SECURITY REQUIREMENTS CHECK LIST (SRCL)

PART A - CONTRACT INFORMATION

Contract Number

1. Originating Government Department or Organization

2. Branch or Directorate

3. a) Subcontract Number

Name of Subcontractor

Address of Subcontractor

4. Brief Description of Work

5. a) Will the supplier require access to Controlled Goods?

5. b) Will the supplier require access to unclassified military technical data subject to the provisions of the Technical Data Control Regulations?

6. Indicate the type of access required

6. a) 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)

6. b) Will the supplier and its employees (e.g. cleaners, maintenance personnel) require access to restricted access areas? No access to PROTECTED and/or CLASSIFIED information or assets is permitted.

6. c) Is this a commercial courier or delivery requirement with no overnight storage?

7. a) Indicate the type of information that the supplier will be required to access

Canada
NATO
Foreign

8. Will the supplier require access to PROTECTED and/or CLASSIFIED COMSEC information or assets?

9. Will the supplier require access to extremely sensitive INFOSEC information or assets?

Short Title(s) of material: Document Number:

PART B - PERSONNEL (SUPPLIER)

10. a) Personnel security screening level required

RELIABILITY STATUS
CONFIDENTIAL
SECRET
TOP SECRET
TOP SECRET (SIGINT)
NATO CONFIDENTIAL
NATO SECRET
COSMIC TOP SECRET
SITE ACCESS

Special comments:

NOTE: If multiple levels of screening are identified, a Security Classification Guide must be provided.

10. b) May unscreened personnel be used for portions of the work?

PART C - SAFEGUARDS (SUPPLIER)

INFORMATION / ASSETS

11. a) Will the supplier be required to receive and store PROTECTED and/or CLASSIFIED information or assets on its site or premises?

11. b) Will the supplier be required to safeguard COMSEC information or assets?

PRODUCTION

11. c) 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?

INFORMATION TECHNOLOGY (IT) MEDIA

11. d) Will the supplier be required to use its IT systems to electronically process, produce or store PROTECTED and/or CLASSIFIED information or data?

11. e) Will there be an electronic link between the supplier’s IT systems and the government department or agency?

12. a) Is the description of the work contained within this SRCL PROTECTED and/or CLASSIFIED?

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

12. b) Will the documentation attached to this SRCL be PROTECTED and/or CLASSIFIED?

If Yes, classify this form by annotating the top and bottom in the area entitled “Security Classification” and indicate with attachments (e.g. SECRET with Attachments).

PART D - AUTHORIZATION

13. Organization Project Authority

Name (print)

Title

Telephone No.

Facsimile No.

E-mail address

Date

14. Organization Security Authority

Name (print)

Title

Telephone No.

Facsimile No.

E-mail address

Date

15. Are there additional instructions (e.g. Security Guide, Security Classification Guide) attached?

16. Procurement Officer

Name (print)

Title

Telephone No.

Facsimile No.

E-mail address

Date

17. Contracting Security Authority

Name (print)

Title

Telephone No.

Facsimile No.

E-mail address

Date