DD254 _20151119.docx

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650th MI Group Electronic Security System
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W912PA-16-R-0001
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W912PA-16-R-0001_Amendment_05.pdf PDF
RELEASED_W912PA-16-R-0001-0004 _ESS_Amendment_4.pdf PDF
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ESS_Amendment_3_Released.pdf PDF
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W912PA-16-R-0001-AMENDMENT_2.pdf PDF
Non_Disclosure_Agreement-ESS.pdf PDF
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DEPARTMENT OF DEFENSE

1. CLEARANCE AND SAFEGUARDING

CONTRACT SECURITY CLASSIFICATION SPECIFICATION
a. FACILITY CLEARANCE REQUIRED

SECRET

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

b. LEVEL OF SAFEGUARDING REQUIRED

SECRET

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

a. PRIME CONTRACT NUMBER

a. ORIGINAL (Complete date in all cases)
Date (YYYYMMDD)
|_|
20151104

b. SUBCONTRACT NUMBER

b. REVISED (Supersedes all previous specs) Revision No.

Date (YYYYMMDD)

|_|
|_|
c. SOLICITATION OR OTHER NUMBER
Due Date (YYYYMMDD)
c. FINAL (Complete Item 5 in all cases)
Date (YYYYMMDD)
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4. IS THIS A FOLLOW-ON CONTRACT?
|_|
YES
|X|
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?
|_|
YES
|_|
NO. 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. 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 OFFICES ( Name, Address, and Zip Code)

None

8. ACTUAL PERFORMANCE

a. LOCATION
b. CAGE CODE
c. COGNIZANT SECURITY OFFICE (Name, Address, and Zip Code)
650th Military Intelligence Group, Rue de l’Escaut, SHAPE, Belgium
00000
650th Military Intelligence Group

Unit 21420

APO AE 09705

9. GENERAL IDENTIFICATION OF THIS PROCUREMENT

To install an Electronic Security System for several buildings within the 650th MI Gp and to provide operation and maintenance training.

10. THIS CONTRACT WILL REQUIRE ACCESS TO:
YES
NO
11. IN PERFORMING THIS CONTRACT, THE CONTRACTOR WILL:
YES
NO

a. COMMUNICATIONS SECURITY (COMSEC)

INFORMATION

|_|
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a. HAVE ACCESS TO CLASSIFIED INFORMATION ONLY AT ANOTHER CONTRACTOR’S FACILITY OR A GOVERNMENT ACTIVITY
|_|
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b. RESTRICTED DATA
|_|
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b. RECEIVE CLASSIFIED DOCUMENTS ONLY
|_|
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c. CRITICAL NUCLEAR WEAPON DESIGN INFORMATION
|_|
|_|
c. RECEIVE AND GENERATE CLASSIFIED MATERIAL
|_|
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d. FORMERLY RESTRICTED DATA:
|_|
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d. FABRICATE, MODIFY, OR STORE CLASSIFIED HARDWARE
|_|
|_|

e. INTELLIGENCE INFORMATION:

e. PERFORM SERVICES ONLY
|_|
|_|
(1) Sensitive Compartmented Information (SCI)
|_|
|X|
f. HAVE ACCESS TO U.S. CLASSIFIED INFORMATION OUTSIDE THE U.S., PUERTO RICO, U.S. POSSESSIONS AND TRUST TERRITORIES
|_|
|_|
(2) Non-SCI
|_|
|X|
g. BE AUTHORIZED TO USE THE SERVICES OF DEFENSE TECHNICAL INFORMATION CENTER (DTIC) OR OTHER SECONDARY DISTRIBUTION CENTER
|_|
|_|
f. SPECIAL ACCESS INFORMATION
|_|
|_|
h. REQUIRE A COMSEC ACCOUNT
|_|
|_|
g. NATO INFORMATION
|X|
|_|
i. HAVE A TEMPEST REQUIREMENT
|_|
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h. FOREIGN GOVERNMENT INFORMATION
|_|
|_|
j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS
|_|
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i. LIMITED DISSEMINATION INFORMATION
|_|
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k. BE AUTHORIZED TO USE THE DEFENSE COURIER SERVICE
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j. FOR OFFICIAL USE ONLY INFORMATION
|_|
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l. OTHER (Specify).
|_|
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k. OTHER Specify)

|_|
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DD Form 254, DEC 1999 Previous editions are obsolete

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 release shall be submitted for approval prior to release

Direct

Through (Specify):

Commander, 650th Military Intelligence Group Unit 21420

APO AE 09705

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 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.

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. All applicable provisions of DoD 5220.22M and its supplements apply.

1a. The contractor will be required to have a SECRET Facility Clearance granted by the Defense Security Service (DSS) prior to contract implementation (see item 10g).

8a. All contract work will be performed at the 650th MI Group facilities at SHAPE, Belgium, and at the US Army Military Police monitoring station at Daumerie Caserne, Belgium.

10g. The contract will require access to NATO SECRET.

THIS DD254 HAS BEEN REVIEWED AND CERTIFIED BY THE SECURITY MANAGER PRIOR TO INPUT INTO ACAVS.

14. ADDITIONAL SECURITY REQUIREMENTS. Requirements, in addition to ISM requirements, 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 cognizant security office. Use Item 13 if additional space is needed.)
|_|
Yes
|X|
No

15. INSPECTIONS. Elements of this contract are outside the inspection responsibility of the cognizant security office. (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.

|_|
Yes
|X|
No

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

David E. Sibert, Jr.

b. TITLE Command Security Manager 650th Military Intelligence Group

c. TELEPHONE (Include Area Code) DSN 314-366-6516 or

DSN 314-423-8879

d. ADDRESS (Include ZIP Code)
17. REQUIRED DISTRIBUTION

650TH MI GP, ATTN: ACSH-MI-B, Unit 21420

APO AE 09705

a. CONTRACTOR

b. SUBCONTRACTOR

c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR

e. SIGNATURE
|_|

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

e. ADMINISTRATIVE

f. OTHERS AS NECESSARY

DD Form 254 (BACK), DEC 1999

File details come from the government source that posted it. Updated .