"Solid Waste Facility Standby Trust Fund Amendment" - Florida

Solid Waste Facility Standby Trust Fund Amendment is a legal document that was released by the Florida Department of Environmental Protection - a government authority operating within Florida.

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Download "Solid Waste Facility Standby Trust Fund Amendment" - Florida

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SAVE
PRINT
CLEAR
Mail duplicate original to:
Solid Waste Financial Coordinator
Florida Department of Environmental Protection
2600 Blairstone Road MS 4548
Tallahassee, Florida 32399-2400
AMENDMENT
Amendment to the State of Florida Solid Waste Facility
Agreement entered
Enter “Trust Fund” or “Standby Trust Fund
into as of
by and between
,
Date of Agreement
Owner or operator
the Grantor, and
, the Trustee,
Financial Institution Name
for account number
Enter “N/A” if pooled account or no acct. no. assigned
*
This amendment changes
.
This amendment is executed on
and is to be attached to the original agreement.
Date
This amendment will become effective upon FDEP approval.
GRANTOR
TRUSTEE
Name of Owner or Operator (Permittee)
Name of Corporate Trustee
Authorized Signature for Grantor
Authorized Signature for Trustee
Type Name and Title
Type Name and Title
Telephone Number
Telephone Number
E-mail Address
E-mail Address
Signature of Witness or Notary
Date
Printed Name of Witness or Notary Seal
__________
*
- Removal of a facility from a standby trust fund or trust fund agreement, in accordance with FDEP regulations, requires prior
written permission from the FDEP Tallahassee Office. Authorization will be addressed to the Trustee and will specify agreement
by date.
SAVE
PRINT
CLEAR
Mail duplicate original to:
Solid Waste Financial Coordinator
Florida Department of Environmental Protection
2600 Blairstone Road MS 4548
Tallahassee, Florida 32399-2400
AMENDMENT
Amendment to the State of Florida Solid Waste Facility
Agreement entered
Enter “Trust Fund” or “Standby Trust Fund
into as of
by and between
,
Date of Agreement
Owner or operator
the Grantor, and
, the Trustee,
Financial Institution Name
for account number
Enter “N/A” if pooled account or no acct. no. assigned
*
This amendment changes
.
This amendment is executed on
and is to be attached to the original agreement.
Date
This amendment will become effective upon FDEP approval.
GRANTOR
TRUSTEE
Name of Owner or Operator (Permittee)
Name of Corporate Trustee
Authorized Signature for Grantor
Authorized Signature for Trustee
Type Name and Title
Type Name and Title
Telephone Number
Telephone Number
E-mail Address
E-mail Address
Signature of Witness or Notary
Date
Printed Name of Witness or Notary Seal
__________
*
- Removal of a facility from a standby trust fund or trust fund agreement, in accordance with FDEP regulations, requires prior
written permission from the FDEP Tallahassee Office. Authorization will be addressed to the Trustee and will specify agreement
by date.