RFP_Attachment 03 - DD254-SER 056-18_21RLM01.pdf

CLASSIFICATION (When filled in): Unclassified NRL SER:056- I 8

DEPARTMENT OF DEFENSE 0MB No. 0704-0567 CONTRACT SECURITY CLASSIFICATION SPECIFICATION 0MB approval expires:

{The requirements of the National Industrial Security Program (NISP) apply to all security aspects of this effort involving classified information.) 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 lo comply with a coJlection of information if ii does no! display a currenHy valid 0MB control number.

RETURN COMPLETED FORM AS DIRECTED IN THE INSTRUCTIONS.

1. CLEARANCE AND SAFEGUARDING

a. LEVEL OF FACILITY SECURITY CLEARANCE (FCL) REQUIRED b. LEVEL OF SAFEGUARDING FOR CLASSIFIED INFORMATION/ (See Instructions) MATERIAL REQUIRED AT CONTRACTOR FACILITY

Top Secret None (See instructions)

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

• a. PRIME CONTRACT NUMBER (See instructions.)

~ a. ORIGINAL (Complete date in all cases.)

DATE (YYYYMMDD)

20180618

• b. SUBCONTRACT NUMBER b. REVISED (Supersedes all previous specifications.)

• REVISION NO. DATE (YYYYMMDD)

c. SOLICITATION OR OTHER NUMBER DUE DATE (YYYYMMDD)

~ 82-2040-18 • c. FINAL (Complete Item 5 in all cases.) DA TE (YYYYMMDDJ

4. IS THIS A FOLLOW-ON CONTRACT? IZ] No 0 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? [gj No 0 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 b. CAGE CODE c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optionaQ

FOR RFP PURPOSES ONLY; NOT VALID FOR NIA

ACTUAL CONTRACT AWARD NIA

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)

NIA NIA

NIA

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

a. LOCA TION(S) (For actual performance, see instructions.) b. CAGE CODE c. COGNIZANT SECURITY OFFICE(S) (CSO) (If applicable, (Name, Address, ZIP Code, Telephone required; Email Address optional)

SEE BLOCK 13

see Instructions.}

NIA

NIA

9. GENERAL UNCLASSIFIED DESCRIPTION OF THIS PROCUREMENT

SYSTEMS ENGINEERING, ANALYTICAL AND TECHNICAL SUPPORT FOR SPECIALIZED AEROSPACE SYSTEMS.

DD FORM 254, APR 2018 PREVIOUS EDITION IS OBSOLETE.

CLASSIFICATION (When filled in): Unclassified

AEM LiveCycle Designer

Research, Development, and EngineeringSupport for Specialized Aerospace Systems RFP No.: N00173-21-R-LM01

Attachment 03 - DD254

CLASSIFICATION (When filled in): Unclassified NRL SER:056-18

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

igj a. COMMUNICATIONS SECURITY (COMSEC) INFORMATION O f. SPECIAL ACCESS PROGRAM (SAP) INFORMATION

0 b. RESTRICTED DATA

0 c. CRITICAL NUCLEAR WEAPON DESIGN INFORMATION (CNWDI) {If CNWDI applies, RESTRICTED DA TA must also be marked.)

0 d. FORMERLY RESTRICTED DATA

e. NATIONAL INTELLIGENCE INFORMATION:

IZ] (_1) Sensitive Compartmented Information (SCI)

IZJ (2) Non-SCI

IZl g. NORTH ATLANTIC TREATY ORGANIZATION

(NATO) INFORMATION

0 h. FOREIGN GOVERMENT INFORMATION

• i. ALTERNATIVE COMPENSATORY CONTROL MEASURES

(ACCM) INFORMATION

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

0 k. OTHER (Specify) (See instructions.)

11. IN PERFORMING THIS CONTRACT, THE CONTRACTOR WILL: ()( 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

IZl ACTIVITY (Applicable only if there is no access or storage required at contractor facility.

See instructions.)

0 b. RECEIVE AND STORE CLASSIFIED DOCUMENTS ONLY

• c. RECEIVE, STORE, AND GENERATE CLASSIFIED

INFORMATION OR MATERIAL

0 d. FABRICATE, MODIFY, OR STORE CLASSIFIED HARDWARE

0 e. PERFORM SERVICES ONLY

f. HAVE ACCESS TO U.S. CLASSIFIED INFORMATION OUTSIDE

0 THE U.S.,PUERTO RICO, U.S. POSSESSIONS AND TRUST

TERRITORIES

12. PUBLIC RELEASE

g. BE AUTHORIZED TO USE THE SERVICES OF DEFENSE

0 TECHNICAL INFORMATION CENTER (DTIC) OR OTHER

SECONDARY DISTRIBUTION CENTER

0 h. REQUIRE A COMSEC ACCOUNT

0 i. HAVE A TEMPEST REQUIREMENT

IZJ j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS

0 k. BE AUTHORIZED TO USE DEFENSE COURIER SERVICE

I. RECEIVE, STORE, OR GENERATE CONTROLLED UNCLASSIFIED

0 INFORMATION (CUI).

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

IZ] m. OTHER (Specify) (See instructions.)

SECURE VOICE CAPABILITY

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)

D DIRECT IZ] THROUGH (Specify below) Public Release Authority:

13. SECURITY GUIDANCE

PUBLIC RELEASE OF ANY INFORMATION, TO INCLUDE

SCI, CONCERNING THIS CONTRACT IS NOT AUTHORIZED.

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.)

1. Contractor Sensitive Compartmented Information (SCI) work/access is granted at US Government facilities only. Contractors requiring SCI access must be US citizens, possess a final DoD granted TOP SECRET security clearance, based on an favorably adjudicated Tier 5 investigation; be ICD 704 eligible, and be indoctrinated for the applicable SCI compartments prior to access. Names of contractor personnel requiring SCI access will be submitted to the SCI POC named in para 11. Contractor personnel requiring access to non-SCI classified material or unclassified information at NRL must be a US citizen and have a favorably adjudicated DoD Tier 3 investigation and final SECRET security clearance. The number of DSS requested clearances is limited to 6. (Items I 0e (1) (2))

2. NATO briefings required. Initial NATO briefings must be within a 5 year scope of the completed investigation. Visit request and a copy of NATO indoctrination must be sent to Code 1231 for all initial NATO briefings, prior to access. NATO briefing date must be within the current year. Annual refresher briefings for NATO access are required. A copy oftbe signed annual re-briefings must be forwarded to NRL Code 1231 annually. (Item 10g)

3. COMSEC briefmgs required. (Item 10a)

4. Contractor will NOT be required to receive, generate, or have custody of CLASSIFIED material at the contractor's facility.

DD FORM 254, APR 2018 PREVIOUS EDITION IS OBSOLETE.

CLASSIFICATION (When filled in): Unclassified

AEM LiveCycle Designer

Research, Development, and EngineeringSupport for Specialized Aerospace Systems

5. A v1s1t request ts requrred tor all personnel assigned to work on this contract. YISlt requests must mclude full name, SSN, contract number, clearance level and date of closed investigation.

6 . Foreign Nationals are not authorized to work on this contract.

7. Contractor personnel performing any function designated as a component of the Cyber Security Work Force (CSWF), and/or having privileged user access to NRL information systems will require background investigations and security clearances commensurate with the access level and security classification of the system being accessed as specified in DON 5239.2M (2009). System Administrators with privileged access may work in the computing, network and/or enclave environments. System Administrators with privileged access shall meet the training and certification requirements for IA T level I at the computing environment (CE), IA T level II at the network environment (NE), and IA T level ill for the enclave environment as specified in DON 5239.2M (2009). The submission of an SSBI is required for all System Administrators with privileged access serving in these positions.

8. CUI, such as Proprietary, Privacy Act or FOUO information associated with this contract, must be handled/controlled IA W DoD

5200.01 Vol. 4. (Item lOj)

9 . All contractors (including subcontractors) identified in the Statement of Work shall supplement their current security practices by requiring any personnel involved in executing the contract to complete Government-sponsored and administered Operations Security (OPSEC) training, OPSE-1301. (Item 1 lj) I 0. The prime contractor will forward a copy of all proposed subcontracts and task orders, related to this contract, to the COR named in paragraph 11, regardless of classification, for review, approval and coordination with the officials named in para 11. All subcontracts must be approved in writing, by the official named in para 17a below prior to the start of work.

11 . The NRL COR for this contract is Sheleen Spencer, NRL Code 8221 , (202) 404-3307. The SCI point of contact for thi s contract is Mary Neuland, Code 1232, (202) 279-5165 and the NRL Security POC is the official named in 17a.

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

14. ADDITIONAL SECURITY REQUIREMENTS

NAME & TITLE OF REVIEWING OFFICIAL

Harry N. Avig, Jr. NRL SSO

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

SIGNATURE

A VIG.HARRY.N. l);gii,Jly,;gnedby

A VIG.I-IARRY.N.JR. 1044734 105

JR. I 044734105 D,tcc20 18.07.1008AL2l -04'00'

0 No IZJ 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.)

SEE SCI ADDENDUM ATTACHED. SEE BLOCK 13 PARAGRAPH 9.

15. INSPECTIONS

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

0 No lZ] 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.)

NRL SIO HAS EXCLUSIVE SECURITY RESPONSIBILITY FOR SCI CLASSIFIED MATERIAL DEVELOPED, STORED AND

RELEASED UNDER THIS CONTRACT.

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

DD FORM 254, APR 2018 PREVIOUS EDITION IS OBSOLETE.

CLASSIFICATION (When filled in) : Unclassified

AEM LiveCycle Designer

Research, Development, and EngineeringSupport for Specialized Aerospace Systems

a. GCANAME c. ADDRESS (Include ZIP Code) d. POC NAME

VICKI L. CICALA

NAVAL RESEARCH LABORATORY

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

4555 OVERLOOK A VE. SW.

WASHINGTON, D.C. 20375-5320

e. POC TELEPHONE (Include Area Code)

+ 1 (202) 767-2576

N00I73

17. CERTIFICATION AND SIGNATURES

f. EMAIL ADDRESS (See Instructions) vicki.cicala@nrl.navy.mil

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) d. AAC OF THE CONTRACTING OFFICE h. SIGNATURE (See Instructions) (See Instructions) CICALA Digitally signed

CICALA, VICKI, L. N00173 • by

1------------------------------+-----------------_jVICKI.L CICALAVICKJ

b. TITLE

HEAD, INFORMATION SECURJTY & SPECIAL PROGRAMS

c. ADDRESS (Include ZIP Code)

4555 OVERLOOK A VE. SW.

WASHINGTON, D.C. 20375-5320

18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL

IZJ a. CONTRACTOR

0 b. SUBCONTRACTOR

1v1 c. COGNIZANT SECURITY OFFICE FOR PRIME AND

161 SUBCONTRACTOR

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

ADMINISTRATION

IZJ e. ADMINISTRATIVE CONTRACTING OFFICER

e. CAGE CODE OF THE PRIME CONTRACTOR LOUISE.12292 (See Instructions.) OUISE. 12 s 1s1 6

f. TELEPHONE (Include Area Code)

+l (202) 767-2567

g. EMAIL ADDRESS (See Instructions) vicki.cicala@nrl.navy.mil

29281816 Date: 2018.06.29 14:37:34 -04'00'

i. DATE SIGNED (See Instructions)

20180629

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

1222, 1230, 1232, 8202, 8221

DD FORM 254, APR 2018 PREVIOUS EDITION IS OBSOLETE. Page 4 of 4 AEM LiveCycle Designer

CLASSIFICATION (When filled in): Unclassified

Research, Development, and EngineeringSupport for Specialized Aerospace Systems

SSO NRL DD Form 254 SCI Addendum July 9, 2018

RELEASE OF SENSITIVE COMPARTMENTED INFORMATION (SCI) INTELLIGENCE

INFORMATION TO U.S. CONTRACTORS

ATTACHMENT TO DD FORM 254 FOR CONTRACT NO.: PR 82-2040-18

ORDER NO.: NIA

CONTRACT ESTIMATED COMPLETION DATE (ECD): TBD

SCI NETWORK ACCESS REQUIRED: TBD

The Naval Research Laboratory (NRL) Cognizant Senior Intelligence Officer (SIO) has exclusive security responsibility for all Sensitive Compartmented Information (SCI) classified material released to or developed under the contract and held within the Contractor's SCI Facility (SCIF). Access to SCI Intelligence material requires adherence to the requirements set forth in the following:

Department ofDefense (DoD) Manual (DoDM) 5105.21, Volume 1, SCI Administrative Security Manual:

Administration oflnformation and Information Systems Security; DoDM 5105.21, Volume 2, SCI Administrative Security Manual: Administration of Physical Security, Visitor Control, and Technical Security; DoDM 5105.21, Volume 3, SCI Administrative Security Manual: Administration of Personnel Security, Industrial Security, and Special Activities; ICD 403, Foreign Disclosure and Release of Classified National Intelligence; ICD 703, Protection of Classified National Intelligence Including Sensitive Compartmented Information; lCD 703-02, Reporting Requirements for Individuals with Access to Sensitive Compartmented Information; ICD 703-03, Protection of Classified National Intelligence Including SCI Shared with Entities Outside the Intelligence Community; ICD 703-04, Foreign Ownership, Control, or Influence (FOCI); ICD 710, Classification Management and Control Markings Systems; ICPG 710.1 , Application of Dissemination Controls: Originator Control (ORCON);

DoD 5220.22-M, Change 2, National Industrial Security Program Operating Manual (NISPOM); and DoD 5220.22-R, DoD Industrial Security Program. Contractor's will comply with all regulations/manuals/directives stated therein which provide the necessary security and classification guidance for personnel, information, physical, automated information security (AIS), and technical security measures and is a part of the SCI security specifications for the contract. Inquiries pertaining to SCI classification guidance or interpretations shall be directed to the Contracting Officer Representative

(COR).

1. Requirements for access to SCI:

a. All SCI will be handled in accordance with special security requirements, which will be furnished by the NRL Special Security Officer (SSO).

b. SCI will not be released to contractor employees without specific release approval of the originator of the material as outlined in governing directives; based on prior approval and certification of "need-to-know" by the designated COR.

c. The contractor must restrict access to only those individuals who possess the necessary security clearance and who are actually providing services under the contract with a valid need to know. Further dissemination to other contractors, subcontractors, other government agencies, private individuals or organizations is prohibited unless authorized in writing by the originating agency through the COR.

Research, Development, and EngineeringSupport for Specialized Aerospace Systems

d. Names of contractor personnel requiring access to SCI will be submitted to the COR for approval. Upon receipt of written approval from the COR, the company security officer will submit request(s) for special background investigations, in accordance with the NISPOM, to the Defense Security Service (DSS).

e. SCI material must not be released to foreign nationals or immigrant aliens whether they are consultants, U.S. contractors, or employees of the contractor and regardless of the level of their security clearance, except with advance written permission from the originator. Requests for release to foreign nationals shall be initially forwarded to the COR and shall include:

1. A copy of the proposed disclosure.

11. Full justification reflecting the benefits to U.S. interests.

111. Name, nationality, particulars of clearance, and current access authorization of each proposed foreign national recipient.

f. Contractor personnel must maintain accountability for all intelligence materials released to their custody.

g. SCI material will not be reproduced without prior approval of the originator of the material. All SCI material shall bear a prohibition against reproduction while in the contractor's custody.

h. Inquiries pertaining to classification guidance on SCI will be directed through the NRL SSO to the responsible COR as indicated on the DD Form 254.

1. SCI released to cleared-DoD Contractors, all reproductions thereof, and all other information generated based on, or incorporating data from, in support of this contract, remains the property of the U.S. Government. Upon completion or cancellation of the contract, all SCI material furnished will be returned to the direct custody of the NRL SSO, or destroyed IAW instructions outlined by the COR.

J. SCI will be stored and maintained only in properly accredited facilities meeting the physical security requirements in ICD 705, SCI Facilities and JCS 705, Technical Specifications for Construction and Management of SCI Facilities.

k. The NRL SSO will recognize the above noted estimated completion date (ECO) as the completion date for the contract. The NRL SSO will initiate action to debrief contractor personnel with access to this contract unless extensions or modifications to the contract are received by the NRL SSO office no later than 30 days after the established completion date.

Research, Development, and EngineeringSupport for Specialized Aerospace Systems

I. The contractor is governed by ICD 704, ' Personnel Security Standards and Procedures Governing Eligibility for Access to Sensitive Compartmented Information (SCI) And Other Controlled Access Program Information' and may be supplemented by additional SSO Navy guidance.

Contractor personnel that are eligible for access to SCI or currently possess an SCI personnel security clearance with another non-DoD agency must have their SCI eligibility accepted and entered into JPAS by the DoD Consolidated Adjudications Facility (CAF) prior to having access to SCI information retained by Naval Research Laboratory, unescorted access to Naval Research Laboratory spaces, and receipt of an Naval Research Laboratory issued contractor badge. The Facility Security Officer (FSO) will identify, in writing, contractor personnel assigned to this contract by NAME, SSN, Date and Place of Birth, and provide this documentation to the COR identified. The COR will identify the SCI caveats for the contract and forward a copy of this documentation to the NRL SSO for processing. This documentation will be marked and protected under the Privacy Act of 197 4.

m. Electronic processing of SCI must be accomplished on equipment accredited in accordance with DoDM 5105.21 Volumes 1- 3, ICD 503, Information Technology System Security Risk Management, Certification and Accreditation, and the DoDIIS Joint Security Implementation Guide (DJSIG), Appendix D.

n. SCI security management issues shall be directed to Harry N. Avig, 202-767-0862 or 202-767- 3800.

o. In accordance with Director of National Intelligence Memorandum 5 May 2017, Access to North Atlantic Treaty Organization (NATO) Information by Intelligence Community (IC) Personnel and Naval Intelligence Security Policy Directive 17-008 Revision, Mandate for North Atlantic Treaty Organization (NATO) Information by Intelligence Community (IC) Personnel, all DoN Contractors with SCI access and access to JWICS or SIPRNet must be briefed into NATO Secret Information.

**NOTE** : ADDITIONAL SECURITY GUIDANCE SPECIFIC TO THE SCI CONTRACT WILL BE

PROVIDED BY THE COR AND COMMAND SSO TO IDENTIFY SECURITY CLASSIFICATION

GUIDES AND PROGRAM SPECIFIC SECURITY GUIDANCE THAT DEFINE TECHNICAL AND

SAFEGUARDING REQUIREMENTS IDENTIFIED IN THE SOW/PWS/SOO.

Dlglta lly signed by AVIG.HARRY.N. AVlG.HARRY.NJR.104473

410S JR.1044734105 Oate: 201s.01.10

08:'42:2 1 --04'00'

NRL SSO

Research, Development, and EngineeringSupport for Specialized Aerospace Systems