Bid document

CLASSIFICATION (When filled in): CUI

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:
August 31, 2028

The public reporting burden for this collection of information, 0704-0567, is estimated to average 36 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the d ata need ed , and completing and reviewing the collection of information. Send comments regard ing this burd en estimate or any other aspect of this collection of information, including suggestions for red ucing the burd en, to the Department of Defense, Washington Head quarters Services, at whs.mc-alex.esd .mbx.d d -d od [email protected]. Respond ents 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

b. LEVEL OF SAFEGUARDING FOR CLASSIFIED INFORMATION/

MATERIAL REQUIRED AT CONTRACTOR FACILITY

a. LEVEL OF FACILITY SECURITY CLEARANCE (FCL) REQUIRED

(See Instructions)

SECRET

NONE

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

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

a. PRIME CONTRACT NUMBER (See instructions.)

a. ORIGINAL (Complete date in all cases.)
b. REVISED (Supersedes all previous specifications.)

b. SUBCONTRACT NUMBER

REVISION NO.

c. SOLICITATION OR OTHER NUMBER

c. FINAL (Complete Item 5 in all cases.)

No

Yes

No

DATE (YYYYMMDD)

If yes, complete the following:

Classified material received or generated under

5. IS THIS A FINAL DD FORM 254?

DATE (YYYYMMDD)

DUE DATE (YYYYMMDD)

HDTRA126R0085

4. IS THIS A FOLLOW-ON CONTRACT?

DATE (YYYYMMDD)

(Preceding Contract Number) is transferred to this follow-on contract.

Yes

In response to the contractor's request dated

If yes, complete the following:

, 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

TBD

b. CAGE CODE

TBD

c. COGNIZANT SECURITY OFFICE(S) (CSO)

(Name, Address, ZIP Code, Telephone required; Email Address optional)

TBD

7. SUBCONTRACTOR(S) (Click button if you choose to add or list the subcontractors