The public reporting burden for this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications Directorate (0701-0050). Respondents 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.
PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ORGANIZATION. SEND COMPLETED FORM TO THE ADDRESS IN NOTE 2 ON BACK.
NOTE: THIS FORM DOES NOT CONSTITUTE A CIVIL AIRCRAFT LANDING PERMIT.
Please read Privacy Act Statement and Instructions on back before completing this form.
If additional space is required, continue on back.
1. THE USER NAMED BELOW, IN CONSIDERATION OF PERMISSION GRANTED BY THE UNITED STATES ARMED FORCES UNDER PL 85-726,
49 USC SECTION 44502(D), TO USE MILITARY AIRFIELD FACILITIES, AGREES: |
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a. The User releases forever the United States, its agencies, and |
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c. For the purposes of this agreement, the term "United States |
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United States personnel, from every liability arising out of the use of |
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personnel" shall include: |
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the military airfield, supplies, or services, by the User. The User will |
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defend, pay or settle every claim or suit against the United States, its |
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(1) Military personnel and civilian employees of the United States, |
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agencies, and United States personnel, by agents or employees of the |
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User or persons claiming through them, or by third parties, and will |
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including non-appropriated fund employees, acting within the scope |
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hold the United States, its agencies, and United States personnel, |
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of their employment, and |
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harmless against every such claim or suit, including attorney fees, |
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costs, and expenses, arising out of the use of the military airfield or |
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(2) Heirs, successors, executors, administrators, and assigns of such |
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military supplies or services, by the User. |
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employees. |
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EXCEPTION: Death, injury, loss or damage to persons or property |
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resulting solely from the willful misconduct of United States |
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d. The User will comply with all pertinent parts of applicable |
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personnel; and, in addition, any liability from another contract |
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military regulations listed in NOTE 1 and local supplements, |
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concerning the use of the military airfield, supplies, or services shall |
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directives, and orders, which are hereby incorporated into this |
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not be affected by the Hold Harmless Agreement. |
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b. The User will pay or settle every claim for death or injury to |
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agreement. |
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United States personnel, or for loss or damage to property of or under |
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e. This agreement replaces previous Hold Harmless Agreements, if |
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the control of the United States or United States personnel, arising |
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any, by the same User, as of the date of this agreement. |
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out of the use of the military airfield or military supplies or services, |
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Termination by the User requires 60 days written notice to the |
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by the User, unless the death, injury, loss, or damage results solely |
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from the negligence or willful misconduct of United States personnel. |
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military authority where the agreement was submitted. |
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NOTE 1 |
ARMY |
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NAVY |
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AIR FORCE |
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AR 95-2 Can be viewed at: |
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SECNAVINST 3770.1C |
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AFI 10-1001 |
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http://books.army.mil/cgi-bin/bookmgr/Shelves |
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Can be viewed at: http://neds.nebt.daps.mil/ |
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Can be viewed at: http://afpubs.hq.af.mil |
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Directives/dirindex.html |
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2. USER |
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(1) |
TYPED COMPANY NAME(S) |
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(2) |
COMPANY ADDRESS(ES) |
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B. INDIVIDUAL OR FIRST CORPORATE OFFICER |
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(1) |
TYPED NAME (Last, First, Middle Initial) |
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(2) |
ADDRESS (If corporation, may state "Same as Above") |
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(3) |
SIGNATURE (Blue Ink) |
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(4) |
TITLE (If corporate officer) |
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3. VERIFICATION (Complete if the user is a company, corporation, etc.) |
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I hereby verify that the signatory above holds the position indicated and is duly authorized to sign on behalf of the User. |
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A. SECOND CORPORATE OFFICER |
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(1) |
TYPED NAME (Last, First, Middle Initial) |
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(2) |
SIGNATURE (Blue Ink) |
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(3) |
TITLE |
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4. DATE SIGNED (YYYYMMDD) |
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DD FORM 2402, AUG 2004 |
PREVIOUS EDITION IS OBSOLETE. |