HomeMy WebLinkAboutHanford Mission Integration Solutions, LLC - Service Agreement.1 1
THIS AGREEMENT, effective this 15th day of April 2021, is made by and between HAFOD MISSION
INTEGRATION SOLUTIONS, LLC ("HMIS"), prime contractor to the UNITED STATES DEPARTMENT OF
ENERGY, RICHLAND OPERATIONS OFFICE ("DOE"), a Department of the United States of America
(Government) and the CITY OF YAKIMA ("Customer'").
SCOPE OF SERVICES
Subject to the terms and conditions set forth below, HMIS has been authorized by DOE to, and shall, furnish to
Customer certain equipment, services, and/or staff fortraining purposes (hereinafter referred to as the
"Activity"), which is part of this Agreement.
COSTS AND INVOICING
Costs associated with the Activity will be invoiced to and paid by Customer to the account of HMIS in
accordance with the pricing policy.
SCHEDULING
Customer understands and agrees (i) that the Activity is subject to the priority of the DOE on a not -to -interfere
basis; and (ii) that DOE, through its facility administrator HMIS, has sole responsibility and discretion for
allocating and scheduling use of the equipment, services, and/or staff needed foror involved in the Activity.
LIABILITY AND INDEMNITY
A. Neither the Government nor DOE and its agents, employees, or contractors (including HMIS) or other
persons acting on their behalf, including officers, directors, officials, representatives, employees, staff,
and subcontractors will be responsible forany personal injury or damage to or destruction of property of
any kind whatsoever resulting from the furnishing of and use by Customer of equipment, material, and/or
staff under this Agreement, unless directly resulting from the negligence of the Government, DOE, or
agents or persons acting on their behalf, consistent with the Washington Comparative Fault Statute
(R. C. W. 4.22 et seq. ).
B. Neither the Government, nor DOE and its agents, employees, or contractors (including HMIS), or, and
other persons acting on their behalf, including officers, directors, officials, representatives, employees,
staff, and subcontractors will be responsible, irrespective of cause, forfailure to furnish any equipment,
material, and/or staff under this Agreement at any particular time or in any particular manner when the
interests of the Government preempt any schedule.
C. Customer shall indemnify the Government, DOE, and their agents, employees, or contractors (including
HMIS), and other persons acting on their behalf, including officers, directors, officials, representatives,
employees, staff, and subcontractors, forall damages, claims, costs, and expenses, including attorney"s
fees, arising from personal injury (including death) or property damage or destruction occurring as a
result of using the equipment or material furnished under this Agreement.: Customer shall give notice to
HMIS as soon as practicable of any claim made against the Government, DOE, or their agents or other
persons acting on their behalf and/or Customer and afford them the opportunity, to the extent allowed by
applicable laws, rules, or regulations, to participate in and control their defense. Customer shall provide
reasonable assistance and information to the Government, DOE, HMIS, and their agents and other
persons acting on their behalf to support their defense. To the extent that Customer and Customer's
Personnel are covered by the Washington Industrial Insurance Act (R.C.W. Title 51) or any other
industrial insurance, workers compensation, or similar act, Customer specifically waives any and all
immunity provided under these acts and their regulations and rules related to the Customer's
indemnification obligation set forth in this paragraph.
ENTIRE AGREEMENT
This Agreement constitutes the entire contract between the parties and supersedes any other promises,
ogmaemmnts, or written correspondence. This Agreement cannot be amended and noprovision can be waived
except byen instrument in writing duly executed by each ufthe parties.
AUTHORITY' ADMINISTRATION, AND TRANSFER
It is understood and agreed that this Agreement is entered into by HK8kS in its role as prime contractor to DOE
and thot(i) H&i|S is authorized to and will administer this Agreement forOOE;(ii)administration of this
Agreement may be assigned by HyN|G to DOE or its designee upon written notice to Customer; and (i\i) in nooe
ofsuch assignment and notice thereof toCustomer, HK8|S shall have nofurther responsibility hereunder.
STATEMENT OF WORK
The EVOC Training Center at Hanford Patrol Training Academy will provide the City of Yakima access to the
Emergency Vehicle Operations Course (EVO[) Skills Pod, Track and Trailer on July 23. 3021.
Provide access and oversight to the props listed below:
COST ESTIMATE
The estimated price forthis training is below. Please refer to the attached estimate fordetails.
Price excludes 3%OOE-RL federal administrative adder. The use of the facility and associated services are
aub]eotbo the referenced letter agreement terms and conditions.
2-AINIAM
Payment will be sent to the following address:
Hanford Mission Integration Solutions
Attn: Cashier 1-13-09
PO Box 943
Richland, WA 99352
TERMINATION/CANCELLATION POLICY
Either party may terminate this Agreement fVreny reason at any time by giving not less than 14 days prior
written notice to the other party; provided, however, that O(]E reserves the right to immediately bamnincde this
Agreement without regard to the aforesaid written notice when termination of this Agreement is determined to
be in the best interests of the Government. Termination nhe|| only affect the term of this Agreement and shall
otherwise be without prejudice to the rights of either party.
Customers canceling 10xwnhking days mrmore prior toscheduled dates offacility use will be able toobtain a
10096 refund of monies paid, less any costs incurred specifically in support ofcustomer requirements.
Cancellations of less than 10 working days but 5ormore will result in a refund of6U96 less incurred costs.
NOTICE
Any notice required under this Agreement shall be given to the following parties verbally or in writing'.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement effective as of the date and year
first written above.
Cu R
Sig nature
0 6 U) 0r
Name (print)
C-(� nq1 aCta
Title j
Maki
Date j
}l.
Phone/Email
2, 11'1,d_�2Lre d -, 0 &-L?,
Mailing Address L)
CITY CONTRACT NO'AZ2j--0-
RESOLUTION NO: - I'l i A,
Approved Kjja 9mqj1
Signature
10Mo
Name (print)
P 20mul 4:001W.-M �o�
Date
Ricole Zawadzki
Hanford Mission Integration Solutions
P.O. Box 1000 (G5-51)
Richland, WA 99352
Statement of Work
All vehicles used at the EVOCshall bepolice or law enforcement vehicles; nuprivate vehicles authorized.
Any reference to vehicles means police vehicles.
Deliverables
As requested by the PTA EVOC Progra m Ma nager (PM), in H FACTS complete a nd submit a Customer
Requirements Form (CR F) to reserve the EVOC s kills pad, track a nd trailer for the tra ining dates agreed
to by the PTA EVOC PM a nd the Law Enforcement Customer's Point of Conta ct (LE POC).
Prepa re a nd submit required contracting documents (e.g., Service Agreement a nd a Cost Estimate) to
the LEPQCand others, if/as required.
Give copies of any required clocumentsto the LE POC for review and approval. Ensure paper copies of
the aforementioned documents are maintained on file, including thosethat have been signed
(approved) bythe LEPO[
The Hanford PTA will:
Unless pre -approved by the Commandant, PTA, allows only one agency at a time to use the EVOC.
Confirm the LE POC wants his/her department personnel trained tothe PTA's approved EVOC lesson
plan'and not to a variation of same, e.g., one that has been modified, tweaked revised orotherwise
changed.
Confirm the LE EVOCInstructors are certified for the type of vehicles the agency will bring to the
training.
Ensure only vehicles authorized for use on EVOC by Hanford PTA are used during the training event.
Have the HAMMER LE PM reservethe EVOC skills pad, trackand trailerfor the training dotes agreed to
by the PTA EVOC PM and the LE POC.
Complete and submit/file the required HAMMER approval paperwork.
Provide the LE Customer's personnel accesstothe EVOC classroom and props as scheduled.
Provide the initial PTA/EVO[facility training/safety bhe0no/orientationtoEVOCLEPO[beforetnaining
commences.
training can be conducted in compliance with a pplicabie hazard a nalys is (reference SAS-7321, Hazards Analysis Procedure) and PTA facili
training, safety and environmental requirements. I
Statement of Work
IFY 2021 Law Enforcement EVOCj[A!qjng
at Hanford Patrol Training Academy (PITA)A![Yehicles
Provide certification and recertification of LE POC EVOC instructors (Certification is per the Washington
State Criminal Justice Training Center Requirements for EVOC Insructors).
Ensure training conducted per the PTA's approved EVOC lesson plan.
LE Customer POC will:
Submit the EVOC training request to the PTA EVOC PM and confirm department personnel are to be
trained to the PTA's approved EVOC lesson plan and not to a variation of same, e.g., one that has been
modified, tweaked, revised or otherwise changed.
Upon receipt of required contracting documents (e.g., Contract Service Agreement), review and approve
(sign/date) if acceptable then return them to the HAMMER LE PM. If not acceptable, workwith the PTA
EVOC PM and/or the HAMMER LE PM to resolve the issue(s).
Ensure that department personnel who are to be trained complete the PTA/EVOC facility training/safety
briefing/orientation before training commences.
Ensure department personnel are trained in accordance with the PTA's approved EVOC lesson plan.
During the period of his/her department's EVOC reservation, deny EVOC use to other external agencies
unless prior approval is granted by the Commandant, Hanford Patrol Training Academy.
Will ensurethat their EVOC instructors recertifyevery two years or sooner as needed.
Will ensure PTA approval for any vehicles not previously authorized for use at the EVOC.
'AMISTech POC-
Mick J. Thompson
(509) 376-4686 - Office
(509) 366-1431 - Cell
HMISFinance POC: Vanessa Pulido
(509) 205-2317 - Cell
vanessa n ul 6 fl, �sa n ido
1
�&I ki 101 K111111�
With City of Yakima
Tolpente
GENERAL RELEASE AND INDEMNIFICATION
U.S. Citizens
1, the undersigned, expressly acknowledge that my participation in the Volpentest HAMMER
Federal Training Center (HAM MER)/Patro|Training Academy (PTA)training activities may expose
me, eitherdirectly or indirectly, to certain hazards inherent in the transportation to, viewing of,
and participating in the operation of training props and demonstrations. Such hazards may give
rise topersonal injury, including death, orproperty damage urloss.
I have been informed and understand that Hanford Mission Integration Solutions, LLC (HMIS)
and the U.S. Department ofEnergy (O[>E) do not provide accident, health, medical, disability, or
nthertypesofinsurance for the protection ofthose who participate in the HAMMER/PTA
training activities. Furthermore, | understand that itisrecommended that | have amedical
insurance policy in effect during my participation.
| certify that if have any reason (physical, medical or otherwise) which would impact my ability
to participate in this training, | will advise HA&4K8ER/PTAstaff mfnnycondition and follow
instructions given me by HAIVIMER/PTA staff.
In consideration of the privilege of participating in HAMIVIER/PTA training activities, the
undersigned, for myself, nnyheirs,adnnin��rators,execu�oo,succ�sson�repnssenta1ives,and
assigns, do hereby knowingly, willingly, and voluntarily assume any and all risks of accident,
personal injury, orpropertVdannagetonmyselfandtonoypnopehLyconsis1entxviththeStateof
Washington Comparative Fault Statute (R.C.VV.4.%2). | agree to now and foreverre|ease,acquit,
discharge, indemnify, and hold harmless HK8|S and DOE, their officers, officials, directors,
representatives, agents, employees, and contractors, from and against any and all claims, loss,
causes of action, suits, cost or expense forany and all personal injury, death, or property
Participant's Signature Date
Participant's Name (Print)
Organization, Company, Affiliation (Print)
Service Agreement
CRF 6807-017
with City of Yakima
For the use of the
Patrol Training Academy's Emergency Vehicle Operations Course
THIS AGREEMENT, effective this 26th day of May 2021, is made by and between HANFORD MISSION
INTEGRATION SOLUTIONS, LLC ("HMIS"), prime contractor to the UNITED STATES DEPARTMENT OF
ENERGY, RICHLAND OPERATIONS OFFICE ("DOE"), a Department of the United States of America
(Government) and the CITY OF YAKIMA ("Customer").
SCOPE OF SERVICES
Subject to the terms and conditions set forth below, HMIS has been authorized by DOE to, and shall, furnish to
Customer certain equipment, services, and/or staff for training purposes (hereinafter referred to as the
"Activity"), which is part of this Agreement.
COSTS AND INVOICING
Costs associated with the Activity will be invoiced to and paid by Customer to the account of HMIS in
accordance with the pricing policy.
SCHEDULING
Customer understands and agrees (i) that the Activity is subject to the priority of the DOE on a not -to -interfere
basis; and (ii) that DOE, through its facility administrator HMIS, has sole responsibility and discretion for
allocating and scheduling use of the equipment, services, and/or staff needed for or involved in the Activity.
LIABILITY AND INDEMNITY
A. Neither the Government nor DOE and its agents, employees, or contractors (including HMIS) or other
persons acting on their behalf, including officers, directors, officials, representatives, employees, staff,
and subcontractors will be responsible for any personal injury or damage to or destruction of property of
any kind whatsoever resulting from the furnishing of and use by Customer of equipment, material, and/or
staff under this Agreement, unless directly resulting from the negligence of the Government, DOE, or
agents or persons acting on their behalf, consistent with the Washington Comparative Fault Statute
(R. C. W. 4.22 et seq.).
Neither the Government, nor DOE and its agents, employees, or contractors (including HMIS), or, and
other persons acting on their behalf, including officers, directors, officials, representatives, employees,
staff, and subcontractors will be responsible, irrespective of cause, for failure to furnish any equipment,
material, and/or staff under this Agreement at any particular time or in any particular manner when the
interests of the Government preempt any schedule.
Customer shall indemnify the Government, DOE, and their agents, employees, or contractors (including
HMIS), and other persons acting on their behalf, including officers, directors, officials, representatives,
employees, staff, and subcontractors, for all damages, claims, costs, and expenses, including attorney's
fees, arising from personal injury (including death) or property damage or destruction occurring as a
result of using the equipment or material furnished under this Agreement. Customer shall give notice to
HMIS as soon as practicable of any claim made against the Government, DOE, or their agents or other
persons acting on their behalf and/or Customer and afford them the opportunity, to the extent allowed by
applicable laws, rules, or regulations, to participate in and control their defense. Customer shall provide
reasonable assistance and information to the Government, DOE, HMIS, and their agents and other
persons acting on their behalf to support their defense. To the extent that Customer and Customer's
Personnel are covered by the Washington Industrial Insurance Act (R.C.W. Title 51) or any other
industrial insurance, workers compensation, or similar act, Customer specifically waives any and all
immunity provided under these acts and their regulations and rules related to the Customer's
indemnification obligation set forth in this paragraph.
ENTIRE AGREEMENT
This Agreement constitutes the entire contract between the parties and supersedes any other promises,
agreements, or written correspondence. This Agreement cannot be amended and no provision can be waived
except by an instrument in writing duly executed by each of the parties.
AUTHORITY, ADMINISTRATION, AND TRANSFER
It is understood and agreed that this Agreement is entered into by HMIS in its role as prime contractor to DOE
and that (i) HMIS is authorized to and will administer this Agreement for DOE; (ii) administration of this
Agreement may be assigned by HMIS to DOE or its designee upon written notice to Customer; and (iii) in case
of such assignment and notice thereof to Customer, HMIS shall have no further responsibility hereunder.
STATEMENT OF WORK
The EVOC Training Center at Hanford Patrol Training Academy will provide the City of Yakima access to the
Emergency Vehicle Operations Course (EVOC) Skills Pad, Track and Trailer on June 23 and July 23, 2021.
Provide access and oversight to the props listed below:
Prop/Building
Dates
Emergency Vehicle Operations Course
(EVOC) Skills Pad, Track and Trailer
June 23 and July 23, 2021
COST ESTIMATE
The estimated price for this training is below. Please refer to the attached estimate for details
Total Due
$396.49
Price excludes 3% DOE-RL federal administrative adder. The use of the facility and associated services are
subject to the referenced letter agreement terms and conditions.
PAYMENT
Payment will be sent to the following address
Hanford Mission Integration Solutions
Attn: Cashier H3-09
PO Box 943
Richland, WA 99352
TERMINATION/CANCELLATION POLICY
Either party may terminate this Agreement for any reason at any time by giving not less than 14 days prior
written notice to the other party; provided, however, that DOE reserves the right to immediately terminate this
Agreement without regard to the aforesaid written notice when termination of this Agreement is determined to
be in the best interests of the Government. Termination shall only affect the term of this Agreement and shall
otherwise be without prejudice to the rights of either party.
Customers canceling 10 working days or more prior to scheduled dates of facility use will be able to obtain a
100% refund of monies paid, less any costs incurred specifically in support of customer requirements.
Cancellations of less than 10 working days but 5 or more will result in a refund of 50% less incurred costs
Less than 5 days will result in no refund.
DAMAGE POLICY
Per the Washington Comparative Fault Statute (R.C.W. 4.22), parties are responsible for personal injury and
property damage they may cause during the use of HAMMER and/or the Patrol Training Academy.
NOTICE
Any notice required under this Agreement shall be given to the following parties verbally or in writing:
IN WITNESS WHEREOF, the parties hereto have executed this Agreement effective as of the date and year
first written above.
Signature
HANFORD MISSION INTEGRATION SOLUTIONS
Approved via email
Signature
Nicole Zawadzki
Name (print) Name (print)
k1 r4(, r
Title
r`kijtet�31 ?
5 Dc05-1 - (0
For HAMMER Director
Title
Date
(509) 376-5502/ nicole,,slawadzki( rl.gov
hone/Email Phone/Email
1T N `�-'�r` . L t .iY, 0,14
Mailing Address
CITY CONTRACT NO: h '
FtZ�,,,.UTIUN NO:_
Nicole Zawadzki
Hanford Mission Integration Solutions
P.O. Box 1000 (G5-51)
Richland, WA 99352
Statement of Work
FY 2021 Law Enforcement EVOCTraining
at Hanford Patrol Training Academy (PTA) All Vehicles
General
All vehicles used at the EVOC shall be police or law enforcement vehicles; no private vehicles authorized.
Any reference to vehicles means police vehicles.
Deliverables
HAMMER/Ha nfnrd Training Center will:
As requested by the PTA EVOC Program Manager(PM), in HFACTS complete and submit a Customer
Requirements Form (CRF) to reserve the EVOC skills pad, track and trailer for the training dates agreed
to by the PTA EVOC PM and the Law Enforcement Customer's Point of Contact (LE POC).
Prepare and submit required contracting documents (e.g., Service Agreement and a Cost Estimate) to
the LE POC and others, if/as required.
Give copies of any required documents to the LE POC for review and approval. Ensure paper copies of
the aforementioned documents are maintained on file, including those that have been signed
(approved) by the LE POC.
The Hanford PTA will:
Unless pre -approved by the Commandant, PTA, allows only one agency at a time to use the EVOC.
Confirm the LE POC wants his/her department personnel trained to the PTA's approved EVOC lesson
plant and not to a variation of same, e.g., one that has been modified, tweaked, revised or otherwise
changed.
Confirm the LE EVOC Instructors are certified for the type of vehicles the agency will bring to the
training.
Ensure only vehicles authorized for use on EVOC by Hanford PTA are used during the training event.
Have the HAMMER LE PM reserve the EVOC skills pad, trackand trailer for the training dates agreed to
by the PTA EVOC PM and the LE POC.
Complete and submit/file the required HAMMER approval paperwork.
Provide the LE Customer's personnel access to the EVOC classroom and props as scheduled.
Provide the initial PTA/EVOC facility training/safety briefing/orientation to EVOC LE POC before training
commences.
1 All PTA lesson plans are required to be reviewed and approved by the Hanford Patrol Protective Force Safety Organization to ensure the
training can be conducted in compliance with applicable hazard analysis (reference SAS-7321, Hazards Analysis Procedure) and PTA facility,
training, safety and environmental requirements.
Statement of Work
FY 2021 Law Enforcement EVOCTraining
at Hanford Patrol Training Academy (PTA)All Vehicles
Provide certification and recertification of LE POC EVOC instructors (Certification is per the Washington
State Criminal Justice Training Center Requirements for EVOC Insructors).
Ensure training conducted per the PTA's approved EVOC lesson plan.
LE Customer POC will:
Submit the EVOC training request to the PTA EVOC PM and confirm department personnel are to be
trained to the PTA's approved EVOC lesson plan and not to a variation of same, e.g., one that has been
modified, tweaked, revised or otherwise changed.
Upon receipt of required contracting documents (e.g., Contract Service Agreement), review and approve
(sign/date) if acceptable then return them to the HAMMER LE PM. If not acceptable, work with the PTA
EVOC PM and/or the HAMMER LE PM to resolve the issue(s).
Ensure that department personnel who are to be trained complete the PTA/EVOC facility training/safety
briefing/orientation before training commences.
Ensure department personnel are trained in accordance with the PTA's approved EVOC lesson plan.
During the period of his/her department's EVOC reservation, deny EVOC use to other external agencies
unless prior approval is granted by the Commandant, Hanford Patrol Training Academy.
Will ensure that their EVOC instructors recertify every two years or sooner as needed.
Will ensure PTA approval for any vehicles not previously authorized for use at the EVOC.
Contacts:
HMISTech POC: Mick,J. Thompson
(509) 376-4686 - Office
(509) 366-1431- Cell
m j mick thompson@rl.gov
HMISFinance POC:
Vanessa Pulido
(509) 205-2317 - Cell
vanessa n pulido@rl.gov
�r COST ESTIMATE PROPOSAL
p.. �,. HMIS - FY21
Version 0
t woo. Request No
3 CACN
4. VVBS
A. GENERAL INFORMATION
Title
Prepared by
Date
EVOC Clity of Yakima
Linda Liikala (509) 372-0742
3/16/2021
Requestor
Company
Technical POC
Financial POC
City of Yakima
Jim Yates (509) 575-6250
Jim Yates (509) 575-6250
Performer
0rg. Title
Technical POC
Financial POC
HMIS
Mick Thompson (509) 376.4686
Vanessa Polido (505) 205.2317
Performance Dates
Begin:
6/23/2021
End:
7/23/2021
Total Estimated
Contract Value
Funding
Available Uncosled
Balance (Inc prior year)
Estimated Funding
Requ. From Customer
$ 396.49
$ -
$ 396 49
B. DETAIL DESCRIPTION OF COST ELEMENTS
ID. Direct Labor
Estimated Hours
FY2021
Estimated Cost
($) FY2021
Total Estimated
Hours
Total Estimated Cost
($)
Cost Center
COCSIDesenption
TOTAL DIRECT LABOR
$ _ -
$ -
1. Material
Calculate SPEF L NO
$ -
$ -
2. Subcontracts
5 -
$ -
3 Other Direct Costs
$ -
5 -
4. Other Originated Costs
$ -
$
TOTAL
$ -
$ -
5 Revenue 1 Calculate HAMMER Adder
NO
5 356 44
6 366.44
13 Overhead Allocations SUB and Direct Cost Adder
FY21 0.H. RATE %
FY2021 x BASE
TOTAL DCA COST
Content/Records
Management
IH0722
21.5%
$ -
$ -
$ •
Janitorial
IHE240
22.8%
$ -
$
S •
Maintenance
IHD220
50.5%
$ -
$ -
$ -
Transportation
IHE210
34.8%
$ •
$ •
$ .
Software Engineering
IHH230
18 7%
$ -
$ -
$ -
I
TOTAL DIRECT LABOR ADDER
5 -
$ -
TOTAL BASE COST (Total Wilms 1 through 5)
$ 366 44
$ _ 366.44
7 General and Administrative 1 FY21 Rate:I 8 20%I
$ 30 05
$ 30 05
TOTAL ESTIMATED COST
$ 396.49
$ 396.491
8. Proposed Fee (see instructions'
Rate' 7.0%, RFSs ONLY
Fee Applicable? (Yes / No) L NO
Fee is calculated below by element of cost
Estimated Cost Total Estimated
($) FY2021 Cost ($)
Labor Fee Adder
0
$ -
Non Labor Fee Adder
0
$ -
TOTAL ESTIMATED FEE
$ -
$ -
9 TOTAL ESTIMATED COST PLUS FEE TO RE:UESTOR
S 396.49
$ 396.49
10. Federal Adminlslrallon Charge (FAC) f NO f Rate€ 3.00%1x Item 9
0
$ -
TOTAL ESTIMATED CONTRACT VALUE (Cost plus fee if applicable)
$ 396.49
$ 396.49
Other -Revenue Estimate
FY2021
Resource
Basis Of Estirnste
January
February
March
April
May
June
July
August
September—FY2021
Total
134-EVT-Emergency Vehicle Oper Revenue
IEVUU 2=Day (June 23 2k July ZJ,
2021)
183.22
183 22
1
$ 366.44
APPENDIX B
To Service Agreement No. CRF 6807-017
With City of Yakima
June 23 and July 23, 2021
Volpentest HAMMER Federal Training Center/Patrol Training Academy
GENERAL RELEASE AND INDEMNIFICATION
U.S. Citizens
I, the undersigned, expressly acknowledge that my participation in the Volpentest HAMMER
Federal Training Center (HAMMER)/Patrol Training Academy (PTA) training activities may expose
me, either directly or indirectly, to certain hazards inherent in the transportation to, viewing of,
and participating in the operation of training props and demonstrations. Such hazards may give
rise to personal injury, including death, or property damage or loss.
I have been informed and understand that Hanford Mission Integration Solutions, LLC (HMIS)
and the U.S. Department of Energy (DOE) do not provide accident, health, medical, disability, or
other types of insurance for the protection of those who participate in the HAMMER/PTA
training activities. Furthermore, I understand that it is recommended that I have a medical
insurance policy in effect during my participation.
I certify that if I have any reason (physical, medical or otherwise) which would impact my ability
to participate in this training, I will advise HAMMER/PTA staff of my condition and follow
instructions given me by HAMMER/PTA staff.
In consideration of the privilege of participating in HAMMER/PTA training activities, the
undersigned, for myself, my heirs, administrators, executors, successors, representatives, and
assigns, do hereby knowingly, willingly, and voluntarily assume any and all risks of accident,
personal injury, or property damage to myself and to my property consistent with the State of
Washington Comparative Fault Statute (R.C.W. 4.22). I agree to now and forever release, acquit,
discharge, indemnify, and hold harmless HMIS and DOE, their officers, officials, directors,
representatives, agents, employees, and contractors, from and against any and all claims, loss,
causes of action, suits, cost or expense forany and all personal injury, death, or property
damage arising directly or indirectly from my participation in HAMMER/PTA training activities.
Participant's Signature
Participant's Name (Print)
Organization, Company, Affiliation (Print)
5/26/21
Date