DD254Doc1.pdf

DD FORM 254

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

None

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)

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)

SOLICITATION ONLY 20160125

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 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)

SOLICITATION ONLY TBD SOLICITATION ONLY

7. SUBCONTRACTOR

a. NAME, ADDRESS, AND ZIP CODE b. CAGE CODE c. COGNIZANT SECURITY OFFICES ( Name, Address, and Zip Code)

8. ACTUAL PERFORMANCE

a. LOCATION b. CAGE CODE c. COGNIZANT SECURITY OFFICE (Name, Address, and Zip Code)

USSOUTHCOM

9301 NW 33rd St

Doral, FL 33172

WO96AA USSOUTHCOM

ATTN: Security Office

9301 NW 33rd St

Doral, FL 33172

9. GENERAL IDENTIFICATION OF THIS PROCUREMENT

Provide the TCA Program, Debit Card Program, and Contracting Support facilitate the Combatant Commander’s theater security cooperation (TSC) activities in the USSOUTHCOM Area of Responsibility

(AOR).

10. THIS CONTRACT WILL REQUIRE ACCESS

TO:

YES NO 11. IN PERFORMING THIS CONTRACT, THE CONTRACTOR

WILL:

YES NO

a. COMMUNICATIONS SECURITY (COMSEC)

INFORMATION

a. HAVE ACCESS TO CLASSIFIED INFORMATION ONLY AT ANOTHER

CONTRACTOR’S FACILITY OR A GOVERNMENT ACTIVITY

b. RESTRICTED DATA b. RECEIVE CLASSIFIED DOCUMENTS ONLY

c. CRITICAL NUCLEAR WEAPON DESIGN

INFORMATION

c. RECEIVE AND GENERATE CLASSIFIED MATERIAL

d. FORMERLY RESTRICTED DATA: d. FABRICATE, MODIFY, OR STORE CLASSIFIED HARDWARE

e. INTELLIGENCE INFORMATION: e. PERFORM SERVICES ONLY

(1) Sensitive Compartmented Information (SCI) f. HAVE ACCESS TO U.S. CLASSIFIED INFORMATION OUTSIDE THE

U.S., PUERTO RICO, U.S. POSSESSIONS AND TRUST TERRITORIES

(2) Non-SCI 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 i. HAVE A TEMPEST REQUIREMENT

h. FOREIGN GOVERNMENT INFORMATION j. HAVE OPERATIONS SECURITY (OPSEC) REQUIREMENTS

i. LIMITED DISSEMINATION INFORMATION k. BE AUTHORIZED TO USE THE DEFENSE COURIER SERVICE

j. FOR OFFICIAL USE ONLY INFORMATION l. OTHER (Specify).

k. OTHER Specify) SIPR access is required within government facility

Security Classification Guidance will include but are not limited to;

USSOUTHCOM SCG, DISA Circular and any additional guidance provided by the COR.

DD Form 254, DEC 1999 Previous editions are obsolete

A-1-1

Attachment 1 DD FORM 254 REVERSE SIDE

2. 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):

USSOUTHCOM

ATTN: Security Office 9301 NW 33rd St Doral, FL 33172 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.

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 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 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 Michael L. White

b. TITLE Chief, Information Security

c. TELEPHONE (Include Area Code)

(305) 437-1175

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

9301 NW 33rd Street

Doral, Florida 33172

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 CONTRACTING OFFICER

f. OTHERS AS NECESSARY

DD Form 254 (BACK), DEC 1999 A1-2