CIA-RDP96-00788R001500110012-2

EXCEPTION TO SF 30, APPROVED BY NARS 5/79
STANI ARD FORM 30, JULY 1966
GENERAL SERVICES Ar DRONOd Fat Ralease GOOA ISELLATATIAN? MED1:0078SROSA 50010012-2.
FED. PROC. REG. (41 CFR) 1-16.101
PAGE
1
OF
5
1. AMENDMENT/MODIFICATION NO.
PO0002
2. EFFECTIVE DATE
30SEP81
3. REQUISITION/PURCHASE REQUEST NO.
1208/5702/81
4. PROJECT NO. (1/ applicable)
5. ISSUED BY
CODE
HIASA7
Virginia Contracting Activity
ATTN: RS-Q2
Washington, DC 20301
6. ADMINISTERED BY (If other than black 5)
DCASMA San Francisco
1250 Bayhill Drive
San Bruno, CA 94066
CODE
S0507A
7. CONTRACTOR
NAME AND ADDRESS
SRI International
333 Ravenswood Avenue
Menlo Park, CA 94025
FACILITY CODE
3.
AMENDMENT OF
SOLICITATION NO,
DATED
(See block 9)
MODIFICATION OF
CONTRACT/ORDER NO.
MDA903-81-C-0292
DATED
06APR81
(See block 11)
9. THIS BLOCK APPLIES ONLY TO AMENDMENTS OF SOLICITATIONS
The above numbered solicitation is amended as set forth in block 12.
The hour and date specified for receipt of Offers
is extended,
is not extended.
Offerors must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation, or as amended, by one of the following methods:
*
(a) By signing and returning.
copies of this amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or telegram
which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE ISSUING OFFICE PRIOR TO THE HOUR AND
DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER. If, by virtue of this amendment you desire to change an offer already submitted, such change may be made by telegram
or letter, provided such telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.
10. ACCOUNTING AND APPROPRIATION DATA (1/ required)
ACRN:
AB 2112020 25-2037 P381321.03250-2572 S18128 2P29
$189,892.00
11. THIS BLOCK APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS
(a)
This Change Order is issued pursuant to
The Changes set forth in block 12 are made to the above numbered contract/order.
(b)
The above numbered contract/order is modified to reflect the administrative changes (such as changes in paying office, appropriation data, etc.) set forth in block 12.
(c)
This Supplemental Agreement is entered into pursuant to authority of
10 U.S.C. 2304 (a) (11)
It modifies the above numbered contract os set forth in block 12.
12. DESCRIPTION OF AMENDMENT/MODIFICATION
A. Delete any and all references to Contract No. MDA903-81-C-0292 and substitute therefor
Contract No. MDA908-81-C-0004.
B. Add the following as task number 2.1.10 to the Statement of Work (Classified) dated
19MAR 81:
(U) 2.1.10 Continue development and evaluation of CRV training program.
C. Add task numbers 2.1 and 2.2 of the Contractor's technical proposal number ESU 81-60
(Classified), dated 23MAR81, to the Statement of Work (Classified) dated 19MAR81.
These tasks shall be remumbered 2.3 and 2.4 respectively.
D. Add an additional paragraph or section to the quarterly and final reports specified
in paragraph C.2 of the contract to cover the tasks added by this modification.
E. Add the following as paragraph H.9 of the contract:
(continued )
Except as provided herein, all terms and conditions of the document referenced in block 8, as heretofore changed, remain unchanged and in full force and effect.
13
CONTRACTOR/OFFEROR IS NOT REQUIRED
TO SIGN THIS DOCUMENT
CONTRACTOR/OFFEROR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN
2
COPIES TO ISSUING OFFICE
14. NAME OF CONTE CTOR/OFFEROR
BY
(Signature of person ouybrized to sign)
17. UNITED STATES OF AMERICA-
Barry 2. MCVa
BY
Contracting Officer)
15 NAME OF TITLE OF SIGNER (Type or print)
16. DATE SIGNED
Spencer Floyd
Director, ComprareA dar Release 200 /10/102
18. NAME OF CONTRACTING OFFICER (Type er print)
19. DATE SIGNED
CIARDR96M00788R001500110012-2 81SEP29
30-101-20
CODE
03652
(Street, city.
county, state,
and ZIP
Code)
L

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Contract MDA903-81-C-0292
Modification P00002
(New Contract MDA908-81C-0004)
Page 2 of 5
H-9
USE OF HUMAN SUBJECTS (1978 Aug)
(a) The following definitions are used in this clause:
(1) At risk means that the human subject may be exposed to the
possibility of harm - physical, biological, psychological, sociological, or
other - as a consequence of an act or omission that goes beyond the applica-
tion of those established and accepted methods or procedures which are in his
best interests, or that increases ordinary risks of daily life, including the
recognized risks inherent in his chosen occupation or field of service.
(2) Human Subject means any human being who, knowingly or unkowingly,
is subjected to an act or omission, whether at risk or not, the object of which
is to contribute to knowledge to be gained as a part of work to be performed under
the scope of this contract.
(b) The Contractor, before undertaking to perform any study involving
human subjects, whether at risk or not, shall insure that the following minimum
conditions are complied with:
(1) The proposed study has been reviewed and approved by a committee
meeting the requirements set forth in Chapter 46 of Title 45 of the Code of
-Federal Regulations.
(2) The number of human subjects used will be kept to the minimum
number that will reasonably achieve the required results.
(3) The study must be such as to contribute significantly to scientific
knowledge and have reasonable prospects of yielding important results essential to
an Army research program.
(4) The study will be conducted only by persons possessing the requisite
scientific qualifications. The highest degree of skill and care will be required
during all stages of study of persons who conduct or assist in the study.
(5) The human subject will be informed that at any time during the
course of his participation he has the right to revoke his consent and withdraw
from participation without prejudice to himself.
(6) Participation by subjects will be immediately terminated if it sub-
sequently appears that the risk to the subjects is significantly greater than
anticipated at the time review and approval was granted.
(7) There shall be no greater intrusion into the privacy of the human
subject than is absolutely necessary for the conduct of the study involved. Ex-
cept for the submission of reports and other data required by this contract, any
information obtained about human subjects as a result of their participation shall
be held as confidential as the law allows.
(8) The study will be conducted so as to avoid all unnecessary physical
or mental suffering or injury.
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Contract MDA903-81-C-0292
Modification P00002
(New Contract MDA908-81-C-0004)
Page 3 of 5
(9) No study will be conducted if there is any inherent reason to believe
that death or disabling injury is likely to occur. Sufficient animal or laboratory
experiments, or other evaluations, must have been completed to give assurance of
acceptable risks prior to the use of human subjects.
(10) The degree of risk to be taken will never exceed that which is
justified by the benefit to the subject and/or the humanitarian importance of
the knowledge to be gained.
(11) A physician will be responsible for the medical care of subjects.
Even if not the project leader, the physician will have authority to terminate
the study at any time that he believes death, injury or harm is likely to result.
(12) Proper preparations will be made, and adequate facilities provided,
to protect the subject against all foreseeable possibilities of injury, disability,
or death. This includes but is not limited to hospitalization and medical treatmen
as may be required. In addition, all apparatus and instruments necessary to deal
with likely emergency situations will be available.
(13) Human subjects will have no physical or mental conditions which will
make participation more hazardous for them than it would be for normal healthy
persons, unless such condition is a necessary prerequisite for the particular
study involved. In any such case, the use of human subjects with such pre-existing
conditions must have been specifically described and justified in the scope of the
work to be performed under this, contract.
(14) The scientifically qualified person conducting the study, and each
member of his research team, will be prepared to terminate the subject's partici-
pation at any stage if he has reason to believe, in the exercise of the good faith,
superior skill, and careful judgment required of him, that continuation is likely
to result in injury, disability, or death to the human subject.
(c) The Contractor, before permitting any person to participate as a human
subject, whether at risk or not, shall insure that the following minimum conditions
are complied with:
(1) Legally effective informed consent will be obtained by adequate
and appropriate methods in accordance with the provisions of this clause.
(2) All consent must be voluntary. It must be the knowing consent of
the individual or his legally authorized representative, so situated as to be able
to exercise free power of choice without there having been any use of force, fraud,
deceit, duress, constraint, coercion, or lawful or improper inducement. The ele-
ments of information necessary to such consent include :
(1) A fair explanation of the procedures to be followed, and their
purposes, including identification of any procedures which are experimental.
(ii) A description of any attendant discomforts or risks reasonably
to be anticipated.
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Contract MDA903-81-C-0292
Modification P00002
(New Contract No. MDA908-81-C-0004)
Page 4 of 5
(iii) A description of any benefits reasonably to be anticipated.
(iv) A disclosure of any appropriate alternative procedures that
might be advantageous to the subject.
(v) An offer to answer any questions concerning the procedure.
(vi) An instruction that the subject is free to revoke his consent
and to discontinue participation at any time without prejudice to himself.
(d) .Exculpatory language through which the subject is made to waive, or
appear to waive, any of his legal rights, including any release from liability
for negligence, is prohibited.
(e) Prior consent by a subject or his legally authorized representative
shall be obtained in all cases. Such consent shall be in writing whenever it
is reasonably possible to do so. The consent form may be read to the subject
or his legally authorized representative, but in any event he or his legally
authorized representative must be given adequate opportunity to read it and to
ask questions they might have. This consent form should then be signed by the
subject or his legally authorized representative and by a witness not directly
involved in the study. Oral consent may be used only when it has been specifi-
cally described and justified in the scope of the work to be performed under
this contract or approved in writing by the contracting officer. When so author-
ized and used, oral consent is subject to all the same standards as apply to
written consent, except that the signature of the subject or his legally author-
ized representative is not required.
(f) Prior to conduct of the study, the contractor shall subait for approval
to the contracting officer a detailed description of the means by which informed
consent will be obtained, to include any forms to be used. Upon completion of the
study, the contractor will submit to the contracting officer detailed report demon-
strating compliance with paragraph (c), to include copies of the written consent if
such was obtained.
(g) The Contractor shall not undertake to conduct either the clinical
pharmacology or clinical trails of an investigational drug unless this contract
contains the clause entitled "Clinical Study of Investigational Drugs."
(h) Prisoners of war will not be used under any circumstances.
F.
Add the following as paragraph H.10 of the contract:
H.10
All persons participating as human subjects, as defined by paragraph
H.9(a)(2) hereof, shall be known to possess the abilities and qualities
which will be observed and analyzed during the conduct of this contract.
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Approved For Release 2001/04/02 : CIA-RDP96-00788R001500110012-2
Contract No. MDA903-81-C-0292
Modification P00002
(New Contract No. MDA908-81-C-0004)
Page 5 of 5
G. Military security requirements in the performance of contract MDA908-81-C-0004
as modified shall be maintained in accordance with the revised DD Form 254
attached hereto. The highest classification involved in the performance
of this contract as modified is TOP SECRET.
SGFOIA2
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سنة
DEPARTMENT OF DEFENSE
CONTRACT SECURITY CLASSIFICATION SPECIFICATION
1. THE REQUIREMENTS OF THE DOD INDUSTRIAL SECURITY MANUAL
APPLY TO ALL SECURITY ASPECTS OF THIS
EFFORT. THE FACILITY CLEARANCE REQUIRED Is: TOP Secret
2.
THIS SPECIFICATION
IS FOR:
3. CONTRACT NUMBER OR OTHER
IDENTIFICATION NUMBER
(Prime contracts must be shown
for ell subcontracts)
4.
DATE TO BE
COMPLETED
(Estimated)
5.
THIS SPECIFICATION IS:
(Seo "NOTE" below. If item bor cie "X'd"".
also enter date for item a)
..
X
PRIME CONTRACT
1. PRIME CONTRACT NUMBER
MDA908-81-C-0004
82APRO5
..
ORIGINAL (Complete
date in all cose#)
DATE
81APR06
b. SUBCONTRACT (Use item
15 for subcontracting
beyond second tier)
b. FIRST TIER SUBCONTRACT NO.
b.
X
(Cupersedet
all provtous
specificationa)
1
DATE
81AUG21
C. REQUEST FOR BID.
REQUEST FOR PROPOSAL
OR REO FOR QUOTATION
C. IDENTIFICATION NUMBER
C. DUE DATE
c.
FINAL
DATE
6. Is this a follow on contract?
.. MDA903-81-C-0292
b.
[X] Yes
No.
If YES, complete the following:
c. Accountability for classified material on preceding contract
DATE COMPLETED
PRECEDING CONTRACT NUMBER
[XXI: [] Is not, transferred to this follow-on contract,
7a. Name, Address & Zip Code of Prime Contractor *
SRI International
333 Ravenswood Ave
Menlo Park, CA
b. FSC Number
c. Name, Address & Zip Code of Cognizant Security Office
DCASR Los Angeles, ATTN: Directorate of
Industrial Security, 11099 S.La Cienga
Blvd., Los Angeles, CA 90045
Ba. Name, Address & Zip Code of First Tier Subcontractor *
b. FSC Number
c. Name, Address & Zip Code of Cognizant Security Office
9a. Name, Address & Zip Code of Second Tier Subcontractor, of
facility associated with IFB, RFP OR RFQ *
b. FSC Number
c. Name, Address & Zip Code of Cognizant Security Office
" When actual performance is al a location other than that specified, identify such other "location in Item 15.
10a. Genera! identification of the Procurement for which this specification upplies
S&T Intelligence Study/Analysis
c. Are there additional security requirements established in accordance with paragraph 1-114 or 1-115. ISR?
pertinent contractual documents in Item 15.
d. Are any elements of this contract outside the inspection responsibility of the cognizant security office?
Item 15 and identify specific areas of elements.
11.
ACCESS REQUIREMENTS
YES
NO
ACCESS REQUIREMENTS (Continued)
NO
YES
a. 'Access to Classified Information Only at other
contractor/Government activities.
X
k. Access to other Special Access Program information
(Specify in item 15).
X
1. Access to U. S. classified information outside the U. S.
Panama Canal Zone, Puerto Rico, U. S. Possessions
and Trust Territories,
X
c. Receipt and generation of classified documents
or other materiel.
X
m. Defense Documentation Center or Defense information
Analysis Center Services may be requested.
X
n. Classified ADP processing will be involved.
X
e.
Graphic arts services only.
[. Access to IPO information.
g. Access to RESTRICTED DATA.
X
h. Access to classified COMSEC information.
1. Cryptographic Access Authorization required.
X
12. Refer all questions pertaining to contract security classification specification to the official named below (NORMALLY, thru ACO (item 16e);
EMERGENCY, direct with written record of Inquiry and response to ACO) (thru prime contractor for subcontracts).
a. The classification guidance contained in this specification and attachments referenced herein is complete and adequate.
b. Typed name, title and signature of /orderom/proiect medard or other
Deputy Directorate for Scientific and
Technical Intelligence
SG1J
Defense Intelligence Agency
c. Activity name, address, Zip Code, telephone number and office symbol
Defense Intelligence Agency
ATTN: DT-1A
Washington. D.C. 20301
SG1J
NOTE: Original Specification (Item 5a) is authority for contractors to mark classifl
you are Final specturcutions (Items 5b and c) are
authority for contractors to remark the regraded classified information. Such actions by contractors shall be taken in accordance with the provisions
of the Industrial Security Manual.
FORM
DD 1 JAN 78 254
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EDITION OF 1 APR 71 IS OBSOLETE. ALSO REPLACES DD FORM 254c WHICH IS OBSOLETE
Yes
No.
If YES, explain in
j. Access to SENSITIVE COMPARTMENTED INFORMATION.
X
b. Receipt of classified documents or other material
for reference only (nc generation).
X
d. Fabrication/Modification/Storage of classified hardware.
X
o. REMARKS:
DOD DIR 5200.17
DOD DIR 5200.1R
b. DoDAAD Number of Procuring Activity
identified in Item 16d.
Yes
No.
If YES, identify the
-
b. REVISED
REVISION
NO.

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13a. Information pertaining to classified contracts or projects, even though such information is considered unclassified, shall not be released for public
dissemination except as provided by the Industrial Security Manual (paragraph 50 and Appendix IX).
b. Proposed public releases shall be submitted for approval prior to release [" ] Direct
CJ Through (Specify):
Public Release of 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
accordance with paragraph 50 of the Industrial Security Manual.
. In the case of non-DOD User Agencies, see footnote, paragraph 50, Industrial Security Manual.
14. Security Classification Specifications for this solicitation contract are identified below ("X" applicable box(es) and supply attachments as required).
Any narrative or classification guide(s) furnished shall be annotated or have information appended to clearly and precisely identify each element of
information which requires a classification. When e classification guide is utilized, that portion of the guide(s) pertaining to the specific contractual
effort may be extracted and furnished the contractor. When a total guide(s) is utilized , each individual portion of the guide(s) which pertains to the
contractual effort shall be clearly identified in Item 14b. The following information must be provided for each item of classified information identified
in an extract or guide:
(I) Category of classification. (II) Date or event for declassification or review for declassification, and (III) The date or event for downgrading
(If applicable).
The official named in Item 12b, is responsible for furnishing the contractor copies of all guides and changes thereto that are made a part of this
specification. Classified information may be attached or furnished under separate cover.
7 .. A completed narrative is. (1)
attached, or (2) [X
transmitted under separate cover and mede a part of this specification.
b. The following classification guide(s) is made a part of this specification and is (1)
attached, or (2)
transmitted under separate
cover. (Liat guides under Item 15 or in an attachment by title, reference number and date).
[jc. Service-type contract/subcontract. (Specify instructions in accordance with ISR/ISM, as appropriate.).
d. "X" only if this is a final specification and Item 6 is . "NO" answer. In response to the contractor's request dated
retention of the identified classified material is authorized for a period of
e. Annual review of this DD Form 254 is required. If "X'd", provide date such review is due:
15. Remarks (Whenever possible, illustrate proper classification, declassification, and if applicable, downgrading instructions).
a.
This contract requires access to SCI. The Defense Intelligence Agency has exclusive
security responsibility for such information released to the contractor or developed
under this contract. DIAM 50-5 provides the necessary guidenace for physical, personnel
and information security measures and is a part of the security specifications for this
contract. DCASR is relieved of responsibility for all SCI material or information
released to the contractor under this contract.
b. foreign national employees of the contractor or subcontractor(s) are not authorized
access to classified information resulting from or use in the performance of this
Contract.
c. The Contractor shall notify the COTR in writing no later than five (5) days after
receipt of the contract of the following information regarding the individuals assigned
to work on this contract.
(1)
Name
(2)
Date and Place of Birth
(3)
Social Security Number
(SEE CONTINUATION SHEET)
16 a. Contract Security Classification Specifications for Subcontracts issuing from this contract will be approved by the Office named in Item 16e below, or
by the prime contractor, es authorized. This Contract Security Classification Specification and attachments referenced herein are approved by the User
Agency Contracting Officer or his Representative named in Item 16b below.
REQUIRED DISTRIBUTION:
Prime Contractor (Item 7a)
SG1J
Cognizant Security Office (Item 7c)
Administrative Contracting Office (Item 16e)
SG1J
Quality Assurance Representative
Subcontractor (Item 8a)
Cognizant Security Office (Item &c)
Program/Project Manager (Item 12b)
U. S. Activity Responsible for Overseas Security Administration
ADDITIONAL DISTRIBUTION:
1
Approved For Release 2001/04/02
b
USA, Deputy
Asst. Director for Security Services
c.
d.
Id Zip Code
Defense Intelligence Agency
The Pentagon, RSS
Washington, D.C. 20301
e. Name, address and Zip Code of Administrative Contracting Office
DCASMA San Francisco
·
San Bruno.
250 B
RDP96-00788R001500110012-2
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DD Form 254 (Continued)
(4) Certification of clearance investigation and clearance,
date clearance granted, and name of agency granting clearance.
c.
Final classification of the information generated under this
Contract is the responsibility of DIA '(DT-1A). Information generated
under this Contract is subject to the guidelines contained in DoD
Regulation 5200.1R, dated 2 November 1978, which implements EO 12065
which became effective 1 December 1978. Technical reports classified
as high as TOP SECRET SI/SAO will be provided the Contractor by DIA
and other DoD activities, and other DoD contractors for use in
connection with this Contract. These reports may be retained for the
duration of this Contract unless no longer needed. Upon termination of
this Contract, the reports shall be returned to the sender (if required)
or destroyed in accordance with current security regulations. If these
documents are to be retained beyond the ending date of this Contract,
written justification must be forwarded to and authorization given by
the Contracting Officer.
e.
All copies of final documents generated by the Contractor
under this Contract will be transmitted to DIA (DT-1A) for
dissemination to the Grill Flame Committee. No other distribution
is authorized.
f.
Use of the ARFCOS system is required ..
.
. .
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