Attachment_0010_DRAFT_DD254_Department_of_Defense_Contract_Security_Classification_Specification.pdf
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- Solicitation number
- W91B4N-19-R-2018
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Attachment 0010 DRAFT DD254
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DRAFT
SAMPLE
PREVIOUS EDITION IS OBSOLETE.
Page of AEM LiveCycle Designer
DD FORM 254, APR 2018
NEEDS DD67
DEPARTMENT OF DEFENSE
CONTRACT SECURITY CLASSIFICATION SPECIFICATION
(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. ORIGINAL (Complete date in all cases.)
b. REVISED (Supersedes all previous specifications.)
4. IS THIS A FOLLOW-ON CONTRACT?
If yes, complete the following:
Classified material received or generated under
5. IS THIS A FINAL DD FORM 254?
If yes, complete the following:
6. CONTRACTOR (Include Commercial and Government Entity (CAGE) Code)
7. SUBCONTRACTOR(S) (Click button if you choose to add or list the subcontractors -- but will still require a separate DD Form 254 issued by a prime contractor to each subcontractor)
8. ACTUAL PERFORMANCE (Click button to add more locations.)
10. CONTRACTOR WILL REQUIRE ACCESS TO: (X all that apply. Provide details in Blocks 13 or 14 as set forth in the instructions.)
e. NATIONAL INTELLIGENCE INFORMATION:
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.)
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)
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. The field will expand as text is added. When removing any expanded text area, use delete key or backspace key, then click out of the text field for it to shrink after the text has been deleted. Also allows for up to 6 internal reviewers to digitally sign. See instructions for additional guidance or use of the fillable PDF.)
14. ADDITIONAL SECURITY REQUIREMENTS
Requirements, in addition to NISPOM requirements for classified information, 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 CSO. The field will expand as text is added or you can also use item 13. When removing any expanded text area, use delete key or backspace key, then click out of the text field for it to shrink after the text has been deleted. (See instructions for additional guidance or use of the fillable PDF.)
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. The field will expand as text is added or you can also use item 13. When removing any expanded text area, use delete key or backspace key, then click out of the text field for it to shrink after the text has been deleted. (See instructions for additional guidance or use of the fillable PDF.)
16. GOVERNMENT CONTRACTING ACTIVITY (GCA) AND POINT OF CONTACT (POC)
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. Upon digitally signing Item 17h, no changes can be made as the form will be locked.
18. REQUIRED DISTRIBUTION BY THE CERTIFYING OFFICIAL
9.0.0.2.20120627.2.874785 DD 254, DoD Contract Security Classification Specification List of Attachments (All Files Must be Attached Prior to Signing, i.e., for any digital signature on the form)
| CurrentPage: |
| PageCount: |
| Classification: Unclassified |
| SerialNum: |
| a. Facility clearance level. Select one.: 2 |
| b. Level of safeguarding for classified information/material required at contractor facility. Select one.: 2 |
| Choose Yes or No: 1 |
| Choose Yes or No: 1 |
| Prime: |
| Choose Yes or No: 0 |
| Choose Yes or No: 0 |
| Sub: |
| Choose Yes or No: 0 |
| Choose Yes or No: 0 |
| Soli: |
| DueDate: |
| dateA: 2018-07-31 |
| RevisionNum: |
| dateB: |
| Final: |
| dateC: |
| No: 1 |
| No: 1 |
| No: 1 |
| No: 1 |
| Yes: 0 |
| Yes: 0 |
| Yes: 0 |
| Yes: 0 |
| Enter your name here.: |
| ReqDated: |
| Enter your name here.: |
| Name: |
| Cage: |
| CSO: |
| addrow: |
| Removerow: |
| Click to delete a row: |
| Location: Afghanistan Area of Responsibility |
| Block9: This requirement is for Guardian Angel (GA) and Private security services for military, DOD Civilians and contractors within the Afghanistan Area of Responsibility. |
| a: 0 |
| a: 1 |
| a: 1 |
| f: 0 |
| f: 1 |
| f: 1 |
| b: 0 |
| b: 1 |
| b: 1 |
| g: 1 |
| g: 0 |
| c: 0 |
| c: 0 |
| c: 1 |
| h: 0 |
| h: 0 |
| d: 0 |
| d: 0 |
| d: 1 |
| i: 0 |
| i: 0 |
| SCI: 0 |
| NonSCI: 1 |
| j: 1 |
| j: 1 |
| k: 0 |
| k: 0 |
| Enter your name here.: |
| e: 1 |
| e: 0 |
| l: 0 |
| m: 0 |
| direct: 0 |
| thru: 1 |
| Enter your name here.: |
| PublicAuthority: |
| AddSig: |
| RemoveSig: |
| text: Please refer to sections 4.6, 4.7 and 4.7.3 of the performance work statement. |
Contract is for private security services. The work performed under this contract and awarded task orders may involve the Contractor having access to and/or the potential safeguarding of classified information/material and shall require a SECRET clearance, as specified per task order requirement and may be granted access to the SIPRNET and NIPRNET. If required by the task order, the security policies, procedures, and requirements stipulated by the National Industrial Security Program (NISP) and DoD 5220.22-M, National Industrial Security Program Operating Manual (NISPOM) (28 February 06) and supplements thereto are applicable to include the following security requirements and/or guidance whenever contract performance will occur on a DoD installation or within a DoD-controlled facility or activity.
1. The Contractor shall comply with DD Form 254 and DoD 5220.22-M, NISPOM http://www.dss.mil/documents/odaa/NISPOM2006-5220.pdf. The Contractor shall ensure all employees have the required security clearances and/or required background checks equal to or greater than the classified information to which they are granted access. The Contractor shall work with the Information Security Program Manager (ISPM) on all security related issues, and shall act appropriately to prevent the unauthorized disclosure of classified information and material to unauthorized individuals, In Conjunction With (ICW) the supported organization(s).
2.The Contractor shall have and maintain a U.S. SECRET facilities clearance. The Contractor shall provide the ISPM a Visitor Authorization List (VAL) and comply with specific ISPM and other Government agencies requirements in order for employees to gain access to specific Government facilities. The Contractor shall provide an Entry Authorization List (EAL) to facility Security Managers (SM) and alarm monitoring agency in order to gain access to customer limited access areas. The Contractor shall develop and maintain EALs for authorized personnel granted to access to contractor-limited access areas. The Contractor shall perform occasional escort duties for contractor work centers. The government will not facility contractor’s employee’s access to work sites. The Contractor is responsible to ensure all employees meet the requirements to receive badges and gain access to facilities.
| attachmentsList: |
| AddAttachment: |
| ViewAttachment: |
| RemoveAttachment: |
| rep: |
| Sig: |
| Enter your name here.: |
| GCAName: |
| AAC: |
| Address: |
| POCName: |
| Phone: |
| Email: |
| Title: |
| Enter the date using the format DD-Mon-YYYY: |
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