DD_Form_254_Draft.pdf

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NUWCDIVNPT 5500/1 (10-17)

FOR OFFICIAL USE ONLY (Until approved for release)

APPROVAL FOR PUBLIC RELEASE OF UNCLASSIFIED TECHNICAL INFORMATION

(For all proposed "Distribution A: Approved for public release" submissions)

SECTION I: SUBJECT INFORMATION

SECTION II: SPONSOR APPROVAL (Sponsor approval must be obtained in writing and retained by author/originator)

I certify that my sponsor has approved public release of this material.

SECTION III: SECURITY GUIDELINE SOURCES CONSULTED (All 4 sources MUST be checked prior to submission for release review)

11. CHECK EACH OF THE FOLLOWING SOURCES TO ENSURE CRITICAL INFORMATION IS NOT CONTAINED IN THE RELEASE:

(NOTE: Links to the CCL, USML, and CIL can be found at https://newportalv3.nwpt.nuwc.navy.mil/10/105/OPSEC/SitePages/OPSEC.aspx )

I certify that I have consulted all 4 sources listed above

SECTION IV: APPROVALS

DEPARTMENTAL REVIEWS AND APPROVALS

15. TECHNICAL REVIEW: I certify that the proposed disclosure is technically accurate

16. DEPARTMENT SECURITY REVIEW: I certify this proposed disclosure is free of classified material

17. DEPARTMENT HEAD REVIEW: I certify there is no programmatic impediment or corporate concern to disclosure of this information at this time

SPECIAL SECURITY OFFICER (SSO)/SPECIAL ACCESS PROGRAM (SAP) REVIEW AND APPROVAL (If applicable)

18. SSO (for SCI-indoctrinated personnel) AND/OR SAP SECURITY OFFICER (for SAP-accessed personnel):

OPSEC REVIEW AND APPROVAL

19. OPSEC OFFICER REVIEW: I certify the proposed disclosure is free of critical technology information with potential intelligence value, or information that would adversely affect the security of the U.S.

PUBLIC AFFAIRS OFFICER (PAO) REVIEW AND APPROVAL

20. PAO REVIEW: I certify the proposed disclosure is approved for public release; distribution is unlimited

Approval Stamp

Note: Originator must email the material and the approved release (preferably a portable document format (pdf) file) to nuwc_npt_103libadmin@navy.mil or send hard copy to the Corporate Research and Information Center, Code 1033, Bldg 101

11.0.1.20130826.2.901444.899636 authorOriginator:

code:

phone:

titleOfRelease:

purposeOfRelease:

sponsorName:

sponsorOrg:

AOName:

AOSignature:

AODate:

SCG: 0

SCGTitleNumber:

CCL: 0

USML: 0

CIL: 0

TRName:

TRSignature:

TRDate:

DSName:

DSSignature:

DSDate:

DHName:

DHSignature:

DHDate:

SSOName:

SSOSignature:

SSODate:

OPSECName:

OPSECSignature:

OPSECDate:

PAOName:

PAOSignature:

PAODate:

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 [2] (All Files Must be Attached Prior to Signing, i.e., for any digital signature on the form) NUWCDIVNPT CIL.pdf NUWCDIVNPT_5500-1.pdf

-Item 10(j): DoD M-5200.01 Volume 4, DoD Information Security Program: Controlled Unclassified Information (CUI) of 2/24/2012

-Item 11 (c): The contractor requires access to classified source data up to and including the level identified in item 1a of this DD254. Classified material generated in support of this contract shall be classified in accordance with the source material of the Navy Security Classification Guidance, which will be provided by the GCA. Automated Information Systems (AIS) must be certified and accredited by the Cognizant Security Agency (CSA) prior to processing classified information from NAVSEA.

-Item 11(g): DD Form 1540 “Registration for Scientific and Technical Information Services” must be completed for registration with DTIC. The contractor may also submit DD Form 2345 “Militarily Critical Technical Data Agreement” (after registration with DTIC) to the Defense Logistics Services Center for access to unclassified, militarily critical technical data from other DoD sources. The GCA must certify the need-to-know to DTIC.

11(j): The Contractor shall protect critical information associated with this contract to prevent unauthorized disclosure. The NUWC Division Newport (NUWCDIVNPT) Critical Information List, Ser 105/103 of April 05, 2017 (FOUO) is identified under separate cover.

11(j) Continued: Performance under this contract requires the contractor to adhere to OPSEC requirements. OPSEC requirements are additional to the requirements of DoD 5220.22-M, National Industrial Security Program Operating Manual, therefore, the Contractor may not impose OPSEC requirements on its subcontractors unless NUWCDIVNPT approves the OPSEC requirements. The contractor shall assign an OPSEC point of contact for this contract at no additional cost to the Government. This individual may be the Facility Security Officer (FSO).

11(j) Continued: During the period of this contract, the Contractor may be exposed to, use, or produce, NUWCDIVNPT Critical Information (CI) and/or observables and indicators which may lead to discovery of CI. NUWCDIVNPT’s CI will not be distributed to unauthorized third parties, including foreign governments, or companies under Foreign Ownership, Control, or Influence (FOCI).

11(j) Continued: Intra-office communications and electronic emails shall be encrypted and protected when containing NUWCDIVNPT's CI. The transfer of unclassified technical data to and from the government or other associated activities must be accomplished via encrypted email or AMRDEC SAFE https://safe.amrdec.army.mil/safe/ only.

Note: Not approved for U-NNPI

11(j) Continued: Assembled large components/systems being transported to and from testing areas, other production or government facilities (whether or not on public roadways) shall be in an enclosed van trailer or covered flatbed trailer. Component/System outside storage, staging, and test areas shall be shielded/obscured from public view wherever physically possible.

11(j) Continued: NUWCDIVNPT's CI shall not be publicized in corporate wide newsletters, trade magazines, displays, intranet pages or public facing websites. Media requests related to this project shall be directed to NAVSEA/NUWCDIVNPT Public Release Authority listed in Item 12 of this DD Form 254.

11(j) Continued: Any attempt by unauthorized third parties to solicit, obtain, photograph, or record, or; incidents of loss/compromise of government Classified or CI, Business Sensitive,Company Proprietary information related to this or other program must be immediately reported to the Facility Security Officer and Defense Security Service and/or the Naval Criminal Investigative Service, and the NUWCDIVNPT Information, Industrial, and Operations Security POCs identified on this DD-254

“This DD-254 is for solicitation purposes only; therefore, it must be returned to NUWCDIVNPT Code 02 to be updated with a contract number upon contract award before the contract DD-254 can be issued to the contractor."

“The program sponsor for this contract is: (Wygant, Tim /Code 00X/401-832-3372/timothy.wygant@navy.mil.)

“The following Security Classification Guide(s) apply to classified performance on this contract. Subsequent updates shall be provided by the Technical Point of Contact/Contracting Officer Representative/Contracting Officer Security Representative (as applicable) as Government Furnished Information (GFI) and shall be executed by the Contractor without obligation to modify this DD-254.”

-05-038.03- SUBMARINE TECHNOLOGY, NUCLEAR AND CONVENTIONAL

-05-090.03- SUBMARINE TECHNOLOGY FOR NEW DESIGN NUCLEAR POWERED ATTACK SUBMARINES

-05-139.2- MK48 ADCAP (MOD 5 AND BEYOND), MK50, AND/OR MK54 TORPEDOES

1176 HOWELL STREET

NEWPORT, RI 02841

Address: Code 1051

1176 HOWELL STREET

NEWPORT, RI 02841