Security requirements check list #4

Security requirements check list #4 form English: (PDF, 752KB)

Part A: Contract information

5a. Will the supplier require access to Controlled Goods?
Selected No Not Selected Yes
5b. Will the supplier require access to unclassified military technical data subject to the provisions of the Technical Data Control Regulations?
Selected No Not Selected Yes

6. Indicate the type of access required: 

6a. Will the supplier and its employees require access to Protected and/or Classified information or assets?
(Specify the level of access using the chart in Question 7. c)
Selected No Not Selected Yes
6b. Will the supplier and its employees (for example cleaners, maintenance personnel) require access to restricted access areas? No access to Protected and/or Classified information or assets is permitted.
Not Selected No Selected Yes
6c. Is this a commercial courier or delivery requirement with no overnight storage?
Selected No Not Selected Yes
7a. Indicate the type of information that the supplier will be required to access: 
Not Selected Canada Not Selected NATO Not Selected Foreign
7b. Release restrictions: 
Canada for Release restrictions
Not Selected No release restrictions for Canada Not Selected Not releasable for Canada Not Selected Restricted to for Canada
NATO for Release restrictions
Not Selected All NATO countries for NATO Not Selected Restricted to for NATO

Foreign for Release restrictions
Not Selected No release restrictions for Foreign Not Selected Restricted to for Foreign
7c. Level of information: 
Canada for Level of information
Not Selected Protected A for Canada Not Selected Protected B for Canada Not Selected Protected C for Canada Not Selected Confidential for Canada Not Selected Secret for Canada Not Selected Top Secret for Canada Not Selected Top Secret (SIGINT) for Canada
NATO for Level of information Not Selected NATO Unclassified Not Selected NATO Restricted Not Selected NATO Confidential Not Selected NATO Secret Not Selected COSMIC Top Secret for NATO
Foreign for Level of information Not Selected Protected A for Foreign Not Selected Protected B for Foreign Not Selected Protected C for Foreign Not Selected Confidential for Foreign Not Selected Secret for Foreign Not Selected Top Secret for Foreign Not Selected Top Secret (SIGINT) for Foreign
8. Will the supplier require access to Protected and/or Classified COMSEC information or assets?
Selected No Not Selected Yes
9. Will the supplier require access to extremely sensitive INFOSEC information or assets?
Selected No Not Selected Yes

Part B: Personnel (supplier)

10. Personnel security screening level required : 

Note

If multiple levels of screening are identified, a security classification guide must be provided.

Not Selected Reliability status Not Selected Confidential Selected Secret Not Selected Top Secret Not Selected Top Secret – SIGINT Not Selected NATO Confidential Not Selected NATO Secret Not Selected COSMIC Top Secret Not Selected Site access
10b. May unscreened personnel be used for portions of the work?
Selected No Not Selected Yes
If yes, will unscreened personnel be escorted?
Selected No Not Selected Yes

Part C: Safeguards (supplier)

Information / assets

11a. Will the supplier be required to receive and store Protected and/or Classified information or assets on its site or premises?
Selected No Not Selected Yes
11b. Will the supplier be required to safeguard COMSEC information or assets?
Selected No Not Selected Yes

Production

11c. Will the production (manufacture, and/or repair and/or modification) of Protected and/or Classified material or equipment occur at the supplier’s site or premises?
Selected No Not Selected Yes

Information technology media

11d. Will the supplier be required to use its IT systems to electronically process, produce or store Protected and/or Classified information or data?
Selected No Not Selected Yes
11e. Will there be an electronic link between the supplier’s IT systems and the government department or agency?
Selected No Not Selected Yes

Note

For users completing the form manually use the summary chart below to indicate the category(ies) and level(s) of safeguarding required at the supplier’s site(s) or premises.

For users completing the form online (via the Internet), the summary chart is automatically populated by your responses to previous questions.

Summary chart: Protected

Summary chart: Protected

Category

A

B

C

Information / assets

Production

IT media

IT link

Summary chart: Classified

Category

Confidential

Secret

Top Secret

Information / assets

 

Production

IT media

 

IT link

Summary chart: NATO

Category

NATO

Restricted

NATO

Confidential

NATO

Secret

COSMIC

Top Secret

Information / assets

Production

IT media

IT link

Summary chart: COSMEC

Category

Protected

A

Protected

B

Protected

C

Confidential

Secret

Top

Secret

Information / assets

Production

IT media

IT link

12a. Is the description of the work contained within this SRCL Protected and/or Classified?

Note

If yes, classify this form by annotating the top and bottom in the area entitled “Security classification”.

Selected No Not Selected Yes
12b. Will the documentation attached to this SRCL be Protected and/or Classified?

Note

If yes, classify this form by annotating the top and bottom in the area entitled “Security classification” and indicate with attachments (for example Secret with Attachments).

Selected No Not Selected Yes

Part D: Authorization

13. Organization project authority: 

Signature:

14. Organization security authority: 

Signature:

15. Are there additional instructions (for example Security Guide, Security classification Guide) attached?

16. Procurement officer: 

Signature:

17. Contracting security authority: 

Signature:

Digitally signed by Saumur, Jacques 0 Date: 2019.09.17 13:08:24 -04'0'0
Date modified: