE

a. b. CAGE CODE c. SECURITY OFFICE (Name, Address, and Zip Code)

9. 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.

g. NATO INFORMATION

h. FOREIGN GOVERNMENT INFORMATION

i. LIMITED DISSEMINATION INFORMATION

j. FOR OFFICIAL USE ONLY INFORMATION

k. (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. 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. (Specify)

CLEARANCE

FACILITY

THIS SPECIFICATION

PRIME

SOLICITATION OR OTHER NUMBER

THIS SPECIFICATION

ORIGINAL

FINAL

IS If

IS If

CONTRACTOR

NAME, COGNIZANT

SUBCONTRACTOR

NAME, COGNIZANT

ACTUAL

LOCATION COGNIZANT

GENERAL

SPECIAL ACCESS INFORMATION

OTHER

HAVE

OTHER

DD FORM 254, DEC 1999 PREVIOUS EDITION IS OBSOLETE.

12. 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.

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. The security classifiection 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. 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. 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. questions shall be referred to the official named below.

b. TITLE c. (Include Area Code) e.

17. 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.

PUBLIC

TYPED NAME OF CERTIFYING OFFICIAL

SECURITY GUIDANCE.

ADDITIONAL SECURITY REQUIREMENTS.

INSPECTIONS.

All

TELEPHONE

SIGNATURE

REQUIRED

OTHERS AS NECESSARY

DD FORM 254 (BACK), DEC 1999

a_FACILITY_CLEARANCE_REQU: CONFIDENTIAL
b_LEVEL_OF_SAFEGUARDING_R: CONFIDENTIAL
FillText1: Off
a_PRIME_CONTRACT_NUMBER:
DATE_YYYYMMDD: 20161025
FillText3: Off
b_SUBCONTRACT_NUMBER:
REVISION_NO:
DATE_YYYYMMDD1:
FillText5: Yes
c_SOLICITATION_OR_OTHER_N: N4523A-17-R-0001
DUE_DATE_YYYYMMDD: 20161107
DATE_YYYYMMDD2:
YES1:
FillText12:
FillText11:
a_NAME_ADDRESS_AND_ZIP_CO: TBD
b_CAGE_CODE:
c_COGNIZANT_SECURITY_OFFI:
a_NAME_ADDRESS_AND_ZIP_C1: TBD
b_CAGE_CODE1:
c_COGNIZANT_SECURITY_OFF1:
a_LOCATION: Puget Sound Naval Shipyard & Intermediate Maintenance Facility

1400 Farragut Ave Bremerton, WA 98314

b_CAGE_CODE2:
c_COGNIZANT_SECURITY_OFF2:
9_GENERAL_IDENTIFICATION: Work specification package NWRMC 502-16 in support of the USS JOHN C STENNIS (CVN 74) FY17 PLANNED INCREMENTAL AVAILABILITY (PIA), Preservation.
a_COMMUNICATIONS_SECURIT1: Off
a_COMMUNICATIONS_SECURIT2: Yes
b_RESTRICTED_DATA1: Yes
b_RESTRICTED_DATA2: Off
c_CRITICAL_NUCLEAR_WEAPO1: Off
c_CRITICAL_NUCLEAR_WEAPO2: Yes
d_FORMERLY_RESTRICTED_DA1: Off
d_FORMERLY_RESTRICTED_DA2: Yes
1_Sensitive_Compartmente1: Off
1_Sensitive_Compartmente2: Yes
2_NonSCI1: Off
2_NonSCI2: Yes
f_SPECIAL_ACCESS_INFORMA1: Off
f_SPECIAL_ACCESS_INFORMA2: Yes
g_NATO_INFORMATION1: Off
g_NATO_INFORMATION2: Yes
h_FOREIGN_GOVERNMENT_INF1: Off
h_FOREIGN_GOVERNMENT_INF2: Yes
i_LIMITED_DISSEMINATION_1: Off
i_LIMITED_DISSEMINATION_2: Yes
j_FOR_OFFICIAL_USE_ONLY_I: Off
j_FOR_OFFICIAL_USE_ONLY_1: Yes
k_OTHER_Specify: Yes
k_OTHER_Specify1: Off
a_COMMUNICATIONS_SECURIT3: Yes
a_COMMUNICATIONS_SECURIT4: Off
b_RESTRICTED_DATA3: Off
b_RESTRICTED_DATA4: Yes
c_CRITICAL_NUCLEAR_WEAPO3: Off
c_CRITICAL_NUCLEAR_WEAPO4: Yes
d_FORMERLY_RESTRICTED_DA3: Off
d_FORMERLY_RESTRICTED_DA4: Yes
e_INTELLIGENCE_INFORMATI3: Yes
e_INTELLIGENCE_INFORMATI4: Off
1_Sensitive_Compartmente3: Off
1_Sensitive_Compartmente4: Yes
2_NonSCI3: Off
2_NonSCI4: Yes
f_SPECIAL_ACCESS_INFORMA3: Off
f_SPECIAL_ACCESS_INFORMA4: Yes
g_NATO_INFORMATION3: Off
g_NATO_INFORMATION4: Yes
h_FOREIGN_GOVERNMENT_INF3: Yes
h_FOREIGN_GOVERNMENT_INF4: Off
i_LIMITED_DISSEMINATION_3: Off
i_LIMITED_DISSEMINATION_4: Yes
1_OTHER_Specify: AIRCRAFT CARRIER ACCESS (RED BADGE AREAS)
FillText13: Yes
FillText14: Off
a_TYPED_NAME_OF_CERTIFYIN: Mary C Cruz
b_TITLE: Industrial Security/ Access Control Officer
c_TELEPHONE_Include_Area: (360) 476-8867
d_ADDRESS_Include_Zip_Cod:
FillText21: Yes
FillText22: Yes
FillText23: Yes
FillText24: Off
FillText25: Yes
FillText26: Off
f_OTHERS_AS_NECESSARY:
FillText15:
FillText16:
other1: Unclassified-NNPI NOFORN
release: PUGET SOUND NAVAL SHIPYARD C/1160 PUBLIC AFFAIRS OFFICE
security: CONTRACT CLAUSE FOR PROTECTION OF NAVAL NUCLEAR PROPULSION INFORMATION

During the performance of this contract Naval Nuclear Propulsion Information (NNPI) may be developed or used. Appropriate safeguards must be proposed by the contractor and provided to the contracting Officer for Security for the safeguarding from actual, potential or inadvertent release of classified or unclassified NNPI in any form by the contractor or any subcontractor. These safeguards shall ensure that access to NNPI is limited to those governmental and contractor parties, including subcontractors, that have an established need to know, and then only under conditions which assure that the information is properly protected. Access by foreign nationals or representatives of foreign interests is not permitted. In addition, any and all issuances or releases of such information beyond such necessary parties, whether or not ordered through an administrative or judicial tribunal, shall be brought to the attention of the Contracting Officer for Security.

The Contracting Officer for Security shall be immediately notified of any litigation, subpoenas, or requests which either seek or may result in the release of NNPI. In the event that a court or administrative order makes immediate review by the Contracting Officer for Security impracticable, the contractor agrees to take all necessary steps to notify the court or administrative body of the Navy’s interest in controlling the release of such information through review and concurrence in any release.

The Contracting Agency reserves the right to audit contractor facilities for compliance with the above restrictions. Exceptions to these requirements may only be obtained with prior approval from the Commander, Naval Sea Systems Command (SEA/04).

Definitions applicable to this clause are provided in the base instructions.

In addition to security clearance requirements, only those verified as being United States Citizen shall be employed under this contract with a final DOD security clearance level.

addit_sec:
Inspections:
Reset:
4_Yes: Off
4_No: No
5_Yes: Off
5_No: No
12_Public_Release_Direct: Off
12_Public_Release_Through: Through.
13_Rules:
13_2:
14_Yes: Off
14_No: No
15_Yes: Off
15_No: No
3_A: Off
3_B: Off
3_C: Off

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