DD2402 Civilian Aircraft Hold Harmless Agreement.pdf

PREVIOUS EDITION IS OBSOLETE.

DD FORM 2402, MAY 2021

CIVIL AIRCRAFT HOLD HARMLESS AGREEMENT OMB No. 0701-0050 Exp: 20231231

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, Washington Headquarters Services, at whs.mc-alex.esd.mbx.dd-dod-informationcollections@mail.mil. 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 APPROPIATE ADDRESS 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:

a. The User releases forever the United States, its agencies, and United States personnel, from every liability arising out of the use of the military airfield, supplies, or services, by the User. The User will defend, pay or settle every claim or suit against the United States, its agencies, and United States personnel, by agents or employees of the User or persons claiming through them, or by third parties, and will hold the United States, its agencies, and United States personnel, harmless against every such claim or suit, including attorney fees, costs, and expenses, arising out of the use of the military airfield or military supplies or services, by the User.

EXCEPTION: Death, injury, loss or damages to persons or property resulting solely from the willful misconduct of United States personnel; and, in addition, any liability from another contract concerning the use of the military airfield, supplies, or services shall not be affected by the Hold Harmless Agreement.

b. The User will pay or settle every claim for death or injury to United States personnel, or for loss or damage to property of or under the control of the United States or United States personnel, arising out of the use of the military airfield or military supplies or services, by the User, unless the death, injury, loss, or damage results solely from the negligence or willful misconduct of United States personnel.

c. For the purposes of this agreement, the term "United States personnel" shall include:

(1) Military personnel and civilian employees of the United States, including non-appropriated-appropiated fund employees, acting within the scope of their employment, and

(2) Heirs, successors, executors, administrators, and assigns of such employees.

d. The User will comply with all pertinent parts of applicable military regulations listed in NOTE 1 and local supplements, directives, and orders, which are hereby incorporated into this agreement.

e. This agreement replaces previous Hold Harmless Agreements, if any, by the same User, as of the date of this agreement. Termination by the User requires 60 days written notice to the military authority where the agreement was submitted.

NOTE 1: ARMY NAVY AND MARINES AIR FORCE

AR 95-2 Can be viewed at:

https://armypubs.army.mil/

CNIC Program Guidance can be viewed at:

https://www.cnic.navy.mil/om/calp.html

AF 10-1001

Can be viewed at: https://afpubs.hq.af.mil

2. USER

a. CORPORATION (Name and address of divisions, subsidiaries, or companies of the parent organization named as user is legally liable should also be listed if this agreement is applicable to their use of military airfields.)

(1) TYPED COMPANY NAME(S)

b. INDIVIDUAL OR FIRST CORPORATE OFFICER

(1) TYPED NAME (Last, First, Middle Initial) (2) ADDRESS (If corporation, may state "Same as Above")

(3) SIGNATURE (Blue Ink) (4) TITLE (If corporate officer)

3. VERIFICATION (Complete if the user is a company, corporation, etc.)

I hereby verify that the signatory above holds the position indicated and is duly authorized to sign on behalf of the User.

a. SECOND CORPORATE OFFICER

(1) TYPED NAME (Last, First, Middle Initial) (2) SIGNATURE (Blue Ink)

(3) TITLE (4) DATE SIGNED (YYYYMMDD)

(2) COMPANY ADDRESS(ES)

https://armypubs.army.mil/ProductMaps/PubForm/Details.aspx?PUB_ID=64645 https://www.cnic.navy.mil/om/calp.html https://afpubs.hq.af.mil

PREVIOUS EDITION IS OBSOLETE.

DD FORM 2402, MAY 2021

PRIVACY ACT STATEMENT

AUTHORITY: 49 U.S.Code, Section 44502(d)

PRINCIPAL PURPOSE(S): Indicates certification by an individual or corporation to hold the U.S. Government harmless in consideration of permission granted for the operation of civil aircraft into military aviation facilities. Used in conjunction with DD Forms 2400 and 2401. It is maintained indefinitely.

ROUTINE USE(S): None. For Internal Use Only.

DISCLOSURE: Voluntary; however, failure to provide this information will result in an individual or corporation being unable to operate civil aircraft into a military aviation facility.

5. REMARKS (If additional space is required, continue here. Refer to item number.)

INSTRUCTIONS

1. Form must be filed along with DD Forms 2400 and 2401 to obtain civil aircraft landing permit.

2. Complete all applicable items and submit to appropriate addresses in Note 2 below.

3. If the user is a corporation/company, all blocks must be completed and the form must be signed by two different corporate officers. If the user is an individual, only items 2b and 4 should be completed.

4. Original, handscribed signatures are required. Signature stamps, camera copied signatures, or any type of facsimile signatures are unacceptable.

5. This form is available at http://www.esd.whs.mil/Directives/forms/dd2000_2499/

ARMY AIR FORCE

COMMANDER, USAASA, ATTN: DAMO-AVA

BLDG 1466, 9325 GUNSTON RD, SUITE N319

FT BELVOIR, VA 22060-5582

(703) 806-0687 usarmy.belvoir.hqda-dcs-g-3-5-7.list.usaasaops@mail.mil

HQ USAF/A3OJ

112 LUKE AVENUE, SUITE 340

JBAB, DC 20032-6400

(202) 404-7886 calp@us.af.mil

See AR 95-2 at https://armypubs.army.mil/ See AFI 10-1001 at https://www.e-publishing.af.mil/

NAVY MARINES

COMMANDER, NAVY INSTALLATIONS COMMAND

WASHINGTON NAVY YARD

716 SICARD ST SE

WASHINGTON, DC 20374

(202) 433-0120 CALP.HQ@navy.mil CNIC/MCICOM guidance can be viewed at:

https://www.cnic.navy.mil/om/calp.html

COMMANDER, MARINE CORPS INSTALLATIONS COMMAND

3000 MARINE, CORPS PENTAGON RM 2D153A

WASHINGTON, DC 20350-3000

(703) 695-0105 mcicom_calp@usmc.mil

CNIC/MCICOM guidance can be viewed at:

https://www.cnic.navy.mil/om/calp.html http://www.esd.whs.mil/Directives/forms/dd2000_2499/ mailto:usarmy.belvoir.hqda-dcs-g-3-5-7.list.usaasaops@mail.mil mailto:usaf.calp@mail.mil https://armypubs.army.mil/ProductMaps/PubForm/Details.aspx?PUB_ID=64645 https://www.e-publishing.af.mil/ mailto:CALP.HQ@navy.mil https://www.cnic.navy.mil/om/calp.html mailto:mcicom_calp@usmc.mil CNIC Program Guidance can be viewed at: https://www.cnic.navy.mil/om/calp.html

DRAFT

SAMPLE

PREVIOUS EDITION IS OBSOLETE.

DD FORM 2402, MAY 2021

Page of

DRAFT

INSTRUCTIONS

PREVIOUS EDITION IS OBSOLETE.

Page of

DD FORM XXXX, 20202409 DRAFT

CIVIL AIRCRAFT HOLD HARMLESS AGREEMENT

OMB No. 0701-0050 Exp: 20231231 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, Washington Headquarters Services, at whs.mc-alex.esd.mbx.dd-dod-informationcollections@mail.mil. 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 APPROPIATE ADDRESS 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:

a. The User releases forever the United States, its agencies, and United States personnel, from every liability arising out of the use of the military airfield, supplies, or services, by the User. The User will defend, pay or settle every claim or suit against the United States, its agencies, and United States personnel, by agents or employees of the User or persons claiming through them, or by third parties, and will hold the United States, its agencies, and United States personnel, harmless against every such claim or suit, including attorney fees, costs, and expenses, arising out of the use of the military airfield or military supplies or services, by the User.

EXCEPTION: Death, injury, loss or damages to persons or property resulting solely from the willful misconduct of United States personnel; and, in addition, any liability from another contract concerning the use of the military airfield, supplies, or services shall not be affected by the Hold Harmless Agreement.

b. The User will pay or settle every claim for death or injury to United States personnel, or for loss or damage to property of or under the control of the United States or United States personnel, arising out of the use of the military airfield or military supplies or services, by the User, unless the death, injury, loss, or damage results solely from the negligence or willful misconduct of United States personnel.

c. For the purposes of this agreement, the term "United States personnel" shall include:

(1) Military personnel and civilian employees of the United States, including non-appropriated-appropiated fund employees, acting within the scope of their employment, and

(2) Heirs, successors, executors, administrators, and assigns of such employees.

d. The User will comply with all pertinent parts of applicable military regulations listed in NOTE 1 and local supplements, directives, and orders, which are hereby incorporated into this agreement.

e. This agreement replaces previous Hold Harmless Agreements, if any, by the same User, as of the date of this agreement. Termination by the User requires 60 days written notice to the military authority where the agreement was submitted.

NOTE 1:

ARMY

NAVY AND MARINES

AIR FORCE

AR 95-2 Can be viewed at:

https://armypubs.army.mil/ CNIC Program Guidance can be viewed at:

https://www.cnic.navy.mil/om/calp.html

AF 10-1001

Can be viewed at: https://afpubs.hq.af.mil

2. USER

a. CORPORATION (Name and address of divisions, subsidiaries, or companies of the parent organization named as user is legally liable should also be listed if this agreement is applicable to their use of military airfields.)

b. INDIVIDUAL OR FIRST CORPORATE OFFICER

3. VERIFICATION (Complete if the user is a company, corporation, etc.)

I hereby verify that the signatory above holds the position indicated and is duly authorized to sign on behalf of the User.

a. SECOND CORPORATE OFFICER

PRIVACY ACT STATEMENT

AUTHORITY: 49 U.S.Code, Section 44502(d) PRINCIPAL PURPOSE(S): Indicates certification by an individual or corporation to hold the U.S. Government harmless in consideration of permission granted for the operation of civil aircraft into military aviation facilities. Used in conjunction with DD Forms 2400 and 2401. It is maintained indefinitely.

ROUTINE USE(S): None. For Internal Use Only.

DISCLOSURE: Voluntary; however, failure to provide this information will result in an individual or corporation being unable to operate civil aircraft into a military aviation facility.

INSTRUCTIONS

1. Form must be filed along with DD Forms 2400 and 2401 to obtain civil aircraft landing permit.

2. Complete all applicable items and submit to appropriate addresses in Note 2 below.

3. If the user is a corporation/company, all blocks must be completed and the form must be signed by two different corporate officers. If the user is an individual, only items 2b and 4 should be completed.

4. Original, handscribed signatures are required. Signature stamps, camera copied signatures, or any type of facsimile signatures are unacceptable.

5. This form is available at http://www.esd.whs.mil/Directives/forms/dd2000_2499/

ARMY

AIR FORCE

COMMANDER, USAASA, ATTN: DAMO-AVA

BLDG 1466, 9325 GUNSTON RD, SUITE N319

FT BELVOIR, VA 22060-5582

(703) 806-0687 usarmy.belvoir.hqda-dcs-g-3-5-7.list.usaasaops@mail.mil

HQ USAF/A3OJ

112 LUKE AVENUE, SUITE 340

JBAB, DC 20032-6400

(202) 404-7886 calp@us.af.mil See AR 95-2 at https://armypubs.army.mil/ See AFI 10-1001 at https://www.e-publishing.af.mil/

NAVY

MARINES

COMMANDER, NAVY INSTALLATIONS COMMAND

WASHINGTON NAVY YARD

716 SICARD ST SE

WASHINGTON, DC 20374

(202) 433-0120 CALP.HQ@navy.mil CNIC/MCICOM guidance can be viewed at:

https://www.cnic.navy.mil/om/calp.html

COMMANDER, MARINE CORPS INSTALLATIONS COMMAND

3000 MARINE, CORPS PENTAGON RM 2D153A

WASHINGTON, DC 20350-3000

(703) 695-0105 mcicom_calp@usmc.mil CNIC/MCICOM guidance can be viewed at:

https://www.cnic.navy.mil/om/calp.html 9.0.0.2.20120627.2.874785

WHS

DD Form 2402, "Civil Aircraft Hold Harmless Agreement"