Amendment 1 - Attachment 3 - 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PREVIOUS EDITION IS OBSOLETE. Page 1 of 4DD FORM 254, MAY 2019 PREVIOUS EDITION IS OBSOLETE.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)

Top Secret

b. LEVEL OF SAFEGUARDING FOR CLASSIFIED INFORMATION/

MATERIAL REQUIRED AT CONTRACTOR FACILITY

Secret

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

a. PRIME CONTRACT NUMBER (See instructions.)

TBA

b. SUBCONTRACT NUMBER

c. SOLICITATION OR OTHER NUMBER DUE DATE (YYYYMMDD)

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

a. ORIGINAL (Complete date in all cases.)

DATE (YYYYMMDD)

20250113

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

TBD

b. CAGE CODE

TBD

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

TBD

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) Add Row Remove last Row Delete All Rows

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.) Add Row Remove last Row Delete All Rows

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

TRADOC Fort Eustis,VA; Fort Novosel, AL; Fort Leavenworth, KS and various CONUS and OCONUS Locations

b. CAGE CODE (If applicable, see Instructions.)

c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional) TRADOC G26 Security 950 Jefferson Ave Fort Eustis, VA 23604

9. GENERAL UNCLASSIFIED DESCRIPTION OF THIS PROCUREMENT

Supporting the Operational Environment (OE) CORE Mission

PREVIOUS EDITION IS OBSOLETE. Page 2 of 4DD FORM 254, MAY 2019 PREVIOUS EDITION IS OBSOLETE. Page 2 of 4DD FORM 254, MAY 2019

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.)

NATO Security Awareness Briefing is required.

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.)

SIPRNET, JWICS Afghan Mission Network, Centrix, Focal Point ACCM Access.

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)

PUBLIC RELEASE OF SCI IS NOT AUTHORIZED

Public Release Authority:

PUBLIC RELEASE OF SCI IS NOT AUTHORIZED

13. SECURITY GUIDANCE Add Signature Remove last Signature Delete All Signatures

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.)

10a: Classified COMSEC material is not releasable to contractor employees who have not received a FINAL clearance at the appropriate security level. COMSEC access shall be IAW DoD 5220.22-M and AR 380-40. Contractor shall be enrolled into DACAP and designated a local element on a government KMI Account.

10e1: SCI Access required. No public release of information authorized, public disclosure or confirmation of any subject related to the support contract is not authorized without first obtaining written approval from the CM.

10e2: Non-SCI Information is not releasable to contractor employees who have not received a clearance at the appropriate security level.

Written concurrence of the CM is required prior to subcontracting. Access to Intelligence information required for performance.

10g. Access to NATO requires final U.S. Government clearance at the appropriate level and NATO level access briefing and debriefing.

10h: Foreign Government Information (FGI) is not releasable to contractor employees who have not received a FINAL clearance at the appropriate security level. Written concurrence of the CM is required prior to subcontracting.

10k: NATO Security Awareness Briefing is required.

10j. Controlled Unclassified Information (CUI): Access to CUI may be a requirement for some work performance on this contract. CUI is unclassified information requiring safeguarding and dissemination controls, consistent with applicable law, regulation, or government-wide

PREVIOUS EDITION IS OBSOLETE. Page 3 of 4DD FORM 254, MAY 2019 PREVIOUS EDITION IS OBSOLETE. Page 3 of 4DD FORM 254, MAY 2019 policy. CUI includes information such as legacy marked For Official Use Only (FOUO) information, OPSEC sensitive information, critical technology, unclassified intelligence information, Privacy information, and personally identifiable information (PII).

Controlled Unclassified Information (CUI) generated and/or provided under this contract shall be controlled and protected, marked, safeguarded, marked, transmitted, and destroyed as specified in DoD 5200.48, Controlled Unclassified Information (CUI) and HQDA (DAMI-CD) memorandum, 27 Aug 2020, subj: Implementing Guidance for Department of Defense Instruction 5200.48, Controlled Unclassified Information. This includes PII, as defined in DoDI 5400.11, DoD Privacy and Civil Liberties Programs.

All contractors including subcontractors handling CUI in support to this contract will successfully complete the DoD CUI training and thereafter, refresher CUI training annually. Training is available at Center for Development of Security Excellence (CDSE) website https://securityawareness.usalearning.gov/cui/index.html. The Contractor shall ensure all new contractor employees and subcontractors performing work under this contract complete CUI training during new employee in-processing on this contract and annually thereafter.

The Contractor shall maintain all CUI training records and shall provide copies to the COR.

11a. Contractor place of performance is restricted to Fort Eustis,Virginia, Fort Novosel, Alabama (Area 15) , Fort Leavenworth, Kansas, and various location identified by the KO and COR.

11c: The contractor requires access to classified source data in support of the work effort. Any extracts or use of such data requires the contractor to apply derivative classifications and markings consistent with the source documents. Use of Multiple Sources on the Derived From line necessitates compliance with the NISPOM rule at 32 Code of Federal Regulation (CFR) Part 117, effective 24 Feb 2021.

11g: Must have final clearance.

11h: Within the Army COMSEC KOAM are only government civilians and military. Contractors can only be Local Elements.

See AR 380-40 for further instructions.

11j: Contractor shall follow TRADOC OPSEC Plan.

11m: SIPRNET, JWICS Afghan Mission Network, Centrix, Focal Point ACCM Access.

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

Add Attachment View Selected Attachment Remove Selected Attachment

NAME & TITLE OF REVIEWING OFFICIAL

Sarah Brown (COR)

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.)

All contractors shall attend TARP training

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

MICC-Eustis

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

W911S0

c. ADDRESS (Include ZIP Code) 661 Shepard Place Fort Eustis, VA 23604

d. POC NAME

Curtis Arthur

e. POC TELEPHONE (Include Area Code)

+1 (757) 501-8122

f. EMAIL ADDRESS (See Instructions) curtis.m.arthur.civ@army.mil

17. CERTIFICATION AND SIGNATURES

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

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)

Patrick Webb

b. TITLE

Industrial Security Program Manager

c. ADDRESS (Include ZIP Code) 950 Jefferson Avenue Fort Eustis, VA

d. AAC OF THE CONTRACTING OFFICE (See Instructions)

W911S0

e. CAGE CODE OF THE PRIME CONTRACTOR

(See Instructions.)

TBD

f. TELEPHONE (Include Area Code)

+1 (757) 501-6174

g. EMAIL ADDRESS (See Instructions) patrick.j.webb.civ@army.mil

h. SIGNATURE

i. DATE SIGNED (See Instructions)

20231214

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.)

DRAFT

SAMPLE

PREVIOUS EDITION IS OBSOLETE.

Page of

DD FORM 254, MAY 2019

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:

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

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 whs.mc-alex.esd.mbx.formswebmaster@mail.mil

WHS

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

950 Jefferson Ave Fort Eustis, VA 23604

10e1: SCI Access required. No public release of information authorized, public disclosure or confirmation of any subject related to the support contract is not authorized without first obtaining written approval from the CM.

10e2: Non-SCI Information is not releasable to contractor employees who have not received a clearance at the appropriate security level. Written concurrence of the CM is required prior to subcontracting. Access to Intelligence information required for performance.

10g. Access to NATO requires final U.S. Government clearance at the appropriate level and NATO level access briefing and debriefing.

10h: Foreign Government Information (FGI) is not releasable to contractor employees who have not received a FINAL clearance at the appropriate security level. Written concurrence of the CM is required prior to subcontracting.

10k: NATO Security Awareness Briefing is required.

10j. Controlled Unclassified Information (CUI): Access to CUI may be a requirement for some work performance on this contract. CUI is unclassified information requiring safeguarding and dissemination controls, consistent with applicable law, regulation, or government-wide policy. CUI includes information such as legacy marked For Official Use Only (FOUO) information, OPSEC sensitive information, critical technology, unclassified intelligence information, Privacy information, and personally identifiable information (PII).

Controlled Unclassified Information (CUI) generated and/or provided under this contract shall be controlled and protected, marked, safeguarded, marked, transmitted, and destroyed as specified in DoD 5200.48, Controlled Unclassified Information (CUI) and HQDA (DAMI-CD) memorandum, 27 Aug 2020, subj: Implementing Guidance for Department of Defense Instruction 5200.48, Controlled Unclassified Information. This includes PII, as defined in DoDI 5400.11, DoD Privacy and Civil Liberties Programs.

All contractors including subcontractors handling CUI in support to this contract will successfully complete the DoD CUI training and thereafter, refresher CUI training annually. Training is available at Center for Development of Security Excellence (CDSE) website https://securityawareness.usalearning.gov/cui/index.html. The Contractor shall ensure all new contractor employees and subcontractors performing work under this contract complete CUI training during new employee in-processing on this contract and annually thereafter. The Contractor shall maintain all CUI training records and shall provide copies to the COR.

11a. Contractor place of performance is restricted to Fort Eustis,Virginia, Fort Novosel, Alabama (Area 15) , Fort Leavenworth, Kansas, and various location identified by the KO and COR.

11c: The contractor requires access to classified source data in support of the work effort. Any extracts or use of such data requires the contractor to apply derivative classifications and markings consistent with the source documents. Use of Multiple Sources on the Derived From line necessitates compliance with the NISPOM rule at 32 Code of Federal Regulation (CFR) Part 117, effective 24 Feb 2021.

11g: Must have final clearance.

11h: Within the Army COMSEC KOAM are only government civilians and military. Contractors can only be Local Elements.

See AR 380-40 for further instructions.

11j: Contractor shall follow TRADOC OPSEC Plan.

11m: SIPRNET, JWICS Afghan Mission Network, Centrix, Focal Point ACCM Access.

Fort Eustis, VA 23604 Address: 950 Jefferson Avenue Fort Eustis, VA