SAQMMA16R0280-_Attachment_11-_DD254_-REV.pdf

DEPARTMENT OF DEFENSE 1. CLEARANCE AND SAFEGUARDING

CONTRACT SECURITY CLASSIFICATION SPECIFICATION a. FACILITY CLEARANCE REQUIRED

SENSITIVE BUT UNCLASSIFIED

(The requirements of the DoD Industrial Security Manual apply to all aspects of this effort)

b. LEVEL OF SAFEGUARDING REQUIRED

NONE

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

a. PRIME CONTRACT NUMBER a. ORIGINAL (Complete date in all cases) Date (YYMMDD)

SSUD UNMISS Contingent Re-Compete - SAQMMA16xxxxx 201602xx

b. SUBCONTRACT NUMBER

b. REVISED (Supersedes all previous specs) Revision No.

Date (YYMMDD)

c. SOLICITATION OR OTHER NUMBER Due Date (YYMMDD) c. FINAL (Complete Item 5 in all cases) Date (YYMMDD)

4. IS THIS A FOLLOW-ON CONTRACT? YES NO. If Yes complete the following

5. IS THIS A FINAL DD FORM 254? YES NO. If Yes complete the following

In response to the contractor's request dated , retention of the identified 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 (Name, Address, and Zip Code) TBD during Technical Panel of Solicitation Bids. Defense Security Service

Industrial Security Field Office 241 18th Street South, Suite 100A Arlington, VA 22202

7. SUBCONTRACTOR

a. NAME, ADDRESS, AND ZIP CODE b. CAGE CODE c. COGNIZANT SECURITY OFFICES ( Name, Address, and Zip Code)

8. ACTUAL PERFORMANCE

a. LOCATION b. CAGE CODE c. COGNIZANT SECURITY OFFICE (Name, Address, and Zip Code) UN Mission to South Sudan, and U.S. Embassy Juba (South Sudan)

9. GENERAL IDENTIFICATION OF THIS PROCUREMENT

10. THIS CONTRACT WILL REQUIRE ACCESS TO: YES NO 11. IN PERFORMING THIS CONTRACT, THE CONTRACTOR WILL: YES NO

a. COMMUNICATIONS SECURITY (COMSEC)

INFORMATION

a. HAVE ACCESS TO CLASSIFIED INFORMATION ONLY AT ANOTHER

CONTRACTOR’S FACILITY OR A GOVERNMENT ACTIVITY

b. RESTRICTED DATA b. RECEIVE CLASSIFIED DOCUMENTS ONLY

c. CRITICAL NUCLEAR WEAPON DESIGN INFORMATION c. RECEIVE AND GENERATE CLASSIFIED MATERIAL

d. FORMERLY RESTRICTED DATA: d. FABRICATE, MODIFY, OR STORE CLASSIFIED HARDWARE

e. INTELLIGENCE INFORMATION: e. PERFORM SERVICES ONLY

(1) Sensitive Compartmented Information (SCI) f. HAVE ACCESS TO U.S. CLASSIFIED INFORMATION OUTSIDE THE U.S., PUERTO

RICO, U.S. POSSESSIONS AND TRUST TERRITORIES

(2) Non-SCI g. BE AUTHORIZED TO USE THE SERVICES OF DEFENSE TECHNICAL

INFORMATION CENTER (DTIC) OR OTHER SECONDARY DISTRIBUTION CENTER

f. SPECIAL ACCESS INFORMATION h. REQUIRE A COMSEC ACCOUNT

g. NATO INFORMATION i. HAVE A TEMPEST REQUIREMENT

h. FOREIGN GOVERNMENT INFORMATION j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS

i. LIMITED DISSEMINATION INFORMATION k. BE AUTHORIZED TO USE THE DEFENSE COURIER SERVICE

j. FOR OFFICIAL USE ONLY INFORMATION l. OTHER (Specify).

k. OTHER Specify)

Sensitive But Unclassified Information

Require connectivity to Department of State computer system

DD Form 254, DEC 1999 Previous editions are obsolete

12. PUBLIC RELEASE. Any information (classified or unclassified) pertaining to this contract shall not be released for public dissemination except as provided by the industrial Security Manual or unless it has been approved for public release by appropriate U.S. Government authority. Proposed public release shall be submitted for approval prior to release

Direct

Through (Specify): INL Office of African and Middle East Programs (INL/AME), INL Public Affairs (INL/PAPD), U.S. Department of State, 2201 C Street NW, Washington DC 20522, DS/IS/IND to the Directorate for Freedom of Information and Security Review, Office of the Assistant Secretary of Defense (Public Affairs)* for review.

*In the case of non-DoD User Agencies, requests for disclosure shall be submitted to that agency.

13. SECURITY GUIDANCE. The security classification guidance 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 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 document/guides/extracts referenced herein.

Add additional pages as needed to provide complete guidance.

Contractor personnel specifically designated by the contracting Officer's Representative (COR) assigned to this contract shall possess a completed Moderate Risk Public Trust (MRPT) security clearances issued by Defense Security Services (DSS) prior to contract performance. However, the Contingent Commander and Deputy Contingent Commander (CC and DCC) under this contract must possess a TOP SECRET security clearance. The COR shall also ask the Contractor to designate two candidates as back-up Deputy Contingent Commanders in order to accommodate for when the Contingent Commander and/or Deputy Contingent Commander are absent or on leave. The two “back-ups” must also have a TOP SECRET security clearance. All personnel designated by the COR as requiring a TOP SECRET personnel security clearance shall have these clearances issued by Defense Security Services (DSS) prior to contract performance due to the nature of job function. Those personnel who are favorably granted an interim security clearance may be assigned to the contract while their final security clearances are pending. Those who are not favorably granted an interim clearance will not be approved for contract performance until their clearances are favorably adjudicated. Any employee who is not favorably granted a final clearance must be removed from the contract immediately at no cost to the Government. All other US contractor personnel assigned to this contract must favorably pass a Moderate Risk Public Trust (MRPT) determination conducted by the Bureau of Diplomatic Security prior to contract performance.

Prior to contract assignment, the contractor must submit a Standard Form (SF) 85P, SF 85 PS, FD, 258 (two legible Fingerprint cards) and a DS Form 4002 (Disclosure and Authorization Pertaining to Consumer Reports) to the Bureau of diplomatic Security, DS/IS/IND prior to anticipated contract performance. Contractor must submit these forms to ensure adequate time is given to determine a preliminary outcome of MRPT investigation.

Personnel who favorably pass this preliminary check may be assigned to the contract while their MRPT's are pending. Those who do not pass the preliminary check will not be approved for contract performance until their MRPT's are favorably adjudicated. Any US contractor employee who does not favorably pass the MRPT must be removed from the contract immediately at no cost to the Government. The Bureau of Diplomatic Security will, if deemed necessary, conduct a personal interview. Contractor will provide DS/IS/IND and INL/AME COR written notification of any and all dismissals from this contract and is required cancel any affected investigation and/or clearance processes.

Visit authorization requests are to be sent to the Department of State (DoS), DS/IS/IND, Washington D.C. 20520, via facsimile at 571-345-3000. Letters of Consent (LOCs) issued by DSS or JCAVS Person Summary must be attached to all visit authorization requests. All DD Forms 254 for subcontracts shall be forwarded to DS/IS/IND, for certification prior to issuance to the proposed subcontractor.

While at DoS locations, including those overseas, the contractor shall comply with the applicable DoS regulations relative to the protection of classified and/or sensitive information, including the National Industrial Security Program Operating Manual (NISPOM) and 12 Foreign Affairs Manual (FAM) 500 and 600. DS/IS/IND is responsible for inspecting contractors assigned to DoS locations.

14. ADDITIONAL SECURITY REQUIREMENTS. Requirements, in addition to ISM requirements, 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 cognizant security office. Use Item 13 if additional space is needed.)

Yes No

U.S. Embassy Juba Building Pass.

15. INSPECTIONS. Elements of this contract are outside the inspection responsibility of the cognizant security office. (If Yes, explain and identify specific areas or elements carved out and the activity responsible for inspections. Use Item 13 if additional space is needed.

Yes No

16. CERTIFICATION AND SIGNATURE. 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.

a. TYPED NAME OF CERTIFYING OFFICIAL Mark T Hove

b. TITLE Africa Program Officer

c. TELEPHONE (Include Area Code)

202-634-1191

d. ADDRESS (Include ZIP Code) 17. REQUIRED DISTRIBUTION U.S. Department of State

a. CONTRACTOR

SA-1, L-505

b. SUBCONTRACTOR

2401 E Street NW, Washington DC 20522

c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR

e. SIGNATURE

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

e. ADMINISTRATIVE CONTRACTING OFFICER

f. OTHERS AS NECESSARY COR

DD Form 254 Reverse, DEC 1999

DD254, BLOCK 13, CONTINUATION

Security clearance for contractors accessing DoS domestic or overseas information systems shall be in accordance with 12 FAM 600. Furthermore, citizens of specifically designed human intelligence and/or technical intelligence threat countries shall not develop, modify, or perform maintenance of software development for use on DoS computer systems without approval by DS/SI/ACD.

Contractors shall immediately report any adverse information concerning any cleared contractor employees performing on DOS contracts to DSS,DS/IS/IND, INL/A COR and INL/A Security Manager, in accordance with the NISPOM and DS/IS/IND, in accordance with 12 FAM 576, 4b.

Contractor personnel working on DOS contracts must report impending marriage, cohabitation and other continuing bonds of affection with foreign nationals to the COR and DS/IS/IND, in accordance with 3 FAM 4100, App. B.

The contractor does not currently have DOS contract approval for classified safeguarding at the contractor’s facility; therefore, no discussion, generation or storage of classified information shall take place at the contractor’s facility in Juba, South Sudan or in Texas. Access to classified information outside of the U.S. is required. All classified material while not in use will remain under the control of U.S. Government employees, or safeguarded in a facility approved by U.S. Government. The contractor is not expected to generate classified documents, material, or hardware. Where required and approved outside of the U.S. and DOS sites, contractor shall store and maintain classified documents, material and hardware according to the markings shown on the source material NTE Secret. The Department of State will provide approved security container for the contractor’s storage and safeguarding of classified information at DOS sites.

All FAM references can be viewed on the DOS website, www.state.gov

Contracting Officer’s Representative (COR) Office Symbol Phone

DD Form 254 Reverse, DEC 1999