"Surety Bond for Recycling Facility/Containment" - New Mexico Download Pdf
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"Surety Bond for Recycling Facility/Containment" - New Mexico

This "Surety Bond for Recycling Facility/Containment" is a document issued by the New Mexico Environment Department specifically for New Mexico residents with its latest version released on July 1, 2016.

Download the up-to-date fillable PDF by clicking the link below or find it on the forms website of the New Mexico Environment Department.

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Download "Surety Bond for Recycling Facility/Containment" - New Mexico

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7/16
State of New Mexico
Energy, Minerals and Natural Resources Department
Oil Conservation Division
(File with Oil Conservation Division, 1220 S. St. Francis Dr., Santa Fe, New Mexico 87505)
Surety Bond for Recycling Facility/Containment (“Bond”)
KNOW ALL MEN BY THESE PRESENTS:
Name of Operator (“Operator”):
Operator’s Address:
State in which Operator is Organized:
Operator’s OGRID Number:
Name of Surety Company (“Surety”):
Surety Company’s Business Address:
Bond Number:
Effective Date:
Required Financial Assurance (“Financial Assurance”):
WHEREAS, Operator, authorized to do business in the State of New Mexico, and Surety, authorized by the
Superintendent of Insurance to do business in the State of New Mexico, pursuant to NMSA 1978, Section 70-2-12, as
may be amended from time to time, are, jointly and severally, firmly bound to the State of New Mexico’s Energy,
Minerals and Natural Resources Department (“Department”), or its successor, for payment of the amount of the
Financial Assurance indicated above.
WHEREAS, Operator has or may enter into the collection, treatment, storage, recycling, or re-use of
produced water in Section
, Township
, Range
, NMPM,
County, New Mexico
( "Facility").
WHEREAS, Surety has been advised that Operator has requested this Bond as security for Operator’s
compliance with all laws, rules, and orders, as they exist now or may exist in the future, applicable to such activities,
including, but not limited to, proper operation, closing and remediation of the Facility (collectively, the “Obligations”).
THEN AND IN THAT EVENT, this obligation shall be null and void; otherwise, and in default of complete
compliance with any and all of said Obligations, this Bond shall remain in full force and effect.
________________________
___________________________
OPERATOR
SURETY
By:________________________
By:____________________________
Signature
Signature*
___________________________
____________________________
Title
Title
*Include Power of Attorney or other
instrument authorizing signature
7/16
State of New Mexico
Energy, Minerals and Natural Resources Department
Oil Conservation Division
(File with Oil Conservation Division, 1220 S. St. Francis Dr., Santa Fe, New Mexico 87505)
Surety Bond for Recycling Facility/Containment (“Bond”)
KNOW ALL MEN BY THESE PRESENTS:
Name of Operator (“Operator”):
Operator’s Address:
State in which Operator is Organized:
Operator’s OGRID Number:
Name of Surety Company (“Surety”):
Surety Company’s Business Address:
Bond Number:
Effective Date:
Required Financial Assurance (“Financial Assurance”):
WHEREAS, Operator, authorized to do business in the State of New Mexico, and Surety, authorized by the
Superintendent of Insurance to do business in the State of New Mexico, pursuant to NMSA 1978, Section 70-2-12, as
may be amended from time to time, are, jointly and severally, firmly bound to the State of New Mexico’s Energy,
Minerals and Natural Resources Department (“Department”), or its successor, for payment of the amount of the
Financial Assurance indicated above.
WHEREAS, Operator has or may enter into the collection, treatment, storage, recycling, or re-use of
produced water in Section
, Township
, Range
, NMPM,
County, New Mexico
( "Facility").
WHEREAS, Surety has been advised that Operator has requested this Bond as security for Operator’s
compliance with all laws, rules, and orders, as they exist now or may exist in the future, applicable to such activities,
including, but not limited to, proper operation, closing and remediation of the Facility (collectively, the “Obligations”).
THEN AND IN THAT EVENT, this obligation shall be null and void; otherwise, and in default of complete
compliance with any and all of said Obligations, this Bond shall remain in full force and effect.
________________________
___________________________
OPERATOR
SURETY
By:________________________
By:____________________________
Signature
Signature*
___________________________
____________________________
Title
Title
*Include Power of Attorney or other
instrument authorizing signature
7/16
APPROVED BY:
Oil Conservation Division of New Mexico
By_________________________________
Date_______________________________
INDIVIDUAL ACKNOWLEDGMENT: (I
)
f dba, must read – Example: John Doe dba ABC Services
State of New Mexico
County of________________
This instrument was acknowledged before me on this _____________day of_______________20_______,
by_________________________________________________________________________________________.
(Individual Operator)
__________________________________
Notary Public
SEAL
My Commission Expires:
____________________
ACKNOWLEDGMENT FOR CORPORATION, PARTNERSHIP OR LIMITED LIABILITY COMPANY
State of New Mexico
County of_______________
This instrument was acknowledged before me on this _________day of __________________,
20_______,
by ____________________________________________________, ____________________________________of
(Name of Person Signing Document)
(Title)
_______________________________________________________________________________________________________.
(Name of Operator)
__________________________________
Notary Public
SEAL
My Commission Expires:
_____________________
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