Attachment_4_NRC_187.pdf

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NRCMD 12

(01-2015)

CONTRACT SECURITY AND/OR

CLASSIFICATION REQUIREMENTS

U.S. NUCLEAR REGULATORY COMMISSION

NRC FORM 187

NRC FORM 187 (01-2015)

Page of

NRC FORM 187

(01-2015)

NRCMD 12

CONTRACT SECURITY AND/OR CLASSIFICATION REQUIREMENTS (Continued)

U.S. NUCLEAR REGULATORY COMMISSION

Page of

NRC FORM 187 (01-2015)

7. Is this contract a follow-on contract?

Yes No

9. Contract Performance Requirements A. Will the contract require access to classified matter (information, systems, and/or material) (i.e., 32 CFR Part 2004 or MD 12.2)?

Yes (continue) No (if no, proceed to Block 9.E.)

B. What is the highest level of classified matter the contractor will need to access to perform contract responsibilities?

C. To carry out requirements of the contract, will the contractor need to possess, generate, or store classified matter at the contractor facility location?

Yes (continue) No (if no, proceed to Block 9.E.)

D. Choose all that apply: In regards to classified matter, the contractor will require:

1) Access to Foreign Intelligence Information

2) Receipt and storage (i.e., safeguarding) of classified matter

3) Access to cryptographic material or other classified COMSEC information

4) Access to classified matter or information processed by another agency

5) Use of a classified information technology processing system

6) Generation of classified at Contractor facility location

7) Generation of classified matter at an NRC facility E. Will the contractor require access to Safeguards Information or Safeguards Information - Modified Handling Information (i.e., 10 CFR 73.21, 73.22, and/or 73.23)?

Yes No F. Will the contractor possess, generate, or store SGI or SGI-M at the contractor facility?

Yes No G. Will the contractor require access to any Sensitive Unclassified Non-Safeguards Information (SUNSI) or sensitive information technology (IT) Systems (i.e., MD 12.6)?

Yes No H. Will the contractor possess, generate, or store SUNSI or have access to NRC sensitive IT systems at the contractor facility?

Yes No I. Was, "Yes" checked to Block 9.A., Block 9.C., Block 9.E., or Block 9.F.?

Yes No (If "Yes", then a Facility Clearance is required to be issued for the contractor and any known sub-contractors by the Facilities Security Branch before final contract award and before work can begin on the contract.)

J. Choose all that apply:

1) Unescorted Access is required to Nuclear Power Plants.

2) Access is required to Unclassified Safeguards Information.

3) Access is required to Sensitive IT Systems and Data.

4) Unescorted Access to NRC Headquarters Building.

5) Require operation of government vehicles or transport passengers for the NRC.

6) Will operate hazardous equipment at NRC facilities.

7) Required to carry firearms.

8) Found to use or admit to use of illegal drugs.

11. Does this contract contain any subcontractors?

Yes No If "No", Leave area blank. (Note: It is the responsibility of the COR to notify FSB if the contractor adds a subcontractor to the contract during the execution of the contract. The sub-contractors may require a facility clearance before work can be allowed).

12. Review of contractor/subcontractor reports, documents for classified, SGI, SGI-M, and/or SUNSI will be reviewed by:

13. Required Distribution of NRC Form 187 for Review (Check all appropriate boxes)

1) Originating NRC office or Division (Item 14A.)

2) Division of Facilities and Security (Item 14B.)

3) Division of Contracts and Property Management (Item 14C.)

14. Approvals Signature Date Signature Date Signature Date

INSTRUCTIONS FOR COMPLETING NRC FORM 187

NRC Form 187, “Contract Security and/or Classification Requirements,” including attachments and supplements, furnishes the basis for providing security and classification requirements to contractors, subcontractors or others (e.g., bidders) who have or may have an NRC contractual relationship which requires access to classified information or matter, for unescorted access to nuclear power plants, access to Unclassified Safeguards Information, access to sensitive unclassified non-Safeguards Information, access to sensitive IT systems or data and/or access to NRC Headquarters buildings.

WHO USES NRC FORM 187: All organizations which have or may have an NRC contractual relationship of the nature set forth above.

WHEN TO USE: Responsibility for initiation of NRC Form 187 rests with the office or division sponsoring a contract, project, or consultant, or requesting that such work be conducted (e.g., at a Department of Energy (DOE) National Laboratory).

Early preparation and submission of this form will help assure that all necessary classification and security actions are initiated and if applicable a facility clearance must be granted prior to contract award. Experience has shown that incomplete information or untimely submission delays both the security and contractual process.

WHERE TO SEND: The form should be routed from the contract initiating office the appropriate contract specialist. Then the form should go to the Division of Facilities and Security. One copy should go to the Facilities Security Branch and another copy should go to the Personnel Security Branch. Once each branch reviews the form, the form will be officially signed off by the Director of Division of Facilities Security or their designee with the appropriate security clauses and/or additional actions. Finally, the form needs to be routed back to the Acquisitions Management Division within the Office of Administration for final signature.

PREPARATION: Items listed below directly correlate to the numbered items on NRC Form 187.

i. If YES, is checked on blocks 9A, 9C, 9E, and/or 9F, then the contractor will require a Facility Clearance issued by the Facilities Security Branch concurrent with the contract award. Without a facility clearance, the contractor cannot conduct sensitive work on the contract.

10. Identify the classification guides that the contractor will be required to abide by while operating under the NRC contract (e.g., Management Directive 12.7, 10 Code of Federal Regulations (CFR) 73.22, and actual classification or designation guides for a specific topic).

INSTRUCTIONS FOR COMPLETING NRC FORM 187 (continued)

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