A01_J1_DD_FORM_254.pdf
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- Attached to
- INFORMATION MANAGEMENT HELP DESK SERVICES Federal contract opportunity
- Solicitation number
- W91CRB-17-R-0023
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A01 J1 DD FORM 254
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Text version
DEPARTMENT OF DEFENSE
CONTRACT SECURITY CLASSIFICATION SPECIFICATION
(The requirements of the DoD Industrial Security Manual apply to all security aspects of this effort.)
1. CLEARANCE AND SAFEGUARDING
a. FACILITY CLEARANCE REQUIRED
b. LEVEL OF SAFEGUARDING REQUIRED
2. THIS SPECIFICATION IS FOR: (X and complete as applicable)
a. PRIME CONTRACT NUMBER
b. SUBCONTRACT NUMBER
c. SOLICITATION OR OTHER NUMBER DUE DATE (YYYYMMDD)
3. THIS SPECIFICATION IS: (X and complete as applicable)
a. ORIGINAL (Complete date in all cases)
REVISION NO.
c. FINAL (Complete Item 5 in all cases)
DATE (YYYYMMDD)
b. REVISED (Supersedes all previous specs)
DATE (YYYYMMDD)
DATE (YYYYMMDD)
4. IS THIS A FOLLOW-ON CONTRACT? YES 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 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 OFFICE (Name, Address, and Zip Code)
8. ACTUAL PERFORMANCE
a. LOCATION b. CAGE CODE c. COGNIZANT SECURITY OFFICE (Name, Address, and Zip Code)
9. GENERAL IDENTIFICATION OF THIS PROCUREMENT
10. CONTRACTOR WILL REQUIRE ACCESS TO: 11. IN PERFORMING THIS CONTRACT, THE CONTRACTOR WILL:YES NO YES NO
a. COMMUNICATIONS SECURITY (COMSEC) INFORMATION
b. RESTRICTED DATA
c. CRITICAL NUCLEAR WEAPON DESIGN INFORMATION
d. FORMERLY RESTRICTED DATA
e. INTELLIGENCE INFORMATION
(1) Sensitive Compartmented Information (SCI)
(2) Non-SCI
f. SPECIAL ACCESS INFORMATION
g. NATO INFORMATION
h. FOREIGN GOVERNMENT INFORMATION
i. LIMITED DISSEMINATION INFORMATION
j. FOR OFFICIAL USE ONLY INFORMATION
k. OTHER (Specify)
a. HAVE ACCESS TO CLASSIFIED INFORMATION ONLY AT ANOTHER
CONTRACTOR'S FACILITY OR A GOVERNMENT ACTIVITY
b. RECEIVE CLASSIFIED DOCUMENTS ONLY
c. RECEIVE AND GENERATE CLASSIFIED MATERIAL
d. FABRICATE, MODIFY, OR STORE CLASSIFIED HARDWARE
e. PERFORM SERVICES ONLY
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
h. REQUIRE A COMSEC ACCOUNT
i. HAVE TEMPEST REQUIREMENTS
j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS
k. BE AUTHORIZED TO USE THE DEFENSE COURIER SERVICE
l. OTHER (Specify)
DD FORM 254, DEC 1999 PREVIOUS EDITION IS OBSOLETE. Adobe Professional X
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 releases shall be submitted for approval prior to release
a. TYPED NAME OF CERTIFYING OFFICIAL
Direct Through (Specify)
d. ADDRESS (Include Zip Code)
Yes No 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 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. 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. Add additional pages as needed to provide complete guidance.)
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 No15. 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.)
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.
b. TITLE c. TELEPHONE (Include Area Code)
e. SIGNATURE
17. REQUIRED DISTRIBUTION
a. CONTRACTOR
b. SUBCONTRACTOR
c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR
d. U.S. ACTIVITY RESPONSIBLE FOR OVERSEAS SECURITY ADMINISTRATION
e. ADMINISTRATIVE CONTRACTING OFFICER
f. OTHERS AS NECESSARY
DD FORM 254 (BACK), DEC 1999
| fac_clear: SECRET |
| safe_level: SECRET |
| prime_no: |
| xprime: Off |
| sub_no: |
| xsub: Off |
| xsolic: Yes |
| solic_no: W91CRB-17-R-0023 |
| due_date: |
| xspec3: Orig |
| orig_date: |
| rev_no: |
| rev_date: |
| final_date: |
| xfollowon: No |
| prec_no: |
| xfinal: No |
| req_dated: |
| period: |
| ctr_name: |
| ctr_cage: |
| ctr_ofc: |
| sub_name: |
| sub_cage: |
| sub_ofc: |
| perf_loc: U.S. Army Security Assistance Command (USASAC) |
4402 Martin Road, Redstone Arsenal, AL 35898, 9875 Michie Place, Fort Belvoir, VA 22060, 54 M Avenue, Suite 1, New Cumberland, PA 17070, 3832 Ardennes Road, Building C-3832, Fort Bragg, NC 28310
| perf_cage: W25P02 |
| perf_ofc: U.S. Army Security Assistance Command |
4402 Martin Road Redstone Arsenal, AL 35898
| gen_id: Help Desk Services |
| x10a: Yes |
| x10b: No |
| x10c: No |
| x10d: No |
| x10e1: Yes |
| x10e2: Yes |
| x10f: No |
| x10g: Yes |
| x10h: Yes |
| x10i: No |
| x10j: Yes |
| x10k: Off |
| other10k: |
| x11a: Yes |
| x11b: No |
| x11c: No |
| x11d: No |
| x11e: No |
| x11f: No |
| x11g: No |
| x11h: No |
| x11i: No |
| x11j: Yes |
| x11k: No |
| x11l: Off |
| other11l: |
| xrelease: No |
| release_thru: Commander, U.S. Army Security Assistance Command (USASAC) 4402 Martin Road, Redstone Arsenal, AL 35898 |
| guidance: USASAC, Redstone Arsenal, AL, Fort Belvoir, VA, New Cumberland, PA and Fort Bragg, NC |
10a. Classified COMSEC material is not releasable to contractor employees who have not received a FINAL clearance at the appropriate security level. COMSEC access shall be IAW DoD 5220.22M and AR 380-40. When access is required at Government facilities, contractor personnel will adhere to COMSEC rules and regulations as mandated by Command policy and procedures. Written concurrence of the Contracting Officer (KO) is required prior to subcontracting. 10e(2): 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. 10h. Foreign Government Information (FGI) is not releasable to contractor employees who have not received a FINAL clearance at the appropriate security level. Written concurrence of the KO is required prior to subcontracting. 10j. For Official Use Only (FOUO) Information generated and/or provided under this contract shall be safeguarded and marked as specified in DoD 5200.1-R, Appendix 3 (attached). 10k. Secret Internet Protocol Network (SIPRNET) access required. The 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. In the event that any special access is required, the KO must modify the requirements for the DD Form 254. Note: Once the KO has modified the requirements for the DD Form 254, the Contractor must complete the SIPRNET Access Request Form, along with the modified DD Form 254, and forward to the KO prior to receiving access. A NATO awareness brief will also be required for all Contractors prior to access to the SIPRNET.11a. Contractor performance is restricted to USASAC. Government agency or activity will provide security classification guidance for performance of this contract. Submit visit request to the KO and/or Security Management Office for the need-to-know verification.
SUSAN C. HOOVER //signed//
| xaddlsec: Yes |
| addl_sec: Contractor employees must wear their assigned building passes at all times when working under this contract. |
| xinsp: No |
| inspections: |
| cert_name: EDWIN REYES |
| cert_title: SECURITY MANAGER |
| cert_phone: 256-450-5621 |
| cert_addr: U.S. Army Security Assistance Command 4402 Martin Road |
Redstone Arsenal, AL 35898
| x17a: Off |
| x17b: Off |
| x17c: Off |
| x17d: Off |
| x17e: Off |
| x17f: Off |
| other_dist: |
File details come from the government source that posted it. Updated .