Attachment 0003 - DD254 - Solicitation.pdf

UNCLASSIFIED

DEPARTMENT OF DEFENSE OMB No. 0704-0567 OBM approval expires Jun 30, 2025

CONTRACT SECURITY CLASSIFICATION SPECIFICATION

(The requirements of the National Industrial Security Program (NISP) apply to all security aspects of this effort involving classified information.)

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 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 I des not display a currently valid OMB number.

RETURN COMPLETED FORM AS DIRECTED IN THE INSTRUCTIONS.

1. CLEARANCE AND SAFEGUARDING

a. LEVEL OF FACILITY SECURITY CLEARANCE (FCL) REQUIRED (See Instructions)

b. LEVEL OF SAFEGUARDING FOR CLASSIFIED INFORMATION / MATERIAL

REQUIRED AT CONTRACTOR FACILITY

TOP SECRET None

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

(See instructions.) a. ORIGINAL (Complete date in all cases) DATE (YYYYMMDD)

TBD

b. REVISED (Supersedes all previous specifications.)

REVISION NO.

DATE (YYYYMMDD)

TBD

a. PRIME CONTRACT NUMBER

TBD

b. SUBCONTRACT NUMBER

c. SOLICITATION OR OTHER NUMBER

W50NH9-26-R-A002

DUE DATE

(YYYYMMDD)

c. FINAL (Complete Item 5 in all cases) DATE (YYYYMMDD)

X4. IS THIS A FOLLOW-ON CONTRACT? No Yes If Yes, complete the following:

Classified material received or generated under (Preceding Contract Number)

X5. 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 identified classified material is authorized for the period of:

6. PRIME CONTRACTOR (Include Commercial and Government Entity (CAGE) Code.)

a. NAME, ADDRESS, AND ZIP CODE

TBD

b. CAGE CODE

TBD

c. COGNIZANT SECURITY OFFICE (CSO)

(Name, Address, ZIP Code, Telephone; Email Address optional)

TBD

7. SUBCONTRACTOR (None.)

8. ACTUAL PERFORMANCE

a. LOCATION(S)

USA INTELLIGENCE & SECURITY COMMAND /

MISSION SUPP, 8825 BEULAH STREET, FT BELVOIR,

VA, 22060-5246

b. CAGE CODE

W00YAA3

c. COGNIZANT SECURITY OFFICE (CSO)

(Name, Address, ZIP Code, Telephone; Email Address optional)

8825 BEULAH STREET, FT BELVOIR, VA, 22060-5246

9. GENERAL UNCLASSIFIED DESCRIPTION OF THIS PROCUREMENT

Headquarters, Department of the Army (HQDA), DAMI-IT, Data

Capabilities Division (DCD) - Intelligence Automation Support (IAO)

DD Form 254, APR 2018 PREVIOUS EDITION IS OBSOLETE

X

X

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 X 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 GOVERNMENT INFORMATION

d. FORMERLY RESTRICTED DATA i. ALTERNATIVE COMPENSATORY CONTROL

MEASURES (ACCM) INFORMATION

e. NATIONAL INTELLIGENCE INFORMATION: X j. CONTROLLED UNCLASSIFIED INFORMATION (CUI)

X (1) Sensitive Compartmental Information (SCI) X k. OTHER (Specify)

X (2) Non-SCI

11. IN PERFORMING THIS CONTRACT, THE CONTRACTOR WILL:

X a. HAVE ACCESS TO CLASSIFIED INFORMATION ONLY AT

ANOTHER CONTRACTOR’S FACILITY OR A GOVERNMENT

ACTIVITY

g. BE AUTHORIZED TO USE THE SERVICES OF

DEFENSE TECHNICAL INFORMATION CENTER (DTIC)

OR OTHER SECONDARY DISTRIBUTION CENTER

h. REQUIRE A COMSEC ACCOUNT

b. RECEIVE AND STORE CLASSIFIED DOCUMENTS ONLY i. HAVE A TEMPEST REQUIREMENT

c. RECEIVE, STORE, AND GENERATE CLASSIFIED INFORMATION

OR MATERIAL ( ACCESS , PROCESS )

j. HAVE OPERATIONS SECURITY (OPSEC)

REQUIREMENTS

d. FABRICATE, MODIFY, OR STORE CLASSIFIED HARDWARE

( ACCESS , PROCESS )

k. BE AUTHORIZED TO USE THE DEFENSE COURIER

SERVICE

e. PERFORM SERVICES ONLY X l. RECEIVE, STORE, OR GENERATE CONTROLLED

UNCLASSIFIED INFORMATION (CUI).

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

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

TERRITORIES

X m. OTHER (Specify)

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 (INSPOM) or unless it has been approved for public release by appropriate U.S. Government authority. Proposed public release 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 X THROUGH (Specify below) PUBLIC RELEASE AUTHORITY:

PUBLIC RELEASE OF SCI IS NOT AUTHORIZED

PUBLIC RELEASE OF SCI IS NOT AUTHORIZED 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.

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 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.)

SEE SECTION 13 CONTINUATION SECTION AT THE BOTTOM OF THIS FORM

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

DD Form 254, APR 2018 PREVIOUS EDITION IS OBSOLETE

DD Form 254, APR 2018 PREVIOUS EDITION IS OBSOLETE

NAME & TITTLE OF REVIEWING OFFICIAL

X

S I G N A T U R E

14. ADDITIONAL SECURITY REQUIREMENTS

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

No X 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 cognizant security office (CSO).

See SCI addendum / Contractors may or may not be hand receipt holders. Within the Army, COMSEC customdians are either DA civilians or military members. Contractors are considered hand receipt holders. See AR 380-40 for further guidance on COMSEC.

15. INSPECTIONS.

Elements of this contract are outside the inspection responsibility of the cognizant security office (CSO).

No X Yes If Yes, explain and identify specific areas and government activity responsible for inspections.

SCI addendum / HQDA, G2

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

a. GCA NAME d. POC NAME

ACC-DTA Paul Horrell

b. AAC OF CONTRACTING OFFICE e. POC TELEPHONE

W911W4 571-588-9135

c. ADDRESS f. EMAIL ADDRESS

ACC - INSCOM 8825 BEULAH STREET FORT BELVOIR

VA 22060

paul.w.horrell.civ@army.mil

17. 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. Upon digitally signing Item 17h, no changes can be made as the form will be locked.

a. TYPED NAME OF CERTIFYING OFFICIAL (Last, First, Middle Initial)

d. AAC OF CONTRACTING OFFICE

X h . S IG N A TU R E

Nephew, Pamela W911W4

b. TITLE e. CAGE CODE OF THE PRIME CONTRACTOR

Intelligence Specialist 1RCV7

c. ADDRESS (Include ZIP Code) f. TELEPHONE (Include Area Code.) I. DATE SIGNED

8825 BEULAH STREET, FT BELVOIR, VA, 22060-5246 571-515-7404

g. EMAIL ADDRESS pamela.d.nephew.civ@army.mil

18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL

X a. CONTRACTOR f. OTHERS AS NECESSARY (If more room is needed, continue on Item 13 or on additional page if necessary.)

b. SUBCONTRACTOR

X c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR

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

ADMINISTRATION

X e. ADMINISTRATIVE

DD Form 254, APR 2018 PREVIOUS EDITION IS OBSOLETE

Section 13 Continuation: 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.

10e1: SCI Access required. Reference SCI addendum. 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 KO.

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 KO is required prior to subcontracting. Access to Intelligence information required for performance.

10g: Personnel who require access to NATO classified information, NATO COSMIC, NATO Secret or access to the NATO accredited SIPRNET terminals, must possess a FINAL clearance based upon the appropriate personnel security investigation required. Personnel with access to NATO ATOMAL information must possess a FINAL clearance. The government program/project manager will ensure the contractor personnel are NATO briefed prior to access. Prior approval from the KO is required for subcontracting.

10j: Controlled Unclassified Information generated and/or provided under this contract is identified as (enter CUI or provide reference to an attachment with details) and shall be marked, safeguarded and protected in accordance with (enter specific guidance or reference DoDI 5200.48). Additional notes:

Controlled Unclassified Information generated and/or provided under this contract shall be safeguarded and marked as specified in DODI 5200.48.

10k: Access to NIPRNET, SIPRNET and JWICS is required. A NATO Awareness briefing is required for everyone who needs access to the SIPRNET/JWICS. The purpose of providing a NATO awareness briefing is to inform personnel of how to protect NATO information in the event they come across it while on the SIPRNET/JWICS

11a: Contractor performance is restricted to USA INTELLIGENCE & SECURITY COMMAND / MISSION SUPPORT 8825 BEULAH STREET, FT BELVOIR, VA, 22060-5246. Government agency or activity will provide security classification guidance for performance on this contract. Additional notes:

Submit visit request to the KO and/or Security Management Office for need-to-know verification through DISS or current system of recorded

11f: Access to classified information outside the US at Government and Government leased facility only. OCONUS travel may be required for GEN 302 training and meetings to FVEY related countries.

11l: Requires Safeguarding and dissemination of CUI.

11m: SI, TK, G, KLM-R and HCS access and TARP Training are required.

US ARMY SCI ADDENDUM TO DD FORM 254

X (1)-This contract requires access to Sensitive Compartmented Information (SCI). The Commander, US Army Intelligence and Security Command (INSCOM), acting on behalf of the DA Deputy Chief of Staff (DCS), G-2 is the Cognizant Security Authority (CSA) for the US Army, has exclusive security responsibility for all SCI released to the contractor or developed under the contract and held within the Contractor's SCI Facility (SCIF) or Co-utilization Agreement (CUA).

X (2)-The Defense Intelligence Agency (DIA) has security inspection responsibility for SCI and the

Defense Counterintelligence and Security Agency (DCSA) retains responsibility for all collateral information released or developed under the contract and held within the DoD Contractor's SCIF.

All DD Forms 254 prepared for contracts involving access to SCI under this contract must be processed through ACCS to the CM and Industrial Security Specialist for approval.

X (3)-The manuals, regulations, and directives checked below provide the necessary guidance for physical, personnel, and information security for safeguarding SCI, and are part of the security classification specification for this contract:

(a)-ICD 503, Intelligence Community Information Technology Systems

Security Risk Management, Certification and Accreditation

X (b)-ICD 704 Personnel Security Standards and Procedures Governing Eligibility for

Access to Sensitive Compartmented Information

(c)-IC Tech Spec-for ICD/ICS 705, Technical Specifications for Construction and

Management of Sensitive Compartmented Information Facilities

X (d)-DoDM 5105.21 Vol 1-3, SCI Administrative Security Manual

X (e)-AR 380-28, Army SCI Security Program

X (f)-AR 25-2, Army Cybersecurity

(g)-AR 380-381, Special Access Programs (SAPS) and Sensitive Activities

(h)-AR 715-30 Secure Environment Contracting

(i)-Other

X (4)-Contract estimated completion date (PERIOD OF PERFORMANCE ONLY): TBD

(NOTE: Option years are not to be included, as an option is not valid until exercised by the government.)

X (5)- Security Personnel. The Contract Monitor and the contractor security officer must be registered in the Army Centralized Contracts and Security Portal (ACCS) at the level of contract, in order to process SCI actions

(a) Contract Monitor

Name: Paul Presti

Telephone: 571-515-7769 Email: paul.n.presti.civ@army.mil

Mailing Address: 8825 BEULAH STREET, FT BELVOIR, VA, 22060-5246

(b) Alternate Contract Monitor

Name: Lydia Padilla Email: lydia.g.padilla.civ@army.milTelephone: 5715156631

Mailing Address: 8825 BEULAH STREET, FT BELVOIR, VA, 22060-5246

X

X

X

X

X

(c) Contractor Security POC

Name: TBD Telephone: TBD Email: TBD Mailing Address: TBD

(6)-All DD Forms 254 prepared for contracts involving access to SCI under this contract must be processed through ACCS to the CM and Industrial Security Specialist for approval and to

Contractor Support Element, USAINSCOM, ACofS Security, G2 for review and concurrence of the awarded contract.

(7)-All SCI visit certifications for contractors must be processed through ACCS to the CM for approval and to the CSE for review and processing. Visit certification requests must be submitted at least ten (10) working days prior to the visit

(8)-Debriefings: All FSO’s/CSSO’s must properly debrief all contractors from SCI through ACCS.

FSO/CSSO’s must submit the debrief request NLT 7 days and NET 10 days before actual departure.

FSO’s/CSSO’s will separate all contractors from DISS, or the current system of record, after completion of debriefing.

(9)-The contractor will not reproduce any SCI related material without prior written permission of the CM.

(10)-Security Classification Guides or extracts are attached or will be provided under separate cover.

(11)-Electronic processing of SCI requires accreditation of the equipment in accordance with ICD

503 and AR 25-2. (Note: NATO security awareness briefing is required for access to JWICS indicated in blocks 10k or 11l of DD 254.).

(12)-This contract requires a contractor Controlled Space _X_ or CUA ___

X

X

(13)-Request for Indoctrination/Debrief Authority

(14)-This contract requires (SI) (TK) (G) (HCS) (KLM-R)

(15)-The contractor will perform SCI work under this contract at the following location (Name of government or contractor activity, SCI SMO or CAGE Code):

Companies: TBD

Agencies: WDFKAA - USA NATIONAL GROUND INTELLIGENCE CENTER - CHARLOTT, W095AA

- HQ US FORCES KOREA, WND0AA - 513TH MI BDE, W00YAA2 - USA INTELLIGENCE & SECURITY COMMAND - FT BELVOIR,, WAT3AA3 - I CORPS & FT LEWIS - FT LEWIS, WA, UIC73 - Chairman, Joint Chief of Staff, W4VY16 - GISA - Ft. Liberty, WNGGAA - 116TH MI BDE FORT GORDON, W3NRAAL2 - NGA East Campus, RS HQ - USFOR-A, NSA2 - National Security Agency, W4VY17 - GISA Detachment - Fort Huachuca

(16)-The contractor identified in Block 6 is a Multiple Facility Organization (MFO) and is authorized to submit DD254 and SCI Addendum for the following SCI locations (Facility Name and CAGE Code).

(17)- SCI Courier Requirement