Signed_DD_Form_254_LOGMET_V4.pdf

DEPARTMENT OF DEFENSE

CONTRACT SECURITY CLASSIFICATION SPECIFICATION

(Please read Instructions BEFORE completing this application.) (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 October 31, 2020

CLASSIFICATION (When filled in): FOR OFFICIAL USE ONLY

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.miI. 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 FORMAS DIRECTED IN THE INSTRUCTIONS.

b. LEVEL OF SAFEGUARDING FOR CLASSIFIED INFORMATION/MATERIAL

REQUIREDAT CONTRACTOR FACILITY

b. REVISED (Supersedes X all previous specifications.) 4

W9JJ5J-J8-R-0098 c. FINAL (Complete Item 5 in all cases.)

4. IS THIS A FOLLOW-ON CONTRACT?

ClaSSifiedmaterial received or generated under complete the following:

(Preceding Contract Number) is transferred to this follow-on contract.

5. IS THIS A FINAL DD FORM 254?

In response to the contractor's request dated retention of the classified material is authorized for the period of:

I Telephone)

b. CAGE CODE (If applicable, Telephone) (If applicable, see instructions seeinstructions.) Commander, US Army Yuma Proving Ground

ATTN: TEDT-YP-PLJ, 30J C Street Yuma, AZ 85365-9498 a.

US Army Yuma Proving Ground

9. GENERAL UNCLASSIFIED DESCRIPTION OF THIS PROCUREMENT (Click here if more space is needed.)

To provide aviation support services at US Army Yuma Proving Ground.

PREVIOUS EDITION IS OBSOLETE.

CLASSIFICATION (When filled in): FOR OFFICIAL USE ONLY Adobe LiveCycle Designer ES4

CLASSIFICATION (When filled in): FOR OFFICIAL USE ONLY

11. IN PERFORMINGTHIS CONTRACT, THE CONTRACTOR WILL: IX al/ that apply. See instructions. Provide details in Blocks 13 or 14as set forth in the instructions.)

a. HAVEACCESS TO CLASSIFIED INFORMATION ONLY AT ANOTHER h. REQUIRE A COMSEC ACCOUNT

X CONTRACTOR'S FACILITY OR A GOVERNMENT ACTIVITY (Applicable only if there is no access or storage required at contractor facility. See instructions.) i. HAVE A TEMPEST REQUIREMENT

b. RECEIVEAND STORE CLASSIFIED DOCUMENTS ONLY X j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS

c. R_~~EIVE,STORE. AND GENERATE CLASSIFIED INFORMATION OR k. BEAUTHORIZED TO USE THE DEFENSE COURIER SERVICE (DCS)MATERIAL

d. FABRICATE, MODIFY, OR STORE CLASSIFIED HARDWARE I. RECEIVE, STORE, OR GENERATE CONTROLLED UNCLASSIFIED

X INFORMATION (CUI).

X e. PERFORMSERVICES ONLY (000 Components: refer to DoOM 5200.01, Volume 4 only for specific CUI

f. HAVEACCESS TO U.S. CLASSIFIED INFORMATION OUTSIDE THE U.S., protection requirements. Non-DoD Components: see instructions.)

PUERTO RICO, U.S. POSSESSIONS AND TRUST TERRITORIES X m. OTHER (Specify) (See instructions)

g. BE AUTHORIZED TO USE THE SERVICES OF DEFENSETECHNICAL

See blocks 13 and 14.INFORMATION CENTER (DTIC) OR OTHER SECONDARY DISTRIBUTION

CENTER

12. 'UBLIC . "ny InfOrmatlon.I.Cassmeoor unCIBSSmeO)pertainingto tnlScornracts all notDereieaseoTorPUDIICmssemmanonexceptas provicecDYme NatiOnalmcustnat SecurityProgramOperatingManual(NISPOM)or unlesstt has beenapprovedfor publicreleaseby appropriateU.S.Govemmentauthorny, Proposedpublicreleasesshallbe submittedfor reviewandapprovalpriorto releaseto theappropriategovemmentapprovalauthorttyidentifiedherewith at leastofficeand phonecontactinformationand if available,an e-mailaddress.

~see instruCjons) I DIRECT THROUGH (Specify) PUBLIC RELEASEAUTHORITY:

Commander, US Army Yuma Proving Ground ATTN: TEDT-YP-PLI, 301 C Street, Yuma, AZ 85365-9498

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 fumished 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. Click button to add additional pages as needed to provide complete guidance.)

l la, SCGs will be provided by USAYPG.

lie. Aviation support agreement.

Length of performance including option years is 30 June 2023.

COR's Signature block;

~e~1L.~I~ .M-M)

14. ADDITIONAL SECURITY REQUIREMENTS. Requirements, in addition to NISPOM requirements for classified information, are established for this contract.

:JNO [E] 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. Use Item 13 or click button if additional space is needed.)

llj. OPSEC Plan

15. INSPECTIONS. Elements of this contract are outside the inspection responsibility of the CSO. ,~ No L_j Yes (If Yes, explain and identify specific areas and government activity responsible for inspections. Click button or use Item 13 if additional space is needed.)

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

a. GCANAME b. ACTIVITY ADDRESS CODE (AAC) OF THE c. ADDRESS (Include ZIP Code.)

Mission and Installation Contracting Command - Fort CONTRACTING OFFICE (See instructions.) MICC-FH Food (MICC-FH)

W91151 36000 Darnall Loop Fort Hood, TX 76544-5025

d. POC NAME (See instructions.) e. POC TELEPHONE (Include Area Code.) f. EMAIL ADDRESS (See instructions.)

Womer Heath 254-287-5762 womer.o.heath.civ@mail.mil

17. CERTIFICATION AND SIGNATURES. Security requirements stated herein are complete and adequate for safeguarding the classmed 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. ADDRESS (Include ZIP Code.)

(Last, First, Middle Initial) (See instructions.) Commander, US Army Yuma Proving Ground

Hallahan, Robert J. Security Officer ATTN: TEDT-YP-PLI

d. AAC OF THE CONTRACTING OFFICE e. CAGE CODE OF THE PRIME 301 C Street

(See instructions.) CONTRACTOR (See instructions.) Yuma, AZ 85365-9498

f. TELEPHONE (include Area Code.) I g. EMAIL ADDRESS (See instructions.) I h. DATE h. SIGNATURE

928-328-6003 robert.j.hallahan2.civ@mail.mil 2018-01-10

18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL

f--- D f. OTHERS AS NECESSARY (Ifmore room is needed, continue in Item 13 or on additional page if necessary.)X a. CONTRACTOR f--

b. SUBCONTRACTOR

~ c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR f--

d. U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECURITY ADMINISTRATIONrx e. ADMINISTRATIVE CONTRACTING OFFICER

DO FORM 254 (BACK), NOV 2017 CLASSIFICATION (When filled in): FOR OFFICIAL USE ONLY