CIVIL AIRCRAFT HOLD HARMLESS AGREEMENT
OMB No. 0701-0050
Expires Feb 28, 1997
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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington,
VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0701-0050), Washington, DC 20503.
PLEASE DO NOT RETURN YOUR FORM TO EITHER OF THESE ADDRESSES. SEND YOUR COMPLETED FORM TO ADDRESS IN NOTE 2 ON
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 1507, TO USE MILITARY AIRFIELD FACILITIES, AGREES:
The User releases forever the United States, its agencies, and United
For the purposes of this agreement, the term "United States personnel"
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
(1) Military personnel and civilian employees of the United States,
agencies, and United States personnel, by agents or employees of the
including non-appropriated fund employees, acting within the scope of
User or persons claiming through them, or by third parties, and will
their employment, and
hold the United States, its agencies, and United States personnel,
harmless against every such claim or suit, including attorney fees,
(2) Heirs, successors, executors, administrators, and assigns of such
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 damage to persons or property
The User will comply with all pertinent parts of applicable military
resulting solely from the willful misconduct of United States personnel;
regulations listed in NOTE 1 and local supplements, directives, and
and, in addition, any liability from another contract concerning the use
orders, which are hereby incorporated into this agreement.
of the military airfield, supplies, or services shall not be affected by the
Hold Harmless Agreement.
This agreement replaces previous Hold Harmless Agreements, if any, by
the same User, as of the date of this agreement. Termination by the
The User will pay or settle every claim for death or injury to United
User requires 60 days written notice to the military authority where the
States personnel, or for loss or damage to property of or under the
agreement was submitted.
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.
a. CORPORATION (Name and address of divisions, subsidiaries, or companies of the parent organization named as user and for whom the user is
legally liable should also be listed if this agreement is applicable to their use of military airfields.)
(1) Typed Company Name(s)
(2) Company Address(es)
b. INDIVIDUAL OR FIRST CORPORATE OFFICER
(1) Typed Name
(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
(2) Signature (Blue Ink)
4. DATE SIGNED (YYMMDD)
DD FORM 2402, MAY 94 (EG)
PREVIOUS EDITIONS ARE OBSOLETE.
Designed using Perform Pro, WHS/DIOR, Aug 96