J-2 - DD Form 254.pdf

CLASSIFICATION (When filled in): Unclassified

PREVIOUS EDITION IS OBSOLETE. Page 1 of 4DD FORM 254, MAY 2019 PREVIOUS EDITION IS OBSOLETE. Page 1 of 4DD FORM 254, MAY 2019

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:

20220531

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

a. LEVEL OF FACILITY SECURITY CLEARANCE (FCL) REQUIRED (See Instructions)

Secret

b. LEVEL OF SAFEGUARDING FOR CLASSIFIED INFORMATION/

MATERIAL REQUIRED AT CONTRACTOR FACILITY

None (See instructions)

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

a. PRIME CONTRACT NUMBER (See instructions.)

b. SUBCONTRACT NUMBER

c. SOLICITATION OR OTHER

NUMBER

N6339420R0013

DUE DATE (YYYYMMDD)

3. THIS SPECIFICATION IS: (X and complete as applicable.)

a. ORIGINAL (Complete date in all cases.)

DATE (YYYYMMDD)

20190815

b. REVISED (Supersedes all previous specifications.)

REVISION NO. DATE (YYYYMMDD)

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

4. IS THIS A FOLLOW-ON CONTRACT? No Yes 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? No Yes 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

FOR SOLICITATION PURPOSES ONLY; NOT VALID

FOR CONTRACT AWARD

b. CAGE CODE c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional)

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)

a. NAME, ADDRESS, AND ZIP CODE b. CAGE CODE c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional)

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

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

VARIOUS; SEE BLOCK 13

b. CAGE CODE

(If applicable, see Instructions.)

c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional)

9. GENERAL UNCLASSIFIED DESCRIPTION OF THIS PROCUREMENT

Limited production services required to provide Life-Cycle In-Service support for CDS equipment integrated into the numerous classes of Surface Ships, throughout the USN and FMS Fleet as specified below. to the Air Dominance Department of the Naval Surface Warfare Center, Port Hueneme Division (NSWC PHD), Port Hueneme California.

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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 f. SPECIAL ACCESS PROGRAM (SAP) INFORMATION

b. RESTRICTED DATA

g. NORTH ATLANTIC TREATY ORGANIZATION

(NATO) INFORMATION

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

h. FOREIGN GOVERMENT INFORMATION

d. FORMERLY RESTRICTED DATA

i. ALTERNATIVE COMPENSATORY CONTROL MEASURES

(ACCM) INFORMATION

e. NATIONAL INTELLIGENCE INFORMATION:

(1) Sensitive Compartmented Information (SCI)

(2) Non-SCI

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

k. OTHER (Specify) (See instructions.)

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.)

b. RECEIVE AND STORE CLASSIFIED DOCUMENTS ONLY

c. RECEIVE, STORE, AND GENERATE CLASSIFIED

INFORMATION OR 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 A TEMPEST REQUIREMENT

j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS

k. BE AUTHORIZED TO USE DEFENSE COURIER SERVICE

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.)

See Block 13

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 below)

Commanding Officer, NSWC PHD, Code 103, 4363 Missile Way, Port Hueneme, CA 93041

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. 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.)

***THIS DD254 IS FOR SOLICITATION PURPOSES ONLY; THEREFORE, IT MUST BE RETURNED TO SECURITY, CODE 1051, TO BE UPDATED WITH A CONTRACT NUMBER UPON CONTRACT AWARD BEFORE THE CONTRACT DD254 CAN BE

ISSUED TO THE CONTRACTOR.***

Access to classified information is not required to respond to this solicitation. All responses shall be unclassified.

8.a. Access to classified information will be at NSWC PHD, Port Hueneme, CA and various other government and military locations, ships, and ports as identified in the SOW or other contractual authorization. Classification guidance will be provided on-site by the user activity.

11f. Access to U.S. classified information is required in Yokosuka, Japan; Rota, Spain; Persian Gulf Theater. DoD components are responsible for providing the day-to-day oversight and management of contractors collocated with and supporting government customers.

Security officers on-board the designated ships and installations will maintain control of the classified information and conduct security

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10.j, 11l. FOUO information shall be protected in accordance with DoD M-5200.01 Volume 4, DoD Information Security Program:

Controlled Unclassified Information (CUI) dated 2/24/2012. It is emphasized that FOUO information may not be transmitted via

11.m. Other

- Contractors responsible for unauthorized disclosure of PII may be held accountable for any costs associated with breach mitigation, including those incurred as a result of having to notify personnel.

- Classified or unclassified technical papers to be presented at a classified symposium must be approved by the NSWC PHD Contracting Officer’s Representative prior to the presentation.

- Security classification guides (OPNAVINST 5513 series) and controlled unclassified information (e.g. FOUO, distribution statement controlled) are not authorized for public release; therefore, they cannot be posted on a publicly accessible web-server or transmitted over the internet unless appropriately encrypted. Request for public release cannot be transmitted via the internet until the contractor receives final approval from NSWC PHD Public Affairs.

- Contractor must submit a request for sharing of classified and other sensitive information between prime contractors in writing to the certifying official identified in Block 17(a) of this form for approval.

- All security related issues, incidents, or requests pertaining to this contract shall be presented in writing by the contractor's Facility Security Officer (FSO) to the individual identified in block 17(a) of this DD254. The contractor shall abide by other reporting requirements outlined in the NISPOM.

- All reports of contractor security violations associated with this contract shall be mailed by the Cognizant DSS field office directly to the certifying official in Block 17(a) of this DD Form 254.

- All classified information involved in security incidents shall be retained and provided to the certifying official in Block 17(a) of this DD Form 254 for classification review.

- All classified paper documents destroyed by shredding must be done using a National Security Agency (NSA) approved high security crosscut shredder listed on the NSA/CSS evaluated products list for high security crosscut paper shredders. Destruction may also be accomplished by other approved methods for destruction of classified information.

- Forward a copy of subcontractor DD Form 254s issued under this contract to NSWC PHD Security at the address in Block 17(a) of this DD Form 254.

- When submitting visit request to NSWC PHD, use its Security Management Office (SMO) number (633946).

- All security aspects of this contract fall under the cognizance of NSWC PHD. Security POCs: David Haugland, Security Manager, Code 105, (805) 228-6163; Christine Hansen, Security Specialist, Code 1051, (805) 228-0234, christine.r.hansen@navy.mil at the address in Block 16.

List of Attachments (All Files Must be Attached Prior to Signing, i.e., for any digital signature on the form)

NAME & TITLE OF REVIEWING OFFICIAL SIGNATURE

14. ADDITIONAL SECURITY REQUIREMENTS

Requirements, in addition to NISPOM requirements for classified information, are established for this contract.

No Yes 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.)

PREVIOUS EDITION IS OBSOLETE. Page 4 of 4DD FORM 254, MAY 2019

OPSEC Plan: COMMON DISPLAY SYSTEM (CDS) Sustainment, Installation, Procurement and Engineering Services, 8 June 2018

15. INSPECTIONS

Elements of this contract are outside the inspection responsibility of the CSO.

No Yes 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)

a. GCA NAME

Naval Surface Warfare Center Port Hueneme

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

N63394

c. ADDRESS (Include ZIP Code)

COMMANDING OFFICER, NSWC PHD

4363 MISSILE WAY

PORT HUENEME, CA 93043

d. POC NAME

William Engels

e. POC TELEPHONE (Include Area Code)

+1 (805) 228-5929

f. EMAIL ADDRESS (See Instructions) william.a.engels@navy.mil

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.

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

Hansen, Christine R

b. TITLE

Contracting Officer's Security Representative

c. ADDRESS (Include ZIP Code)

COMMANDING OFFICER, NSWC PHD

4363 MISSILE WAY, CODE 1051

PORT HUENEME, CA 93043

d. AAC OF THE CONTRACTING OFFICE (See Instructions)

N63394

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

f. TELEPHONE (Include Area Code)

+1 (805) 228-0234

g. EMAIL ADDRESS (See Instructions) christine.r.hansen@navy.mil

h. SIGNATURE

i. DATE SIGNED (See Instructions)

18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL

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

HANSEN.C

HRISTINE.

RENEE.116

8692567

Digitally signed by

HANSEN.CHRISTINE.R

ENEE.1168692567

DN: c=US, o=U.S.

Government, ou=DoD, ou=PKI, ou=USN, cn=HANSEN.CHRISTIN

E.RENEE.1168692567

Date: 2019.08.15 15:56:13 -07'00'