Attachment_3_-_DD_Form_254_Fillable.pdf

1. CLEARANCE AND SAFEGUARDING

DEPARTMENT OF DEFENSE a. FACILITY CLEARANCE REQUIRED

CONTRACT SECURITY CLASSIFICATION SPECIFICATION

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

b. LEVEL OF SAFEGUARDING REQUIRED

2. THIS SPECIFICA 11ON IS FOR: (X and complete as applicable) 3. THIS SPECIFICATION IS: (X and complete as applicable)

a. PRIME CONTRACT NUMBER DATE (YYYYMMDD)

a. ORIGINAL (Complete date in all cases)

b. SUBCONTRACT NUMBER b. REVISED I

REVISION NO. DATE (YYYYMMDD)

(Supersedes all previous specs)

c. SOLICITATION OR OTHER NUMBER DUE DATE (YYYYMMDD) DATE (YYYYMMDD)

c. FINAL (Complete I tem 5 in all cases)

4. IS THIS A FOLLOW-ON CONTRACT? L_jYES L_j NO. 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? L_jYES L_jNO. 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 (Name, Address, and Zip Code)

7. SUBCONTRACTOR

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

8. ACTUAL PERFORMANCE

a. LOCATION b. CAGE CODE c. COGNIZANT SECURITY OFFICE (Name, Address, and Zip Code)

9. GENERAL IDENTIFICATION OF THIS PROCUREMENT

10. CONTRACTOR WILL REQUIRE ACCESS TO: YES NO 11. IN PERFORMING THIS CONTRACT, THE CONTRACTOR WILL: YES NO a COMMUNICATIONS SECURITY (COMSEC) INFORMATION a

�t�ttktf6�·$ °Fi\.tfL'ltr/frt' JNJovER��Ul/"¥�t\-i0\ANu I Htcf< b RESTRICTED DATA b. RECEIVE CLASSIFIED DOCUMENTS ONLY

C CRITICAL NUCLEAR \/\EAPON 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) Sens,twe Compartmented Information (SCI) f �d��t'G�rtcr. L s up�oiittgg//j�j? A1D0f�&J1q-�1�W1rngiJ

HE us.

(2) Nori-SCI g. ��rt���fDW�'6� o4��� ��i8��'.k:-1N' 81�fR7sDY�N 1 E�HrJ�AL INcue:MAI l()N f SPECIAL ACCESS INFORMATION h REQUIRE A COMSEC ACCOUNT g NATO INFORMATION I HAVE TEMPEST REQUIREMENTS 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 I. OTHER (Specify)

k. OTHER (Specify/

DD FORM 254, DEC 1999 PREVIOUS EDITION IS OBSOLETE.

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Adobe Professional 7.0

Acquisition of Multi-functional Devices (MFD), supplies, technical services, parts, and device training for the Shipboard Multipurpose Device Program. The contract will support Navy afloat elements, Military Sealift Command (MSC) afloat elements, U.S. Fleet Marine Forces (FMF) afloat elements, Coast Guard and other mobile activities of the Federal Government that have afloat deployments for extended periods. The contractor shall provide six (6) classes (A3 and A4 models) of MFDs, one (1) class of a B&W production MFD, and one (1) class of a Color production MFD, a minimum of two (2) classes SFDs, two (2) classes SDs, for shipboard use.

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 releases shall be submitted for approval prior to release [=1 Direct [=1 Through (Specify) 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 classified 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. (Fi ll in as appropriate for the classified effort. Attach, or forward under separate coffespondence, any documents/guides/extracts referenced herein. Add additional pages as needed to provide complete guidance.)

14. ADDITIONAL SECURITY REQUIREMENTS. Requirements, in addition to ISM requirements, are established for this contract. LJ Yes LJ No

(If Yes, identify the pertinent contractua l 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)

15. INSPECTIONS. Elements of this contract are outside the inspection responsibility of the cognizant security office. LJ Yes LJ No

(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.)

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 b. TITLE c. TELEPHONE (Include Area Code)

d. AD DRESS (Include Zip Code) 17. REQUIRED DISTRIBUTION a CONTRACTOR b SUBCONTRACTOR c COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR d U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECU RITY ADMINISTRATION e. SIGNATURE e ADMINISTRATIVE CONTRACTING OFFICER f OTHERS AS NECESSARY

DD FORM 254 (BACK), DEC 1999

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CHAD. SPITTLE@DLA.MIL

13. SECURITY GUIDANCE. (CON’T.)

Solicitation or Contract # Page #

DD FORM 254 (13 CON’T.), MAY 2010

• Provide a copy of any Defense Security Service letter that indicates a less than satisfactory security rating and/or that negatively impacts the Facility Clearance Level (FCL) of the company within 48-hours of receipt.

•Provide electronic copies of Subcontractor DD Form 254s issued by the Prime and the Subcontractor. The Prime Contractor shall act as the focal point for collecting their Subcontractor’s DD Form 254s and the Prime is responsible for forwarding these DD Form 254s to the DLA HQ Industrial Security Program Office.

•DLA HQ Industrial Security Program Office:

Defense Logistics Agency ATTN: DI / Industrial Security Program Manager 8725 John J. Kingman Road Fort Belvoir, VA 22060-6221 Phone: (703) 767-4376 Email: erica.quinley@dla.mil

Subcontractor Classified Access Approvals:

The Prime Contractor and Subcontractor are authorized to flow access to and/or dissemination of classified information to the level specified in Block 1a to their Subcontractors. Dissemination is only authorized and applicable for information safeguarded at the Contractor’s facility. The Contractor shall provide the appropriate accesses to its Subcontractors as required per NISPOM 5-502. The Prime Contractor and Subcontractor must verify Facility Clearance, Safeguarding Capability and Access Authorizations prior to the dissemination of classified information. Certain accesses require GCA approval prior to subcontracting and are specified herein, if applicable.

Reference Item 11.e: The contractor will be performing services only on this contract and will not be expected to produce deliverable items.

The contractor will be required to provide services in secure Government facilities and may come into contact with Classified or Controlled Unclassified Information (CUI). Actual knowledge, generation, or production of classified information is not required for the performance of this contract. Cleared personnel are required to perform this service because access to classified information cannot be precluded by escorting personnel due to a high risk of aural or visual access to classified information. This access cannot be properly mitigated through other reasonable physical security measures.

Reference Item 11.f:

1. The Contractor shall require access to classified information overseas at areas designated in the Statement of Work, Performance Work Statement, or Statement of Objectives.

2. All Contractor personnel working at the designated location(s) and accessing classified information shall obtain an Area of Responsibility-specific travel briefing and Anti-terrorism Level I Awareness training prior to departing on travel. Required training shall be received within 90 days prior to travel.

Reference Item 11.j:

1. The Contractor is required to apply Operations Security (OPSEC) to enhance protection of classified and unclassified critical information pursuant to DoD Directive 5205.02, “DoD OPSEC Program; DoD 5205.02-M, “OPSEC Program Manual;” National Security Decision Directive Number 298, “National Operations Security Program;” DLA Instruction 3606-01, “Operations Security (OPSEC) Program,” October 3, 2018;

DLA Manual 3606.01, “Operations Security (OPSEC) Program,” October 10, 2018; and supplementary instructions. Service OPSEC guidance may also apply if the contracted activity is performed in a Service-level operational environment. Contractors are required to complete OPSEC refresher training on an annual basis and provide timely and appropriate responses to Agency OPSEC Managers, when necessary.

The Contractor is required to flow-down all applicable requirements of the DD Form 254 to its Subcontractor(s).

Reporting Requirements:

The Contractor shall provide the following to the DLA PLFA Industrial Security Manager (PISM) (contact information listed in block 13 of page two of the DD Form 254):

• Courtesy copy the DLA HQ Industrial Security Program Office on any security incident report (initial and final) involving the loss, compromise, or suspected compromise of classified information sent to the Defense Security Service. The Contractor shall provide a copy to the DLA within the same reporting timeframe as is required by the Defense Security Service.

• Courtesy copy the DLA HQ Industrial Security Program Office on any report involving a cyber-intrusion of DLA program information sent to the Federal Bureau of Investigation and the Defense Security Service per NISPOM Chapter 1, Section 301 and Industrial Security Letter 2013-05.