HomeMy WebLinkAboutC14-205 Innovative Readiness Training Request for Military Assistance Office of the Assistant Secretary of Defense
Reserve Affairs
1500 Defense Pentagon
Washington,DC 20301-1500
INNOVATIVE READINESS TRAINING
REQUEST FOR MILITARY ASSISTANCE
This application is to be used by all civil organizations or governmental agencies
requesting Civil-Military Innovative Readiness Training(IRT) support as authorized by
section 2012 of Title 10,United States Code. Applications are to be mailed to:
OASD/Reserve Affairs
Attn: IRT Director
1500 Defense, Pentagon
Room 2E573
Washington, DC 20301-1500
All IRT applications for support will be reviewed for completeness and eligibility. The
applications will be forwarded to the Service IRT Program Managers and the Services
will review the event for unit and individual training opportunities. The Services will
forward a request to support the training event to the Office of the Assistant Secretary of
Defense for Reserve Affairs (OASD/RA) for final review and approval. It is imperative
that the information provided by the requesting official(s)be accurate and complete. A
requesting official is an individual who submits the request and can sign contracts or
commit funds and resources on behalf of the requesting organization. Specific
information related to medical (Attachment A), engineering(Attachment B), and
transportation and dive (Attachment C) training events must be included with this
application. Complete the additional documents as appropriate for the training event.
Any additional letters, documents,maps that would provide more information or details
to the proposed training event also should be attached to the application as appropriate.
Any request for support that will exceed one year must submit an annual request for
military participation with all supporting documentation. The application must be
completed annually for the length of the training event.
Please include copies of documents listed below with this application:
1. 501 C3 letter-required for non-profit organization request, must not be more
than 10 years old
2. Articles of Incorporation
3. By-laws
4. Copy of newspaper ads which were published twice on two separate dates.
State/Federal/local government entity to use their required process to advertise
for this training event; ie: advertisement in FedBizOpps or contract ads. Ad
must be published annually for the length of the training event.
5. Affidavit of publication(annual requirement for the length of the training
event)
6. Environmental study if appropriate
7. Statement of non-competition(Attachment D)
8. Release of liability(Attachment E)
Organization/Community IRT application effective 29 May 2012
9
The execution of any approved IRT training event is contingent upon the
availability of funding and DoD resources.
1. Name of community, agency, State or Federal entity requesting military support:
Eagle County, Colorado, a body corporate and politic
1 a. Is the requesting agency/organization a military entity, either State or Federal, active,
reserve or Guard?
Yes No X
lb. Is the requester a non-profit organization or entity other than city, state, federal
entity?
Yes No X
If the answer is yes, attach a copy of the articles of incorporation, 501C3 letter,
and organization by-laws with this application.
2. Address of requesting organization:
Eaglet County- 800 MHz
P.O. 113ox 850
City Eagle State Colorado Zip 81631
3a. Will this training event take place at a location different from the address listed
above?
Yes X (see attached map) No If yes, include address in block
below.
39° 3i' 38.81"N- 106° 51' 37.35"W at an elevation of 7015 feet.
City I Gypsum State Colorado Zip 81637
3b. toes the requestor have ownership of real estate or real property where this training
is to take place? Yes No X Property owned by U.S. Bureau of Land
Management_
4. Will this training event take place on a state or federal military installation,post, fort,
base r other facility or property operated/leased/owned by or housing a federal or state
milit ry service or component?
es No X
Organiation/Community IRT application effective 29 May 2012 2
5. Information for requesting official submitting request for support:
Name: Keith Montag
Title: County Manager
Phone number: (970) 328-8605
Email address: keith.Montag @eaglecounty.us
I have authority to enter into a binding agreement/MOU/MOA on behalf of the agency I
represent:
Yes X No
I have authority to commit resources or funds on behalf of the agency I represent:
Yes X No
6. Check which community facilities are available (at no expense) for use by military
during the training event.
Guard city community airfield clinic school office
armory hall center hangar 1/ trailers
offices
Other:
7. What contributions or resources will be provided by the requesting organization to
assist this proposed IRT training event? Place an"x"next to each that applies.
Lodging Computer/internet access transportation
Meals d Telephone access Construction supplies
Office space Fax machine Building materials
7a. Other assistance/financial/facilities provided by the requesting agency/community:
1)Fuel reimbursement
2)Agreement w/U.S. Bureau of Land Management
3) Closure of drop sites for duration of the mission to ensure public safety
4) Ground support @ delivery sites
Organization/Community IRT application effective 29 May 2012 3
8. What other funding/support is being contributed to this training event?
Fed/State/Local/Private Department Amount of Amount of actual
funding appropriated
Requested funds/date appropriated
Example- Local 800 MHz $5,000 $5,000
January 1, 2014
9. Specify and explain three prioritized time frames for the requested IRT support.
TIME FRAME REASON FOR SPECIFIC TIME PERIOD
Summer or early Fall 2014 Snow and access
9-12 Sep 2014 Not drill weekend for the unit
10. [Describe any special events/holidays/activities/or local issues that may be ongoing
during the training period. Include any situations that the military should be aware of that
may impact their activities in the community.
Labor Day Weekend (29 Aug— 1 Sep 14)
Drill weekend is 6 &7 Sep 14
Organzation/Community IRT application effective 29 May 2012
4
11. What is the projected length of time needed to complete this training event?
2 days depending on logistics and schedule
12. Federal, state, city engineering training events -has this training event been listed
on the federal/state/county/city websites for engineering projects and advertised
according to federal/state/county/city contract law or the contract bid process?
Yes_X_ No This is an annual request for the length of the event.
If no, please attach an explanation to why this process was not completed.
All training events-Please include the public notice ads that were placed in the
newspaper for the minimum state required time for public notices.
Attach a copy of the ads and notarized affidavit stating the ads were published and
what was the response to the ads. If this is a multi-year event, a new ad must be
published annually.
12a.
Place of advertisement Date advertised
• Eagle Valley Enterprise May 15, 2014 &May 22, 2014
13. Is the requested support available from a commercial entity? Yes No X
A negative response means there are no contractors or companies in the area/community
of the training event that conduct this type of business.
13a. If services are available from a commercial entity,has the official submitting this
request received a"certificate of non-competition" from the commercial entity that would
otherwise provide such services? Yes No
If applicable, attach a copy of the "certification of non-competition".
Organization/Community IRT application effective 29 May 2012 5
14. Has this training event been presented to any of the following entities: provide name
beneath title if applicable.
US Snator Governor State Senator City Mayor
US Congressman State TAG State Representative other
15.Remarks (attach additional sheet if necessary)
Keith Montag
Printc;d name of requesting official/civil authority
_ -411111PiX
ature of requesting official/c' authority
Date: 5//y /V
Mail ttpplication to:
OASIS/Reserve Affairs
Attn: 'IRT Director
1500 befense, Pentagon
Room 2E573
Washington, DC 20301-1500
Organization/Community IRT application effective 29 May 2012
Attachment A
Medical Support Request
The Civilian Health Organization (CHO) or community/city/state/federal entity
shall conform to all applicable federal, state, and local laws that regulate healthcare
delivery within the state or territory, and all state laws and regulations specific to
the non-DoD healthcare professionals participating.
1. Identify the CHO supervisor overseeing the medical training:
Name:
Title:
Email:
Phone:
2. The CHO/community/city/state/federal entity verifies and documents who will be the
responsible individual at each location as follows:
Medical waste handling and disposal Name:
Email:
Clinical Laboratory Improvement Act(CLIA) Name:
Email:
Credentialing or privileging or military health Name:
care providers to include basic life support, and
if applicable, advance trauma/cardiac Email:
requirements (strictest requirement applies)
Initial emergency evacuation plan for a"real Name:
life incident"
Email:
Follow-up care plan for patients for continuity Name:
of care
Email:
Plan for handling of patients' records for Name:
continuity of care and privacy act issues
Email:
Organization/Community IRT application effective 29 May 2012 7
II
3. Lift the communities in which this training is expected to take place. Additional space
is profrided at the end of this attachment.
Comriunity Nearest City State Population Most needed medical
support(dental,medical,
optometry, veterinary,
behavioral health)
Use initials D, M, 0, V, B
for each need in the
community.
a.
b.
c.
d.
e.
f -
4. Closest medical treatment facility with trauma/emergency room:
Name/location:
5. The CHO shall certify that this medical training:
a. Accommodates an identified underserved healthcare need that is not being met
by current public or private sector assistance. Please provide a
description of the criteria used to identify the medically underserved
community.
}
Organiiation/Community IRT application effective 29 May 2012 8
6. Please place an"X"beside each specialty service that is requested: this is a
preliminary request that can be updated at the initial training planning conference. Blank
space for other specialties not listed.
Projected Projected
case load case load
General dentistry Rheumatology
Oral surgery Family practice
Pediatric dentistry Ob-Gyn -
Endodontist Physician Assistants
Periodontist Nurse practitioners
Dental hygienist Physical therapists
Endocrine Nutritionists
General dentistry Behavior health
Oral surgery Ob-Gyn
Family practice Physician Assistants
Pediatrics Optometry
Internists Eye glasses
Surgeons Veterinary
Anesthesiology CPR certification
Colonoscopy Drug demand reduction
Colposcopy
7. Have any of the communities stated in the previous section ever received past medical
support from the military? If so, state which community,what type of support, when it
occurred and the length of time the military was in the community.
M=medical D=dental V=veterinary 0=optometry B=behavioral health
Community Type of support Dates of Length of time in the
medical support community
a.
b.
c.
d.
e.
Organization/Community IRT application effective 29 May 2012 9
8. Additional Comments or medical support requests:
fr
9. The CHO shall certify that this medical training is provided in a manner that does not
complete with private sector medical/dental/healthcare assistance in the underserved area.
Signature:
Title:
Email:
Phone:
Organization/Community IRT application effective 29 May 2012 10
Attachment B
Engineering Training Event:
1.
Location:
Type of engineering training: Vertical (buildings) Horizontal (roads)
Description of training event:
2. Training specifics: other items already completed should be added to the list or
attached as addendums to this application.
Descriptive Completed by Date Date to be Not
requirements requesting entity- on completed completed applicable
file and submitted with
this request
Environmental study
Land use permits
Blue prints/design
City building permits
Right of way permits
Training timeline
Organization/Community IRT application effective 29 May 2012 11
3. PI ase place an"X"beside each service that is anticipated to be needed in completing
this t aining: this is an initial estimate of the work to be done. The military will assess
the tr ining and make assignments as needed at the initial planning conference.
Electricians Project management Water purification
Plumbers Truck drivers Fuel farm
Carpenters Steelworkers Maintenance facility
Brick layers Welders Other:
Heavy Equipment operators Warehousemen
4. Has your organization ever received past engineering support from the military? If so,
state which community, what type of support, when it occurred and the length of time the
military was in the community.
Com$nunity Type of support—brief project Dates of Length of
description engineering time in the
support community
a.
b.
c.
5.
Additional Comments:
Organization/Community IRT application effective 29 May 2012 12
Attachment C
Transportation/Dive Training
1. General transportation or diving requests: Describe the transportation or diving
request. Additional comments can be attached to this document.
2. Dive training: annotate availability of the below items:
Mooring permits Pier permits
Access to fuel from pier Is USCG aware of training? Yes_ No_
City/community permits Equipment storage facility
Parking Source of power/electricity
Potable water source Meeting room/office space
3. Describe any other transportation or diving issues not addressed in the previous two
questions.
Organization/Community IRT application effective 29 May 2012 13
Attachment D
Statement of Non-Competition
The Iltinovative Readiness Training(IRT) Event Public Safety Radio building flight
(name of event) located in Eagle County, Gypsum area, (city)
Colorado (state) for Fiscal Year 20_14 , would not compete with the
services offered by civilian companies/vendors/entities or private providers. For the
reasoltis set forth below the requested IRT assistance is not reasonably available from
a commercial entity.
On two occasions, (date) ? MAY 2014 and (date) ? May 14 an
advertisement for the services/training to be performed by the military has been
advertised in(name of publication) ** Newspaper
name ** consistent with the requirements of the IRT
Program and the rules, if any, of the requesting organization. Copies of each
advertisement are attached to the application.
No responses have been received by the designated deadline specified in the
advertisements, and this organization has received no objection to the military
participation in this training.
Printed Name: Keith Montag
Signa*ure:
Title: County Manager
Organization: Eagle County
Phone: (970)328-8605
Date:
Organiation/Community IRT application effective 29 May 2012 14
Attachment E
RELEASE AND HOLD HARMLESS AGREEMENT
The Eagle County, Colorado, a body corporate and politic (name of requesting
organization) located in Eagle,Colorado (city/state)
agrees that its request that DoD military personnel conduct an Innovative Readiness Training
(IRT)mission in support of Eagle County 800 MHz Department
(organization) during fiscal year 20 14 is subject to the following conditions:
1. The DoD IRT military support will be limited to that which is approved by the
Department of Defense. Support that has not been previously approved will not be
provided; IRT mission personnel may not perform activities beyond those previously
approved.
2. Support shall be limited to providing personnel and equipment only.
3. All DoD military personnel and equipment will remain under the control and supervision
of the officer or noncommissioned officer responsible for the military unit tasked to
provide the IRT support.
The Eagle County, Colorado, a body corporate and politic (name of the requesting
organization),in exchange for the DoD IRT military support, also agrees, on behalf of itself and
its agents,to:
1. Release the DoD,its subordinate units, its officers,military personnel, employees, agents,
and servants from any claim,demand, action, liability, or suit of any nature whatsoever
for or on account of any injury, loss,or damage to the requesting organization and its
agents arising from or in any way connected with the DoD military personnel support,
excluding,however,any injury, loss, or damage arising solely from the intentional torts
or gross negligence of the DoD military personnel or its agents.
2. Indemnify, defend and hold harmless the DoD,its subordinate units,officers,military
personnel, employees, agents, and servants from any claim, demand, action, liability,or
suit of any nature whatsoever for or on account of any injury, loss, or damage to any third
person or third person's property arising from or in any way connected with the DoD IRT
military support, excluding,however,those arising solely form the intentional torts or
gross negligence of the DoD military personnel or its agents.
With full understanding of the conditions and agreements state above,the undersigned
representative,who is authorized to execute this document which is binding on his organization
and all assigns,heirs, executors,beneficiaries,and derivative claimants,hereby executes this
release of liability and hold harmless agreement. '
Printed name: Keith Montag Date: /'5-A";/',"Signature: .�:�'��� ///
Title: County Manager Organization: axle County,Colorado, a body corporate and
politic
Organization/Community IRT application effective 29 May 2012 15
May 9, 2014
To Whom It May Concern:
Eagle County Government is soliciting support from the Colorado National Guard.The support involves
transportation of a pre-fabricated Public Safety Radio equipment building from the Eagle County
Regional Airport to a ridge top location near the East Beacon tower site. Local contractors who have
questions or wish to voice opposition of National Guard assistance to Eagle County Government may
contact the Emergency Management Director at 970-328-3545.
