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DD Form 254 template

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DD Form 254 template
Shared by: HC111203204718
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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 b. LEVEL OF SAFEGUARDING REQUIRED

to all aspects of this effort) 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 (YYMMDD)

F42 20060320

b. SUBCONTRACT NUMBER b. REVISED (Supersedes Revision No. Date (YYMMDD)

all previous specs)





c. SOLICITATION OR OTHER NUMBER Due Date (YYMMDD) c. FINAL (Complete Item 5 in all cases) Date (YYMMDD)





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 X 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)









8. ACTUAL PERFORMANCE

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

a. LOCATION

AIR FORCES NORTHERN (FIRST AIR FORCE)

(AFNORTH (1AF)), TYNDALL AFB, FL;

9. GENERAL IDENTIFICATION OF THIS PROCUREMENT





OPERATIONAL EXERCISE ENGINEERING ANALYSIS AND ASSESSMENT SUPPORT



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

a. COMMUNICATIONS SECURITY (COMSEC) a. HAVE ACCESS TO CLASSIFIED INFORMATION ONLY AT ANOTHER

INFORMATION

X CONTRACTOR’S FACILITY OR A GOVERNMENT ACTIVITY

X

b. RESTRICTED DATA b. RECEIVE CLASSIFIED DOCUMENTS ONLY

X X

c. CRITICAL NUCLEAR WEAPON DESIGN INFORMATION c. RECEIVE AND GENERATE CLASSIFIED MATERIAL

X X

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

X X

e. INTELLIGENCE INFORMATION: e. PERFORM SERVICES ONLY

X

(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

X

(2) Non-SCI g. BE AUTHORIZED TO USE THE SERVICES OF DEFENSE TECHNICAL

X INFORMATION CENTER (DTIC) OR OTHER SECONDARY DISTRIBUTION CENTER

X

f. SPECIAL ACCESS INFORMATION h. REQUIRE A COMSEC ACCOUNT

X X

g. NATO INFORMATION i. HAVE A TEMPEST REQUIREMENT

X X

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

X X

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

X X

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

X X

k. OTHER Specify)

X

Automated Information Systems



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

X Through (Specify):

325 FW/PA, 445 Suwannee Rd, Suite 129, Tyndall AFB, FL 32403

325 CONS/LGCAB, 501 Illinois Ave, Suite 5, Tyndall AFB, FL 32403

Note: Public release of classified information, to include SCI is not authorized

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.

Contract Expiration Date: ????; Contract Monitor: Col Donald L. Whitehead, Chief, Financial Management, DSN: 523-3903 COMM: (850)283-3903

Ref 10a. Contractor will require access to COMSEC information at the on-base locations listed in item 8a. Contractor will not require their own COMSEC

account. Access will be controlled by the sponsoring agency. Contractor will protect COMSEC material IAW directives deemed necessary by the installation

COMSEC officer. Access to COMSEC material by personnel is restricted to U.S. citizens holding final U.S. Government clearances. Such information is not

releasable to personnel holding only reciprocal clearances. Contractor is authorized to perform duties as a Primary/Alternate COMSEC Responsible Officer

(CRO) after completing CRO training.

Ref 10e(2). The contract will be administered under the following documents: See attachment 2.

Ref 10g. Special briefings are required for access to NATO IAW AFI 31-406, Applying NATO Protection Standards. Prior approval of the contracting activity

is required for submcontracting. Access to classified NATO information requires a final U.S. Government clearance at the appropriate level.

Ref 10h. Access requires a final U.S. Government clearance at the appropriate level.

Ref 10j. FOUO information provided under this contract shall be managed and safeguarded IAW DoD 5400.7-R, Chapter 4, DoD Freedom of Information

Act (FOIA).

Ref 10k. Contractor will require access to SIPRNET.

Ref 11a. The highest level of security clearance required for contract performance is Secret. Security classification guidance of information, hardware, and

equipment is provided in DoD Instruction Number S-3600.2, Information Operations Security Classification Guide, dated 6 Aug 98. See Attachment 1. The

government will oversee the handling and storage of classified information in support of this contract. The government will provide storage capability for all

classified material required for this contract. Contractor personnel deployed to overseas locations may have access to classified information under the

control of U.S. Military, Host Nation Military, or Embassy personnel. All classified information shall be returned to the government upon termination of the

contract.

Ref 14 cont. Visitor Groups will safeguard all collateral classified information IAW DoD 5200.1-R, Information Security Program; AFI 31-401, Information

Security Program Management; AFI 31-601, Industrial Security Program Management, and other directives deemed necessary by the SSA. See attached

Release of SCI Intelligence/Non-Intelligence Information (Attached) for additional security requirements. See attached non-SCI Release of Intelligence

Information (Attachment 3) for additional security requirements. Prior approval of the contracting activity is required for subcontracting. Access to

intelligence information requires special briefings and a final U.S. Government clearance at the appropriate level.

Ref17f. 325 SFS/SFAI, Tyndall AFB, FL 32403.





14. ADDITIONAL SECURITY REQUIREMENTS. Requirements, in addition to ISM requirements, are established for this contract. (If Yes, identify the pertinent Yes No

contractual clauses in the contract document itself, or provide an appropriate statement which identifies the additional requirements. Provide a copy of the requirements

X

to the cognizant security office. Use Item 13 if additional space is needed.)

Visitor Group contractors are required to enter into a security agreement with the host base Information Security Program Manager. Provide the information

requested by the Notification of Government Security Activity Clause, AFFARS 5352.204.9000, and Visitor Group Security Agreements Clause, AFFARS

5352.204.9001, to the Servicing Security Activity (SSA). (Continued in item 13 above)



15. INSPECTIONS. Elements of this contract are outside the inspection responsibility of the cognizant security office. (If Yes, explain and identify specific areas or Yes No

elements carved out and the activity responsible for inspections. Use Item 13 if additional space is needed.

X



When contractors are designated as Visitor Groups on Air Force installations, Industrial Security Reviews for collateral classified information will be

conducted by the Servicing Security Activity.

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 c. TELEPHONE (Include Area Code)

b. TITLE









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





X a. CONTRACTOR





b. SUBCONTRACTOR



X c. COGNIZANT SECURITY OFFICE FOR PRIME AND SUBCONTRACTOR

e. SIGNATURE

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



X e. ADMINISTRATIVE CONTRACTING OFFICER



X

f. OTHERS AS NECESSARY See Item 13

DD Form 254 (Back), DEC 1999


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