Solicitation DD254.pdf
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- Solicitation number
- FA857122R0001
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CLASSIFICATION (When filled in): Unclassified
PREVIOUS EDITION IS OBSOLETE. Page 1 of 6DD FORM 254, APR 2018
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:
May 31, 2022
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)
Secret
b. LEVEL OF SAFEGUARDING FOR CLASSIFIED INFORMATION/
MATERIAL REQUIRED AT CONTRACTOR FACILITY
None (See instructions)
2. THIS SPECIFICATION IS FOR: (X and complete as applicable.)
a. PRIME CONTRACT NUMBER (See instructions.)
b. SUBCONTRACT NUMBER
c. SOLICITATION OR OTHER NUMBER
F3QCCL1082A004
DUE DATE (YYYYMMDD)
3. THIS SPECIFICATION IS: (X and complete as applicable.)
a. ORIGINAL (Complete date in all cases.)
DATE (YYYYMMDD)
20210716
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 N/A
b. CAGE CODE
N/A
c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional) N/A
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.)
See Block 13
b. CAGE CODE
(If applicable, see Instructions.)
N/A
c. COGNIZANT SECURITY OFFICE(S) (CSO) (Name, Address, ZIP Code, Telephone required; Email Address optional)
78 ABW/IP
985 Macon Street Robins AFB, GA 31098
9. GENERAL UNCLASSIFIED DESCRIPTION OF THIS PROCUREMENT
The contractor shall provide Depot Maintenance supply chain analysis, planning to support senior leadership strategic goals, material coordinators support services for support of the Warner Robins Air Logistics Complex (WR- ALC) Aircraft Programmed Depot Maintenance (PDM). Basic supply chain duties that include parts ordering, research and supportability, turn-in of material, and parts tracking. These services shall include basic supply chain duties such as parts ordering, research and supportability, turn-in of material, and parts tracking.
PREVIOUS EDITION IS OBSOLETE. Page 2 of 6DD FORM 254, APR 2018
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.)
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 DoDI 5200.48, only for specific CUI protection requirements. Non-DoD Components: see instructions.)
m. OTHER (Specify) (See instructions.)
See Item 13 - Security Requirements
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)
See Item 13
Public Release Authority:
See Item 13
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.)
Ref. 8a and 11a: Contract performance will occur primarily in Building 210. Additional secure/unsecure facilities at Robins AFB, GA, to include Buildings 640, 645, 228, 229, Flight Line, 125, 81, 82, 84, 48, 49, 50, 59, 59P, 91 and 110. Using activity will provide security classification guidance for the performance of this contract. The Contractor shall forward visit requests through the Defense Information for Security (DISS) or successor system for secure facilities access as required.
Ref. 10a: Access to COMSEC material by personnel is restricted to U.S. citizens holding final U.S Government clearances. Such information is not releasable to personnel holding reciprocal clearances. For on base COMSEC access see AFMAN 17-1302-O, COMSEC Operations for guidance.
Ref. 10j/11l: The contractor shall comply with DoDI 5200.48, Controlled Unclassified Information, DoDM 5200.01V3_AFMAN 16-1404V3, Information Security Program Protection of Classified Information and DoDM 5400.7-Air Force Manual 33 302, DoD Freedom of Information Act (FOIA) Program. The contractor shall monitor CUI aggregation and compilation based on the potential to generate classified information pursuant to security classification guidance addressing the accumulation of unclassified data or information.
Ref. 11e: Contract is for technical and administrative production support services. Classification markings on the material to be furnished will provide the guidance necessary for performance of the contract.
PREVIOUS EDITION IS OBSOLETE. Page 3 of 6DD FORM 254, APR 2018
Ref 11j: Contractor personnel will participate in the OPSEC program administered locally by the AF activity.
Ref. 12: Contractor is to submit requests through the contracting officer for OPSEC program manager review and public release authorization. The contracting officer will provide contractor with written approval/disapproval. Information requiring AF or DoD-level review will be reviewed by the unit’s OPSEC program manager or coordinator who will in-turn forward to the entry-level public affairs office through the AFIMSC Public Affairs Office to the Secretary of the Air Force, Office of Public Affairs, Security and Review Division (SAF/PAX), 1690 Air Force Pentagon, Washington DC 20330-1690.
Ref. 13:
1. These security requirements, promulgated by DoDM 5220.22V2_AFMAN 16-1406V2, National Industrial Security Program, Industrial Security Procedures for Government Activities, and 32 CFR Part 117, National Industrial Security Program Operating Manual (NISPOM), § 117.7(a), are issued for cleared contractors who will be entrusted to have access to classified information. This guidance is applicable for contractor performance as a visitor group (VG) under the 78th Air Base Wing Information Protection Office (IPO) security cognizance, Robins AFB GA. For performance on other installations, prior to the start of performance, the contractor shall contact the host IPO to execute an agreement and/or security requirements as mandated by the above referenced documents.
2. Storage of Classified Material/Information: The government program manager (GPM) may authorize VG to store and handle classified material required for performance on this contract. All classified information shared with the VG must be stored in an approved government-owned and controlled security container. The number of VG employees authorized access to the security container will be kept to the minimum number required for efficient contract performance. When authorized, the VG shall comply with DoDM 5200.01V1_AFMAN 16-1404V1, Information Security Program: Overview, Classification & Declassification, DoDM 5200.01V2_AFMAN 16-1404V2, Information Security Program: Marking of Classified Information, and DoDM 5200.01V3_AFMAN 16-1404V3, Information Security Program: Protection of Classified Information and the government activity’s security program operating instruction (OI). The VG is prohibited from establishing and/or maintaining a separate classified information system. All classified material/information must be returned and secured in the government security container at the end of the duty day.
3. Reproduction of Classified Material: The VG may be authorized to reproduce classified information, as required for contract performance. Authorization must be accomplished IAW DoDM 5200.01V3_AFMAN 16-1404V3 and only AF-approved and controlled equipment can be used.
4. Guard Services: The host government activity will provide guard services.
5. Security Forms: Security forms and publications are accessible at: Air Force publications: https://www.e-publishing.af.mil/ DoD publications: https://www.esd.whs.mil/DD/. Local forms will be provided by the government activity.
6. Security Inspections:
a. The VG shall participate in the host Commander’s self-inspection programs IAW DoDM 5200.01V1_AFMAN 16-1404V1. Deficient items will include a corrective action plan.
b. The security focal point (SFP) will maintain the following documentation and have available for security reviews:
(1) A signed copy of the current prime DD Forms 254, and all subcontractors DD Forms 254, if applicable.
(2) Copy of the Security Agreement for visitor groups under 78 ABW/IP security cognizance.
(3) Documentation the Security Agreement was provided to all subcontractors, if applicable.
(4) Documentation of the last program review and self-inspection.
(5) Consultant Agreements, if applicable.
(6) Current list of all employees identifying their security clearance access level, including subcontractors, if applicable.
7. Transmission of Classified Material/Information:
a. Receipt and dispatch of classified material is the responsibility of the government. The VG is not authorized to perform these activities unless they are specifically contracted for and identified in the Statement of Work or Performance Work Statement. When this service is required for contract performance, the designated VG employee shall comply with DoDM 5200.01V1_AFMAN 16-1404V1, DoDM 5200.01V2_AFMAN 16-1404V2, DoDM 5200.01V3_AFMAN 16-1404V3 and the government activity’s security program OI.
The security assistant (SA) will provide VG personnel training on mail handling procedures, to include proper securing of Registered, Certified, USPS Express and FedEx Mail and/or First Class mail. However, under no circumstances will the VG be authorized to open a
PREVIOUS EDITION IS OBSOLETE. Page 4 of 6DD FORM 254, APR 2018 classified package beyond the outer wrapper to determine further distribution or sign the classified document receipt.
b. The VG is not authorized for direct receipt or dispatch of classified material at RAFB GA through US postal channels or commercial carrier.
c. Classified material transmitted via U. S. postal channels or approved commercial carrier, direct from the government activity, must be prepared IAW DoDM 5200.01V3_AFMAN 16-1404V3 and processed through the classified information control system of RAFB GA.
d. Classified material may be hand carried onto or off RAFB by an appropriately cleared and briefed VG courier, provided the employee is so designated in writing by his/her company FSO as a courier and the activity Director or designee IAW DoDM 5200.1-V3_AFMAN 16-1404V3.
8. Security Badges: The government activity will issue security badges. The contractor shall return security badges to the issuing office upon the period of performance end date, termination of the contract, or when an employee is no longer supporting the contract, whichever is sooner. Transfer of security badges to another contract is not authorized.
9. Visitor Control: The contractor shall comply with DoDM 5200.08V3_AFMAN 31-101V3, Installation Perimeter Access Control, and the host installation commander’s visitor control procedures for access to the installation and the government activity’s visitor control procedures to access facilities.
10. Security Incidents: The contractor shall report security incidents to the unit’s SA and the host IPO. The government shall conduct the preliminary inquiry for security incidents occurring on the installation IAW DoDM 5200.01V1_AFMAN 16-1404V1.
11. Security Checks: Government personnel shall conduct end-of-day security checks unless the contract specifically identifies contractors to conduct end-of-day security checks.
12. Internal Security Controls: The contractor shall comply with the government activity’s security operating instructions.
13. Emergency Procedures to Protect Classified Material: The contractor shall implement emergency procedures to protect classified material as identified in the host government activity’s operating instruction.
14. Training: The contractor shall participate in the host government activity’s initial and reoccurring information protection security awareness and training education programs.
15. Subcontract DD Form 254: Should a subcontract be issued under this effort, whereas the subcontractor will require access to classified information and be physically located on RAFB GA for a minimum of 90 days, the VG must issue a subcontract DD Form 254, IAW the NISPOM, and comply with the following:
a. Provide a signed copy of the subcontract DD Form 254 to the GPM, SA and the SFP and 78 ABW/IPD.
b. Ensure the subcontractor complies with this security agreement or enter into a separate agreement with the subcontractor. The agreement to comply must be documented and a copy of the documentation provided to GPM, SA, SFP and 78 ABW/IPD. If a separate agreement is prepared, a copy shall be provided to the GPM, SA, SFP and 78 ABW/IPD.
16. Consultants: Should a consultant be acquired who will require access to classified information and be physically located on RAFB GA, a copy of the Consulting Agreement must be provided to the GPM, SA, SFP and 78 ABW/IPD.
17. Reporting Requirements: VG employees report shall report adverse information, suspicious contacts, espionage, sabotage, and subversive activities to government activity’s SA IAW DoDM 5220.22V2_AFMAN 16-1406V2, para 4.14 (Added)(AF). The contractor shall furnish a copy of adverse information reports required by 32 CFR Part 117, National Industrial Security Program Operating Manual, § 117.8(c)(1)(i), SEAD 3 and CSA-provided guidance. Reports will be submitted to the installation commander through the 78th ABW Industrial Security Office, 78 ABW/IPD at email: 78abw.ip.indsec@us.af.mil.
List of Attachments (All Files Must be attached Prior to Signing, i.e., for any digital signature on the form) Hide Attachment Bar
WR-ALC/OBCA
478-327-2660
DSN 497-2660
NAME & TITLE OF REVIEWING OFFICIAL
PHYLLIS M. VAIL, GS-12, WR-ALC/
OBCA, ACQ PROGRAM MNGR
SIGNATURE
WR-ALC/OMD
478-926-6095
DSN 468-6095
NAME & TITLE OF REVIEWING OFFICIAL
CLINTON SCOTT BREEZE
OPSEC COORDINATOR
SIGNATURE
PREVIOUS EDITION IS OBSOLETE. Page 5 of 6DD FORM 254, APR 2018
WR-ALC/OMD
478-222-3562
DSN 472-3562
NAME & TITLE OF REVIEWING OFFICIAL
APRIL BAKER
UNIT SECURITY SPECIALIST
SIGNATURE
78 ABW/IPD
478-222-1977
DSN 472-1977
NAME & TITLE OF REVIEWING OFFICIAL
MELVESE HARRIS, NH-03, DAF
SERVICING SECURITY ACTIVITY
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.)
Provide the information requested by the Notification of Government Security Activity and Visitor Group Security Agreements Clause, AFFARS 5352.204-9000, to the Servicing Security Activity indicated in item 13 above. Refer to the contract document for this clause.
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.)
Industrial security reviews of long term visitor groups operating on Robins Air Force Base GA will be conducted by 78 ABW/IPD.
Contractor will comply with the visitor group security agreement provided by the USAF Program/Project Manager.
16. GOVERNMENT CONTRACTING ACTIVITY (GCA) AND POINT OF CONTACT (POC)
a. GCA NAME
Jesse Schwarztrauber
b. ACTIVITY ADDRESS CODE (AAC) OF THE CONTRACTING OFFICE (See Instructions)
FA8571
c. ADDRESS (Include ZIP Code) 375 Perry St, Robins AFB, GA 31098
d. POC NAME
Phyllis M. Vail
e. POC TELEPHONE (Include Area Code)
+1 (478) 327-2660
f. EMAIL ADDRESS (See Instructions) phyllis.vail@us.af.mil
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.
a. TYPED NAME OF CERTIFYING OFFICIAL (Last, First, Middle Initial) (See Instructions)
Schwarztrauber, Jesse
b. TITLE
PCO
c. ADDRESS (Include ZIP Code)
AFSC/PZIMB
375 Perry Street, Building 255, Suite A Robins AFB, GA 31098
d. AAC OF THE CONTRACTING OFFICE (See Instructions)
FA8571
e. CAGE CODE OF THE PRIME CONTRACTOR
(See Instructions.)
TBD
f. TELEPHONE (Include Area Code)
+1 (575) 265-9515
g. EMAIL ADDRESS (See Instructions) jesse.schwarztrauber.1@us.af.mil
h. SIGNATURE
i. DATE SIGNED (See Instructions)
PREVIOUS EDITION IS OBSOLETE. Page 6 of 6DD FORM 254, APR 2018
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.)
78 ABW/IPD, 78 OSS/OSA, 78 OSS Security Manager WR-ALC/OMD Security Manager, WR-ALC/OBWC
HQ DCSA
DRAFT
SAMPLE
PREVIOUS EDITION IS OBSOLETE.
Page of
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:
May 31, 2022 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.)
List of Attachments (All Files Must be attached Prior to Signing, i.e., for any digital signature on the form)
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" Hide Attachment Bar
| CurrentPage: |
| PageCount: |
| Select classification from drop-down list.: Unclassified |
| SerialNum: |
| a. Facility clearance level. Select one.: 2 |
| b. Level of safeguarding for classified information/material required at contractor facility. Select one.: 4 |
| Select for "original.": 0 |
| Select for "original.": 1 |
| Enter prime contract number.: |
| Select for "revised.": 0 |
| Select for "revised.": 0 |
| Enter subcontract number.: |
| Select for "final.": 1 |
| Select for "final.": 0 |
| Enter solicitation or other number.: F3QCCL1082A004 |
| Enter due date in format YYYYMMDD.: |
| Enter date in format YYYYMMDD.: 20210716 |
| Enter revision number.: |
| Enter date in format YYYYMMDD.: |
| Enter final specification.: |
| Enter date in format YYYYMMDD.: |
| Select for "no.": 1 |
| Select for "no.": 1 |
| Select for "no.": 0 |
| Select for "no.": 0 |
| Select for "yes.": 0 |
| Select for "yes.": 0 |
| Select for "yes.": 1 |
| Select for "yes.": 1 |
| Enter preceding contract number.: |
| Enter contractor's request date in format YYYYMMDD.: |
| Enter period.: |
| Enter typed name of certifying official (last, first, middle initial).: TBD |
| Enter typed name of certifying official (last, first, middle initial).: N/A |
| Enter typed name of certifying official (last, first, middle initial).: Schwarztrauber, Jesse |
| Enter CAGE code of the prime contractor.: TBD |
| Enter CAGE code of the prime contractor.: N/A |
| Enter CAGE code of the prime contractor.: N/A |
| Enter CAGE code of the prime contractor.: TBD |
| Enter cognizant security office(s) (Name, Address, ZIP Code, Telephone required; Email Address optional).: TBD |
| Enter cognizant security office(s) (Name, Address, ZIP Code, Telephone required; Email Address optional).: N/A |
| Enter cognizant security office(s) (Name, Address, ZIP Code, Telephone required; Email Address optional).: 78 ABW/IP |
985 Macon Street Robins AFB, GA 31098
| Select to add row to locations.: |
| Select to remove last row from locations.: |
| Select to delete all signatures.: |
| Enter location(s).: See Block 13 |
| Enter general unclassified description of this procurement.: The contractor shall provide Depot Maintenance supply chain analysis, planning to support senior leadership strategic goals, material coordinators support services for support of the Warner Robins Air Logistics Complex (WR- ALC) Aircraft Programmed Depot Maintenance (PDM). Basic supply chain duties that include parts ordering, research and supportability, turn-in of material, and parts tracking. These services shall include basic supply chain duties such as parts ordering, research and supportability, turn-in of material, and parts tracking. |
| Select for "a. CONTRACTOR.": 1 |
| Select for "a. CONTRACTOR.": 1 |
| Select for "a. CONTRACTOR.": 1 |
| Select for "f. OTHER AS NECESSARY.": 0 |
| Select for "f. OTHER AS NECESSARY.": 0 |
| Select for "f. OTHER AS NECESSARY.": 1 |
| Select for "b. SUBCONTRACTOR.": 0 |
| Select for "b. SUBCONTRACTOR.": 0 |
| Select for "b. SUBCONTRACTOR.": 0 |
| Select for "g. BE AUTHORIZED TO USE THE SERVICES OF DEFENSE TECHNICAL INFORMATION CENTER (DTIC) OR OTHER SECONDARY DISTRIBUTION CENTER.": 0 |
| Select for "g. BE AUTHORIZED TO USE THE SERVICES OF DEFENSE TECHNICAL INFORMATION CENTER (DTIC) OR OTHER SECONDARY DISTRIBUTION CENTER.": 0 |
| Select for "c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR.": 0 |
| Select for "c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR.": 0 |
| Select for "c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR.": 1 |
| Select for "h. REQUIRE A COMSEC ACCOUNT.": 0 |
| Select for "h. REQUIRE A COMSEC ACCOUNT.": 0 |
| Select for "d. U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECURITY ADMINISTRATION.": 0 |
| Select for "d. U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECURITY ADMINISTRATION.": 0 |
| Select for "d. U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECURITY ADMINISTRATION.": 0 |
| Select for "i. HAVE A TEMPEST REQUIREMENT.": 0 |
| Select for "i. HAVE A TEMPEST REQUIREMENT.": 0 |
| Select for "e. NATIONAL INTELLIGENCE INFORMATION: - (1) Sensitive Compartmented Information (SCI).": 0 |
| Select for "e. NATIONAL INTELLIGENCE INFORMATION: - (2) Non-SCI.": 0 |
| Select for "j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS.": 1 |
| Select for "j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS.": 1 |
| Select for "k. BE AUTHORIZED TO USE DEFENSE COURIER SERVICE.": 0 |
| Select for "k. BE AUTHORIZED TO USE DEFENSE COURIER SERVICE.": 0 |
| Enter infomration for "other.": See Item 13 - Security Requirements |
| Enter infomration for "other.": 78 ABW/IPD, 78 OSS/OSA, 78 OSS Security Manager |
WR-ALC/OMD Security Manager, WR-ALC/OBWC
HQ DCSA
| Select for "e. ADMINISTRATIVE CONTRACTING OFFICER.": 1 |
| Select for "e. ADMINISTRATIVE CONTRACTING OFFICER.": 1 |
| Select for "l. RECEIVE, STORE, OR GENERATE CONTROLLED UNCLASSIFIED INFORMATION (CUI). .": 1 |
| Select for "m.OTHER.": 1 |
| Select for "direct.": 0 |
| Select for ": 1 |
| Enter specification for "through".: See Item 13 |
| Enter public release authority.: See Item 13 |
| Select to add signature.: |
| Select to remove last signature.: |
| text: Ref. 8a and 11a: Contract performance will occur primarily in Building 210. Additional secure/unsecure facilities at Robins AFB, GA, to include Buildings 640, 645, 228, 229, Flight Line, 125, 81, 82, 84, 48, 49, 50, 59, 59P, 91 and 110. Using activity will provide security classification guidance for the performance of this contract. The Contractor shall forward visit requests through the Defense Information for Security (DISS) or successor system for secure facilities access as required. |
Ref. 10a: Access to COMSEC material by personnel is restricted to U.S. citizens holding final U.S Government clearances. Such information is not releasable to personnel holding reciprocal clearances. For on base COMSEC access see AFMAN 17-1302-O, COMSEC Operations for guidance.
Ref. 10j/11l: The contractor shall comply with DoDI 5200.48, Controlled Unclassified Information, DoDM 5200.01V3_AFMAN 16-1404V3, Information Security Program Protection of Classified Information and DoDM 5400.7-Air Force Manual 33 302, DoD Freedom of Information Act (FOIA) Program. The contractor shall monitor CUI aggregation and compilation based on the potential to generate classified information pursuant to security classification guidance addressing the accumulation of unclassified data or information.
Ref. 11e: Contract is for technical and administrative production support services. Classification markings on the material to be furnished will provide the guidance necessary for performance of the contract.
Ref 11j: Contractor personnel will participate in the OPSEC program administered locally by the AF activity.
Ref. 12: Contractor is to submit requests through the contracting officer for OPSEC program manager review and public release authorization. The contracting officer will provide contractor with written approval/disapproval. Information requiring AF or DoD-level review will be reviewed by the unit’s OPSEC program manager or coordinator who will in-turn forward to the entry-level public affairs office through the AFIMSC Public Affairs Office to the Secretary of the Air Force, Office of Public Affairs, Security and Review Division (SAF/PAX), 1690 Air Force Pentagon, Washington DC 20330-1690.
Ref. 13:
1. These security requirements, promulgated by DoDM 5220.22V2_AFMAN 16-1406V2, National Industrial Security Program, Industrial Security Procedures for Government Activities, and 32 CFR Part 117, National Industrial Security Program Operating Manual (NISPOM), § 117.7(a), are issued for cleared contractors who will be entrusted to have access to classified information. This guidance is applicable for contractor performance as a visitor group (VG) under the 78th Air Base Wing Information Protection Office (IPO) security cognizance, Robins AFB GA. For performance on other installations, prior to the start of performance, the contractor shall contact the host IPO to execute an agreement and/or security requirements as mandated by the above referenced documents.
2. Storage of Classified Material/Information: The government program manager (GPM) may authorize VG to store and handle classified material required for performance on this contract. All classified information shared with the VG must be stored in an approved government-owned and controlled security container. The number of VG employees authorized access to the security container will be kept to the minimum number required for efficient contract performance. When authorized, the VG shall comply with DoDM 5200.01V1_AFMAN 16-1404V1, Information Security Program: Overview, Classification & Declassification, DoDM 5200.01V2_AFMAN 16-1404V2, Information Security Program: Marking of Classified Information, and DoDM 5200.01V3_AFMAN 16-1404V3, Information Security Program: Protection of Classified Information and the government activity’s security program operating instruction (OI). The VG is prohibited from establishing and/or maintaining a separate classified information system. All classified material/information must be returned and secured in the government security container at the end of the duty day.
3. Reproduction of Classified Material: The VG may be authorized to reproduce classified information, as required for contract performance. Authorization must be accomplished IAW DoDM 5200.01V3_AFMAN 16-1404V3 and only AF-approved and controlled equipment can be used.
4. Guard Services: The host government activity will provide guard services.
5. Security Forms: Security forms and publications are accessible at: Air Force publications: https://www.e-publishing.af.mil/ DoD publications: https://www.esd.whs.mil/DD/. Local forms will be provided by the government activity.
6. Security Inspections:
a. The VG shall participate in the host Commander’s self-inspection programs IAW DoDM 5200.01V1_AFMAN 16-1404V1. Deficient items will include a corrective action plan.
b. The security focal point (SFP) will maintain the following documentation and have available for security reviews:
(1) A signed copy of the current prime DD Forms 254, and all subcontractors DD Forms 254, if applicable.
(2) Copy of the Security Agreement for visitor groups under 78 ABW/IP security cognizance.
(3) Documentation the Security Agreement was provided to all subcontractors, if applicable.
(4) Documentation of the last program review and self-inspection.
(5) Consultant Agreements, if applicable.
(6) Current list of all employees identifying their security clearance access level, including subcontractors, if applicable.
7. Transmission of Classified Material/Information:
a. Receipt and dispatch of classified material is the responsibility of the government. The VG is not authorized to perform these activities unless they are specifically contracted for and identified in the Statement of Work or Performance Work Statement. When this service is required for contract performance, the designated VG employee shall comply with DoDM 5200.01V1_AFMAN 16-1404V1, DoDM 5200.01V2_AFMAN 16-1404V2, DoDM 5200.01V3_AFMAN 16-1404V3 and the government activity’s security program OI. The security assistant (SA) will provide VG personnel training on mail handling procedures, to include proper securing of Registered, Certified, USPS Express and FedEx Mail and/or First Class mail. However, under no circumstances will the VG be authorized to open a classified package beyond the outer wrapper to determine further distribution or sign the classified document receipt.
b. The VG is not authorized for direct receipt or dispatch of classified material at RAFB GA through US postal channels or commercial carrier.
c. Classified material transmitted via U. S. postal channels or approved commercial carrier, direct from the government activity, must be prepared IAW DoDM 5200.01V3_AFMAN 16-1404V3 and processed through the classified information control system of RAFB GA.
d. Classified material may be hand carried onto or off RAFB by an appropriately cleared and briefed VG courier, provided the employee is so designated in writing by his/her company FSO as a courier and the activity Director or designee IAW DoDM 5200.1-V3_AFMAN 16-1404V3.
8. Security Badges: The government activity will issue security badges. The contractor shall return security badges to the issuing office upon the period of performance end date, termination of the contract, or when an employee is no longer supporting the contract, whichever is sooner. Transfer of security badges to another contract is not authorized.
9. Visitor Control: The contractor shall comply with DoDM 5200.08V3_AFMAN 31-101V3, Installation Perimeter Access Control, and the host installation commander’s visitor control procedures for access to the installation and the government activity’s visitor control procedures to access facilities.
10. Security Incidents: The contractor shall report security incidents to the unit’s SA and the host IPO. The government shall conduct the preliminary inquiry for security incidents occurring on the installation IAW DoDM 5200.01V1_AFMAN 16-1404V1.
11. Security Checks: Government personnel shall conduct end-of-day security checks unless the contract specifically identifies contractors to conduct end-of-day security checks.
12. Internal Security Controls: The contractor shall comply with the government activity’s security operating instructions.
13. Emergency Procedures to Protect Classified Material: The contractor shall implement emergency procedures to protect classified material as identified in the host government activity’s operating instruction.
14. Training: The contractor shall participate in the host government activity’s initial and reoccurring information protection security awareness and training education programs.
15. Subcontract DD Form 254: Should a subcontract be issued under this effort, whereas the subcontractor will require access to classified information and be physically located on RAFB GA for a minimum of 90 days, the VG must issue a subcontract DD Form 254, IAW the NISPOM, and comply with the following:
a. Provide a signed copy of the subcontract DD Form 254 to the GPM, SA and the SFP and 78 ABW/IPD.
b. Ensure the subcontractor complies with this security agreement or enter into a separate agreement with the subcontractor. The agreement to comply must be documented and a copy of the documentation provided to GPM, SA, SFP and 78 ABW/IPD. If a separate agreement is prepared, a copy shall be provided to the GPM, SA, SFP and 78 ABW/IPD.
16. Consultants: Should a consultant be acquired who will require access to classified information and be physically located on RAFB GA, a copy of the Consulting Agreement must be provided to the GPM, SA, SFP and 78 ABW/IPD.
17. Reporting Requirements: VG employees report shall report adverse information, suspicious contacts, espionage, sabotage, and subversive activities to government activity’s SA IAW DoDM 5220.22V2_AFMAN 16-1406V2, para 4.14 (Added)(AF). The contractor shall furnish a copy of adverse information reports required by 32 CFR Part 117, National Industrial Security Program Operating Manual, § 117.8(c)(1)(i), SEAD 3 and CSA-provided guidance. Reports will be submitted to the installation commander through the 78th ABW Industrial Security Office, 78 ABW/IPD at email: 78abw.ip.indsec@us.af.mil.
text: WR-ALC/OBCA 478-327-2660
DSN 497-2660
text: WR-ALC/OMD 478-926-6095
DSN 468-6095
text: WR-ALC/OMD 478-222-3562
DSN 472-3562
text: 78 ABW/IPD 478-222-1977
DSN 472-1977
| Click on this button to attach a file(s).: |
| rep: PHYLLIS M. VAIL, GS-12, WR-ALC/ OBCA, ACQ PROGRAM MNGR |
| rep: CLINTON SCOTT BREEZE |
OPSEC COORDINATOR
rep: APRIL BAKER
UNIT SECURITY SPECIALIST
rep: MELVESE HARRIS, NH-03, DAF
SERVICING SECURITY ACTIVITY
| Enter signature.: |
| Explain and identify specific areas and government activity responsible for inspections.: Provide the information requested by the Notification of Government Security Activity and Visitor Group Security Agreements Clause, AFFARS 5352.204-9000, to the Servicing Security Activity indicated in item 13 above. Refer to the contract document for this clause. |
| Explain and identify specific areas and government activity responsible for inspections.: Industrial security reviews of long term visitor groups operating on Robins Air Force Base GA will be conducted by 78 ABW/IPD. Contractor will comply with the visitor group security agreement provided by the USAF Program/Project Manager. |
| Enter GCA name.: Jesse Schwarztrauber |
| Enter AAC of the contracting office.: FA8571 |
| Enter AAC of the contracting office.: FA8571 |
| Enter address (include zip code).: 375 Perry St, Robins AFB, GA 31098 |
| Enter address (include zip code).: AFSC/PZIMB |
375 Perry Street, Building 255, Suite A Robins AFB, GA 31098
| Enter POC name.: Phyllis M. Vail |
| Enter telephone number (include area code).: 4783272660 |
| Enter telephone number (include area code).: 5752659515 |
| Enter email address.: phyllis.vail@us.af.mil |
| Enter email address.: jesse.schwarztrauber.1@us.af.mil |
| Enter title.: PCO |
| Enter the datesigned in format YYYYMMDD.: |
File details come from the government source that posted it. Updated .