Guided Technical Scuba Diving for the Overton B-29 Site

COMMERCIAL USE AUTHORIZATION – PART 2: CATEGORY-SPECIFIC FORM Page 1 of 5

Application Checklist: CATEGORY SPECIFIC FORM GUIDED TECHNICAL SCUBA DIVING FOR THE OVERTON B-29 SITE

APPLICATION FOR A COMMERCIAL USE AUTHORIZATION U.S. DEPARTMENT OF THE INTERIOR

Lake Mead National Recreation Area

Please type or print in ink. Answer all questions completely or mark “N/A” if not applicable

1. APPLICANT’S NAME (as stated in Application Form):

______

2. AGREEMENT WITH TERMS AND CONDITIONS OF CUA:

A copy of the CUA for guided technical scuba diving in and around the area of the Overton B-29 Site within Lake Mead National Recreation Area is in the application form. Applicants should carefully review these terms and conditions, as they set out the CUA holder’s rights and obligations in the event that a CUA is issued.

Applicant’s signature at the end of this checklist form evidences the Applicant’s agreement, if selected for issuance of the CUA, to (1) accept the terms and conditions applicable to the CUA for which the Applicant is applying and (2) accept any issued CUA in writing no later than thirty working days after that CUA is issued by the National Park Service.

Applicant Initials: ______

3. REQUIRED SUBMISSIONS: Provide each of the following items and check to indicate the item is attached or otherwise enclosed with the application checklist(please note, item number 10 is not sent in with application but is submitted only when CUA is awarded):

1/17/2015 Page 1 of 5 Required Submission Checklist (1 Diver Certifications: For each proposed dive guide provide Copies of certification cards ) copies of: attached a) a valid nationally recognized certification card for technical diving and b) a valid nationally recognized certification card for divemaster,

(2 U.S. Coast Guard License: If any operation will be conducted Copy of U.S. Coast Guard ) from a vessel, provide for each and every boat operator a copy License of a valid U.S. Coast Guard license. Either an Operator Uninspected Passenger Vessel license (OUPV) or a Master’s License may be provided. Note: In order to obtain this license, please contact the Coast Guard directly at 619.278.7241. The closest office is in San Diego, California.

(3 Client Orientation: Submit an outline of the client orientation Outline Attached ) that it will provide. At a minimum, the orientation must cover: (a) Mission (a) National Park Service mission: to preserve unimpaired the natural and cultural resources (b) Practices and values of the national park system for the enjoyment, (c) Hazards/Safety Issues education, and inspiration of this and future generations. (b) Practices to be followed that will protect the resources while diving at Lake Mead NRA. (c) General description of hazards/safety issues (such as inclement weather and winds) associated with Lake Mead National Recreation Area.

(4 Operating Plan: Submit an Operating Plan. All Operating Operating Plan is attached and ) Plans will be reviewed by NPS for compatibility with the includes: guidelines for commercial services, interpretation, and resource protection at Lake Mead NRA. CUA’s will not be issued and (a) Service Explanations trips must not begin until the Operating Plan has been approved. The CUA Holder will be required as a condition of (b) Proposed Itinerary the CUA to comply with the approved Operating Plan.

(c) Group Size The Operating Plan, at a minimum, should include: (a) Explanation of services to be provided. (d) Guide Qualifications (b) List of proposed itinerary (e) Environment Outline (c) Average and maximum size of group(s) including crew. (f) Safety Procedures (d) List of dive certifications and copies of individual dive guide qualifications (must be current). (g) Resource Protection

(e) Outline of environmental and cultural resource education (h) Emergency Procedures information that will be provided to your clients (in addition to the materials issued to you by the NPS). (i) Dispatch contact

1/17/2015 Required Submission Checklist (f) Safety and/or sanitation precautions/procedures that apply to your service (including contacting Lake Mead dispatch before and after every dive on the B-29 Site) .

(g) Resource preservation and protection measures.

(h) Explanation of the procedures to be taken in case of accidents or other emergencies.

(i) Contact Lake Mead dispatch before and after every dive on the B-29 Site

One of the three factors evaluated to determine application ranking. The operating plan will be used to evaluate resource protection and the ability to operate safely and ability to interact effectively with NPS. The operating plan will be reviewed for completeness and to ensure that procedures are clearly defined. The operating plan will be scored based on the following point system: 0 = not complete 1 = all components included but procedures not defined or not included 2 = all components included; basic procedures were provided that outlined resource protection, safe operations, and effective interaction with NPS 3 = all components included, all procedures fully defined and include complete process

(5 Rate Schedule: Provide rate schedule for services that the Rate Schedule Attached ) Applicant proposes to offer through the CUA.

(6 Insurance: Provide copies of current Certificate of General (a) Certificate ) Liability Insurance, Dive insurance, Land Transportation of General Liability Liability Insurance, (if applicable) and Workers’ Compensation (b) Dive Insurance required by the attached CUA.. Certificates of Insurance insurance for the general liability and any land transportation (c) Certificate of Land liability insurance must include an endorsement listing the Transport Liability (if United States of America as an additional insured applicable) (d ) Certificate of Workers One of the three factors evaluated to determine application Compensation Insurance ranking. Insurance will be used to evaluate the ability to operate safely and appropriately protect employees and visitors. Insurance certifications will be reviewed to ensure that applicants have the appropriate coverage that includes all requirements of the solicitation. Insurance will be scored based on the following point system: 0 = no certificates 1 = some applicable certificates but not complete or

1/17/2015 Required Submission Checklist expired 2 = all required certificates; all required elements of insurance

(7 Qualifications and Experience of Key Personnel: Provide Resumes ) resumes of key individuals who will carry out management and operations under the CUA (8 Experience and Past Performance: Submit a description of Description of experience and ) Applicant’s experience similar to the commercial services to be past performance authorized by the CUA. Include examples of relevant past performance, including in working in remote and protected or environmentally sensitive areas and in using environmentally acceptable methods.

One of the three factors evaluated to determine application ranking. Experience will be evaluated by subject matter experts and will be utilized to evaluate both resource protection and ability to operate safely. Certifications submitted by each applicant will be reviewed and evaluated to ensure that applicants have the appropriate training and underwater experience to safely dive the site and the qualifications to guide visitors during the dive. Experience will also be reviewed to evaluate resource protection practices by determining the type and level of prior experience diving on sensitive cultural resource sites. Experience will be scored based on the following point system: 0 = not qualified 1 = qualified 2 = highly qualified

(9 Application Fee: A non-refundable application fee of $100 is Check for $100 – Application ) due with the application packet. Note: Fees may be paid by fee cashier’s check, certified check or money order and should include the applicant’s employer identification number and be made payable to the National Park Service

(1 Administrative and Monitoring Fees: The Administrative and Check for $880 – 1st year 0) Monitoring Fee for the first year of this two year CUA is $880. Administrative and Monitoring The second year annual fee will be determined in Fall 2013, fee when you will be notified of the second year permit fee. The CUA second year permit fee will be due 12 months after the Do not send in with initial initial issue date of this CUA. Do not send the administrative application. Submit after and monitoring fee with the initial application, this fee is due CUA issuance notification upon selection. Failure to pay this fee with the required written acceptance no later than thirty working days after the CUA is issued by the National Park Service, will render the

1/17/2015 Required Submission Checklist application null and void. Note: Fees may be paid by cashier’s check, certified checks or money orders and should include the applicant’s employer identification number and be made payable to the National Park Service.

4. SIGNATURE:

False, fictitious or fraudulent statements of representations made in this application may be grounds for denial or revocation of the Commercial Use Authorization and may be punishable by fine or imprisonment (U.S. Code, Title 18, Section 1001). All Information provided will be considered in reviewing this application. Applications signed by an agent must be accompanied by evidence of that agent’s authority.

By my signature, I hereby attest that all my statements and answers on this form and any attachments are true, complete, and accurate to the best of my knowledge.

______Signature Date

______Printed Name

______Title

1/17/2015