20180418_DD_254_Rev-1.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

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. LEVEL OF FACILITY SECURITY CLEARANCE (FCL) REQUIRED (See instructions.)

b. LEVEL OF SAFEGUARDING FOR CLASSIFIED INFORMATION/MATERIAL

REQUIRED AT CONTRACTOR FACILITY

Secret None (See instructions)

DUE DATE (YYYYMMDD)c. SOLICITATION OR OTHER NUMBER

b. SUBCONTRACT NUMBER

W911S7-18-X-XXXX

a. PRIME CONTRACT NUMBER (See instructions.)

DATE (YYYYMMDD)

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

DATE (YYYYMMDD)REVISION NO.b. REVISED (Supersedes all previous specifications.)

2018701

DATE (YYYYMMDD)

a. ORIGINAL (Complete date in all cases.)

(Preceding Contract Number) is transferred to this follow-on contract. Classified material received or generated under

YES. If Yes, complete the following:NO4. IS THIS A FOLLOW-ON CONTRACT?

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

YES. If Yes, complete the following:NO5. IS THIS A FINAL DD FORM 254?

Insert Contractor Cognizant Security Officer Information

c. COGNIZANT SECURITY OFFICE (CSO) (Name, Address, ZIP Code, Telephone)

CTR CAGE

b. CAGE CODE

Insert Contractor Information

a. NAME, ADDRESS, AND ZIP CODE

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

N/A

c. COGNIZANT SECURITY OFFICE(S) (CSOs) (Name, Address, ZIP Code, Telephone)

N/A

b. CAGE CODE

N/A

a. NAME, ADDRESS, AND ZIP CODE

7. SUBCONTRACTOR(S) (Click button to add more subcontractors.)

HQ, MSCoE ATTN: ATZT-IN-S (G2/Intelligence & Security) 14000 MSCoE Loop, STE #001 Fort Leonard Wood, MO 65473

c. COGNIZANT SECURITY OFFICE(S) (CSOs) (Name, Address, ZIP Code, Telephone) (If applicable, see instructions.)

N/A

b. CAGE CODE (If applicable, see instructions.)

CEHC/DCIED

15152 FLW WP

Fort Leonard Wood, MO 65473

a. LOCATION(S) (For actual performance, see instructions.)

8. ACTUAL PERFORMANCE (Click button to add more locations.)

This Contract W911S7-18-X-XXX is to provide technical analysis to the Counter Explosive Hazards Center/Directorate for Counter Improvised Explosive Devices (DCIED) and the Capabilities Development Integration Directorate EOD division support efforts to enhance the survivability, reduce the vulnerability and improve the mission effectiveness of units in Army and Joint Forces.

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

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

d. FORMERLY RESTRICTED DATA

c. CRITICAL NUCLEAR WEAPON DESIGN INFORMATION (CNWDI) (If CNWDI applies, RESTRICTED DATA must also be marked.)

b. RESTRICTED DATA

e. NATIONAL INTELLIGENCE INFORMATION:

f. SPECIAL ACCESS PROGRAM (SAP) INFORMATION

k. OTHER (Specify) (See instructions.)

j. CONTROLLED UNCLASSIFIED INFORMATION (CUI) (See instructions.)

i. ALTERNATIVE COMPENSATORY CONTROL MEASURES (ACCM)

INFORMATION

h. FOREIGN GOVERMENT INFORMATION

g. NORTH ATLANTIC TREATY ORGANIZATION (NATO) INFORMATION

SIPRNet, SVTC, NIPRNet

DD FORM 254, NOV 2017 PREVIOUS EDITION IS OBSOLETE. Adobe LiveCycle Designer ES4

CLASSIFICATION (When filled in):

CLASSIFICATION (When filled in):

(1) Sensitive Compartmented Information (SCI)

(2) Non-SCI

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.)

h. REQUIRE A COMSEC ACCOUNT

k. BE AUTHORIZED TO USE THE DEFENSE COURIER SERVICE (DCS)

j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS

i. HAVE A TEMPEST REQUIREMENT

b. RECEIVE AND STORE CLASSIFIED DOCUMENTS ONLY

c. RECEIVE, STORE, AND GENERATE CLASSIFIED INFORMATION OR

MATERIAL

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

e. PERFORM SERVICES ONLY

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

INFORMATION (CUI).

(DoD Components: refer to DoDM 5200.01, Volume 4 only for specific CUI protection requirements. Non-DoD Components: see instructions.)

1. Ref 13i--Visit Request Requirements

2. Ref 13j--Data Release Restrictions

m. OTHER (Specify) (See 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)

DIRECT

US Army MSCoE, 320 Illinois Avenue, ATTN: FLW PAO Office Fort Leonard Wood, MO 65473

THROUGH (Specify) PUBLIC RELEASE 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 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.)

1. All applicable provisions of DoD 5220.22-M (National Industrial Security Program Operating Manual) apply.

2. Visitor Group Security Agreement (VGSA) between Contractor & MSCoE, Fort Leonard Wood, applies.

3. Contractors working under this contract will require access to classified material & will require a security clearance determination of SECRET.

Clearance level determination, need-to-know, SECRET and Nondisclosure Agreement must be verified via the Joint Personnel Adjudication System (JPAS) prior to any access being granted.

4. Ref Item 8a: Contractor performance is restricted to Fort Leonard Wood, MO., or contractor facility as determined by the Project Manager or Government Task Leader.

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

YesNo (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.)

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. Click button or use Item 13 if additional space is needed.)

YesNo

a. Contractor will attend/receive annual OPSEC training provided by the government.

b. Personnel must be readily identifiable as a Contract Employee when performing duties, IPRs, or attending meetings in gov't facilities by the prominent wearing/display of an identification badge; identification requirement also applies to all official e-mail & telephonic communications

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

b. ACTIVITY ADDRESS CODE (AAC) OF THE CONTRACTING OFFICE (See instructions.)

d. AAC OF THE CONTRACTING OFFICE (See instructions.)

e. CAGE CODE OF THE PRIME CONTRACTOR (See instructions.)

d. POC NAME (See instructions.)

c. ADDRESS (Include ZIP Code.) a. GCA NAME

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

18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL

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.

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

Dixon, Julian M.

573-563-6065

f. TELEPHONE (Include Area Code.)

Julian.m.dixon3.civ@mail.mil

g. EMAIL ADDRESS (See instructions.) h. SIGNATUREh. DATE

MSCoE Command Secuirty Manager

b. TITLE HQ, MSCoE ATTN: ATZT-IN-S (G-2/Intelligence & Security) 14000 MSCoE Loop, STE #001 Fort Leonard Wood, MO 65473

c. ADDRESS (Include ZIP Code.)

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

e. ADMINISTRATIVE CONTRACTING OFFICER

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

c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR

b. SUBCONTRACTOR

a. CONTRACTOR

DD FORM 254 (BACK), NOV 2017

CLASSIFICATION (When filled in):

15. INSPECTIONS (Continued)

14. ADDITIONAL SECURITY REQUIREMENTS (Continued)

5. Ref Item l0g: Access to NATO information is required. Personnel requiring access to NATO classified information must possess the equivalent FINAL.

Government representative and/or COR is the designated representative that will ensure the contractor security manager and concerned employees are NATO briefed prior to access being granted. Contractor will maintain strict compliance in regards to NATO information IAW DoD 5220.22-M, Chapter 10, par 10-706.

6. Ref Item l0j: "FOR OFFICIAL USE ONLY" information provided under this contract shall be safeguarded as specified in DoD Manual 5200.01, vol 4, (Information Security Program). (See Addendum #1)

7. Ref Item 10k: Access to SIPRNet (Secret Internet Protocol Net) is required. Contractor shall not access, download or further disseminate any special access data (i.e. intelligence, NATO, COMSEC, etc.) outside the execution of the defined contract requirements and without the guidance and written permission of the KO. Prior to access being granted to SIPRNet, Clearance Determination, Need-to-Know, must be verified and current within JPAS (Joint Personnel Adjudication System). NOTE: Access to NATO information is required due to the large volume of NATO materials contained within the SIPRNET. Access authorization at the NATO SECRET level and a NATO Security Briefing are required. NATO access must be entered into JPAS.

8. Ref Item 11L(2): Contractor is not authorized to release any data to foreign nationals/representatives or release information orally, visually, or documentary to anyone not authorized or associated to this contract.

9. All sensitive/classified documents shall be returned to the Government upon completion of the contract.

10. Contractors working under this task order will require a security clearance level of SECRET.

11. Ref item 8a: Contractor performance at the SECRET Level will be at U.S. Government facilities at these locations:U.S. Army Pacific Command (USARPACOM), Honolulu, HI; U.S. Army Europe (USAREUR), Wiesbaden, Germany; TRADOC, Fort Eustis, VA; U.S. Army Combined Arms Center (CAC), Fort Leavenworth, KS; MSCoE, Fort Leonard Wood, MO (SECRET For all other than the PM-SMA and Alternate-SMA which require TS/SCI);

and U.S. Army Maneuver Center of Excellence (MCoE), Fort Benning, GA.

12. Ref item l0k: Access to SIPRNET is required. A DD Form 2875 must be submitted to the Network Enterprise Center, through the supporting organizations IASO, security manager, and the MSCoE, G-2 (Information Security Manager). NOTE: The requester must have a registered AKO- S account prior to, and indication of the DD Form 2875. Additionally, the requester must read and sign/date a SIPRNET AUP and an Annual NATO SIPRNET User Briefing to be attached with the DD Form 2875 submission.

13. POCs: a. Project Manager (Contractor): Companies PM with email. b. Gov’t Contract Officer: Ms. Hatasha Hanley Hatasha.t.hanley.civ@mail.mil,

c. COR: Kucera, Dean W., dean.w.kucera.civ@mail.mil (573) 563-4157. d.MSCoE Industrial Security Manager: JACKIEWICZ, Johnny J., Johnny.j.jackiewicz.civ@mail.mil (573) 563-7278.

14. Contract expires: fill out expiration date.

13. SECURITY GUIDANCE (Continued)

PagesofContinuation PageDD FORM 254, NOV 2017

CLASSIFICATION (When filled in):

CLASSIFICATION (When filled in):

Additional persons assisting with completion of form (signatures and titles) oscar.m.clark Highlight

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

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. LEVEL OF FACILITY SECURITY CLEARANCE (FCL) REQUIRED (See instructions.)

b. LEVEL OF SAFEGUARDING FOR CLASSIFIED INFORMATION/MATERIAL

REQUIRED AT CONTRACTOR FACILITY

Top Secret None (See instructions)

DUE DATE (YYYYMMDD)c. SOLICITATION OR OTHER NUMBER

b. SUBCONTRACT NUMBER

W911S7-18-X-XXXX

a. PRIME CONTRACT NUMBER (See instructions.)

DATE (YYYYMMDD)

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

DATE (YYYYMMDD)REVISION NO.b. REVISED (Supersedes all previous specifications.)

2018701

DATE (YYYYMMDD)

a. ORIGINAL (Complete date in all cases.)

(Preceding Contract Number) is transferred to this follow-on contract. Classified material received or generated under

YES. If Yes, complete the following:NO4. IS THIS A FOLLOW-ON CONTRACT?

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

YES. If Yes, complete the following:NO5. IS THIS A FINAL DD FORM 254?

Insert Contractor Cognizant Security Officer Information

c. COGNIZANT SECURITY OFFICE (CSO) (Name, Address, ZIP Code, Telephone)

CTR CAGE

b. CAGE CODE

Insert Contractor Information

a. NAME, ADDRESS, AND ZIP CODE

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

N/A

c. COGNIZANT SECURITY OFFICE(S) (CSOs) (Name, Address, ZIP Code, Telephone)

N/A

b. CAGE CODE

N/A

a. NAME, ADDRESS, AND ZIP CODE

7. SUBCONTRACTOR(S) (Click button to add more subcontractors.)

HQ, MSCoE ATTN: ATZT-IN-S (G2/Intelligence & Security) 14000 MSCoE Loop, STE #001 Fort Leonard Wood, MO 65473

c. COGNIZANT SECURITY OFFICE(S) (CSOs) (Name, Address, ZIP Code, Telephone) (If applicable, see instructions.)

N/A

b. CAGE CODE (If applicable, see instructions.)

CEHC/DCIED

15152 FLW WP

Fort Leonard Wood, MO 65473

a. LOCATION(S) (For actual performance, see instructions.)

8. ACTUAL PERFORMANCE (Click button to add more locations.)

This Contract W911S7-18-X-XXX is to provide technical analysis to the Counter Explosive Hazards Center/Directorate for Counter Improvised Explosive Devices (DCIED) and the Capabilities Development Integration Directorate EOD division support efforts to enhance the survivability, reduce the vulnerability and improve the mission effectiveness of units in Army and Joint Forces.

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

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

d. FORMERLY RESTRICTED DATA

c. CRITICAL NUCLEAR WEAPON DESIGN INFORMATION (CNWDI) (If CNWDI applies, RESTRICTED DATA must also be marked.)

b. RESTRICTED DATA

e. NATIONAL INTELLIGENCE INFORMATION:

f. SPECIAL ACCESS PROGRAM (SAP) INFORMATION

k. OTHER (Specify) (See instructions.)

j. CONTROLLED UNCLASSIFIED INFORMATION (CUI) (See instructions.)

i. ALTERNATIVE COMPENSATORY CONTROL MEASURES (ACCM)

INFORMATION

h. FOREIGN GOVERMENT INFORMATION

g. NORTH ATLANTIC TREATY ORGANIZATION (NATO) INFORMATION

SIPRNet, SVTC, NIPRNet

DD FORM 254, NOV 2017 PREVIOUS EDITION IS OBSOLETE. Adobe LiveCycle Designer ES4

CLASSIFICATION (When filled in):

CLASSIFICATION (When filled in):

(1) Sensitive Compartmented Information (SCI)

(2) Non-SCI

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.)

h. REQUIRE A COMSEC ACCOUNT

k. BE AUTHORIZED TO USE THE DEFENSE COURIER SERVICE (DCS)

j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS

i. HAVE A TEMPEST REQUIREMENT

b. RECEIVE AND STORE CLASSIFIED DOCUMENTS ONLY

c. RECEIVE, STORE, AND GENERATE CLASSIFIED INFORMATION OR

MATERIAL

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

e. PERFORM SERVICES ONLY

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

INFORMATION (CUI).

(DoD Components: refer to DoDM 5200.01, Volume 4 only for specific CUI protection requirements. Non-DoD Components: see instructions.)

1. Ref 13i--Visit Request Requirements

2. Ref 13j--Data Release Restrictions

m. OTHER (Specify) (See 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)

DIRECT

US Army MSCoE, 320 Illinois Avenue, ATTN: FLW PAO Office Fort Leonard Wood, MO 65473

THROUGH (Specify) PUBLIC RELEASE 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 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.)

1. All applicable provisions of DoD 5220.22-M (National Industrial Security Program Operating Manual) apply.

2. Visitor Group Security Agreement (VGSA) between Contractor & MSCoE, Fort Leonard Wood, applies.

3. Contractors working under this contract will require access to classified material & will require a security clearance determination of TOP SECRET/ SCI. Clearance level determination, need-to-know, TOP SECRET and Nondisclosure Agreement must be verified via the Joint Personnel Adjudication System (JPAS) prior to any access being granted.

4. Ref Item 8a: Contractor performance is restricted to Fort Leonard Wood, MO., or contractor facility as determined by the Project Manager or Government Task Leader.

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

YesNo (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.)

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. Click button or use Item 13 if additional space is needed.)

YesNo

a. Contractor will attend/receive annual OPSEC training provided by the government.

b. Personnel must be readily identifiable as a Contract Employee when performing duties, IPRs, or attending meetings in gov't facilities by the prominent wearing/display of an identification badge; identification requirement also applies to all official e-mail & telephonic communications

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

b. ACTIVITY ADDRESS CODE (AAC) OF THE CONTRACTING OFFICE (See instructions.)

d. AAC OF THE CONTRACTING OFFICE (See instructions.)

e. CAGE CODE OF THE PRIME CONTRACTOR (See instructions.)

d. POC NAME (See instructions.)

c. ADDRESS (Include ZIP Code.) a. GCA NAME

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

18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL

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.

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

Dixon, Julian M.

573-563-6065

f. TELEPHONE (Include Area Code.)

Julian.m.dixon3.civ@mail.mil

g. EMAIL ADDRESS (See instructions.) h. SIGNATUREh. DATE

MSCoE Command Secuirty Manager

b. TITLE HQ, MSCoE ATTN: ATZT-IN-S (G-2/Intelligence & Security) 14000 MSCoE Loop, STE #001 Fort Leonard Wood, MO 65473

c. ADDRESS (Include ZIP Code.)

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

e. ADMINISTRATIVE CONTRACTING OFFICER

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

c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR

b. SUBCONTRACTOR

a. CONTRACTOR

DD FORM 254 (BACK), NOV 2017

15. INSPECTIONS (Continued)

14. ADDITIONAL SECURITY REQUIREMENTS (Continued)

5. Ref Item l0g: Access to NATO information is required. Personnel requiring access to NATO classified information must possess the equivalent FINAL.

Government representative and/or COR is the designated representative that will ensure the contractor security manager and concerned employees are NATO briefed prior to access being granted. Contractor will maintain strict compliance in regards to NATO information IAW DoD 5220.22-M, Chapter 10, par 10-706.

6. Ref Item l0j: "FOR OFFICIAL USE ONLY" information provided under this contract shall be safeguarded as specified in DoD Manual 5200.01, vol 4, (Information Security Program). (See Addendum #1)

7. Ref Item 10k: Access to SIPRNet (Secret Internet Protocol Net) is required. Contractor shall not access, download or further disseminate any special access data (i.e. intelligence, NATO, COMSEC, etc.) outside the execution of the defined contract requirements and without the guidance and written permission of the KO. Prior to access being granted to SIPRNet, Clearance Determination, Need-to-Know, must be verified and current within JPAS (Joint Personnel Adjudication System). NOTE: Access to NATO information is required due to the large volume of NATO materials contained within the SIPRNET. Access authorization at the NATO SECRET level and a NATO Security Briefing are required. NATO access must be entered into JPAS.

8. Ref Item 11L(2): Contractor is not authorized to release any data to foreign nationals/representatives or release information orally, visually, or documentary to anyone not authorized or associated to this contract.

9. All sensitive/classified documents shall be returned to the Government upon completion of the contract.

10. Contractors working under this task order will require a security clearance level of TOP SECRET SCI.

11. Ref item 8a: Contractor performance will be at the TOP SECRET SCI level at the U.S. Government facilities at these locations:

; Joint Improvised-Threat Defeat Organization (JIDO), Washington DC; U.S. Army Forces Command (FORSCOM), Fort Bragg, NC; MSCoE, Fort Leonard Wood, MO for PM-SMA and alternate PM-SMA only (all other at MSCoE require SECRET); and Intelligence center of Excellence (ICoE), Fort Huachuca, AZ.

12. Ref item l0k: Access to SIPRNET is required. A DD Form 2875 must be submitted to the Network Enterprise Center, through the supporting organizations IASO, security manager, and the MSCoE, G-2 (Information Security Manager). NOTE: The requester must have a registered AKO- S account prior to, and indication of the DD Form 2875. Additionally, the requester must read and sign/date a SIPRNET AUP and an Annual NATO SIPRNET User Briefing to be attached with the DD Form 2875 submission.

13. POCs: a. Project Manager (Contractor): Companies PM with email. b. Gov’t Contract Officer: Ms. Hatasha Hanley Hatasha.t.hanley.civ@mail.mil,

c. COR: Kucera, Dean W., dean.w.kucera.civ@mail.mil (573) 563-4157. d.MSCoE Industrial Security Manager: JACKIEWICZ, Johnny J., Johnny.j.jackiewicz.civ@mail.mil (573) 563-7278.

14. Contract expires: fill out expiration date.

13. SECURITY GUIDANCE (Continued)

PagesofContinuation PageDD FORM 254, NOV 2017

CLASSIFICATION (When filled in):

CLASSIFICATION (When filled in):

Additional persons assisting with completion of form (signatures and titles) oscar.m.clark Highlight