Form DMM-107 "Surety Bond Form" - Virginia

What Is Form DMM-107?

This is a legal form that was released by the Virginia Department of Mines, Minerals and Energy - a government authority operating within Virginia. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on May 1, 2016;
  • The latest edition provided by the Virginia Department of Mines, Minerals and Energy;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form DMM-107 by clicking the link below or browse more documents and templates provided by the Virginia Department of Mines, Minerals and Energy.

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Download Form DMM-107 "Surety Bond Form" - Virginia

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DIVISION OF MINERAL MINING
900 NATURAL RESOURCES DRIVE, STE 400
CHARLOTTESVILLE, VA 22903
(434) 951-6310
SURETY BOND
Permit Number:
Bond:
KNOW ALL MEN BY THESE PRESENTS, THAT THE UNDERSIGNED
______________________________________________________________________________
(hereafter PRINCIPAL),
whose principal place of business is ________________________________________________,
and who does business as a [CHECK ONE ONLY]: □ Corporation; □ Limited Partnership;
□ Limited Liability Company; □ Partnership; or □ Sole Proprietorship, acting herein as
PRINCIPAL, and
______________________________________________________________________________
(hereafter SURETY),
whose principal business address is _________________________________________________
and who was organized and is existing under the laws of the State of ______________________,
and licensed to write and perform surety business in the Commonwealth of Virginia, are held and
firmly bound unto the
COMMONWEALTH OF VIRGINIA,
DIRECTOR, DIVISION OF MINERAL MINING
(hereafter OBLIGEE),
in the sum of ___________________________________________________________________
($___________________) Dollars for the payment of which sum the PRINCIPAL and
SURETY bind themselves, their heirs, executors, administrators, successors, and assigns, jointly
and severally, firmly by these presents.
THE CONDITION OF THE ABOVE OBLIGATION is such that:
WHEREAS, the PRINCIPAL proposes to commence mineral mining to be known as
___________________________________________________________________________
in __________________________ County(ies) of Virginia; and,
DMM-107
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DIVISION OF MINERAL MINING
900 NATURAL RESOURCES DRIVE, STE 400
CHARLOTTESVILLE, VA 22903
(434) 951-6310
SURETY BOND
Permit Number:
Bond:
KNOW ALL MEN BY THESE PRESENTS, THAT THE UNDERSIGNED
______________________________________________________________________________
(hereafter PRINCIPAL),
whose principal place of business is ________________________________________________,
and who does business as a [CHECK ONE ONLY]: □ Corporation; □ Limited Partnership;
□ Limited Liability Company; □ Partnership; or □ Sole Proprietorship, acting herein as
PRINCIPAL, and
______________________________________________________________________________
(hereafter SURETY),
whose principal business address is _________________________________________________
and who was organized and is existing under the laws of the State of ______________________,
and licensed to write and perform surety business in the Commonwealth of Virginia, are held and
firmly bound unto the
COMMONWEALTH OF VIRGINIA,
DIRECTOR, DIVISION OF MINERAL MINING
(hereafter OBLIGEE),
in the sum of ___________________________________________________________________
($___________________) Dollars for the payment of which sum the PRINCIPAL and
SURETY bind themselves, their heirs, executors, administrators, successors, and assigns, jointly
and severally, firmly by these presents.
THE CONDITION OF THE ABOVE OBLIGATION is such that:
WHEREAS, the PRINCIPAL proposes to commence mineral mining to be known as
___________________________________________________________________________
in __________________________ County(ies) of Virginia; and,
DMM-107
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WHEREAS, the above-named PRINCIPAL has submitted [CHECK ONE ONLY]:
Permit Tracking Number or
Permit Number _____________, including a mining and
reclamation plan, to conduct and reclaim a mineral mining operation, as defined pursuant to
Chapter 16 of Title 45.1 of the Code of Virginia, (hereafter, CODE), as amended, with its
attendant regulations; and,
WHEREAS, the PRINCIPAL has chosen to file this performance bond as a guarantee
that the reclamation of the land disturbed during this mining operation will be completed as
required by the CODE, its attendant regulations, and as specified in the permit as issued; and,
WHEREAS, the SURETY, and their successors and assigns agree to guarantee the
obligation and to indemnify, defend, and hold harmless OBLIGEE from any and all losses and
expenses which OBLIGEE may sustain as a result of the PRINCIPAL’S failure to comply with
the condition of the obligation;
WHEREAS, obligations guaranteed by this performance bond shall be in effect for the
following described lands approved as the permit area upon which initial or succeeding
operations will be conducted:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
NOW, if the PRINCIPAL faithfully completes all reclamation and abatement
requirements set forth in the CODE and its Permit issued in reliance on this Surety Bond,
including the mining and reclamation plan, then this obligation shall be void; otherwise, it shall
remain in full force and effect:
(a) Beginning on the date of the approval and issuance of [CHECK ONE ONLY]
Permit Tracking Number or
Permit Number __________ and until abatement
work pursuant to the CODE and the permit has been completed to the satisfaction of
the OBLIGEE; and
(b) Until the bond is released pursuant to the CODE, replaced in accordance with the
CODE, or until the permit has been transferred in accordance with the CODE.
The failure of the PRINCIPAL to fulfill the obligations specified by the CODE and its
permit shall result in a forfeiture of this performance bond according to the procedures described
in the CODE.
The SURETY shall not cancel this bond at any time for any reason, including non-
payment of premium or bankruptcy of the PRINCIPAL during the period of liability.
The SURETY shall give prompt notice to the PRINCIPAL and to the OBLIGEE of any
notice received or action filed alleging the insolvency or bankruptcy of the SURETY or of the
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PRINCIPAL, or alleging any violations or regulatory requirements which could result in
suspension or revocation of the SURETY’S license to do business.
In the event the SURETY becomes unable to fulfill its obligations under the bond for any
reason, notice shall be given immediately to the PRINCIPAL and to the OBLIGEE. Any
proceeding, legal or equitable, under this bond must be instituted in a Virginia court of
competent jurisdiction and shall be governed by the laws of the Commonwealth of Virginia.
Upon the incapacity of the SURETY by reason of bankruptcy, insolvency, or suspension
or revocation of its license, the PRINCIPAL shall be deemed to be without bond coverage in
violation of the CODE and subject to enforcement actions described therein.
I. BY COMPANY/PRINCIPAL:
(SEAL) By: ___________________________
Company /Principal
Company/Principal Official
_________________________________
Title
Date
Subscribed and sworn/affirmed to before me by ___________________________________________,
this _____________day of ____________________, 20____, in the City/County of
____________________.
(SEAL)
Notary Public
My Commission expires _____________________________, 20____.
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II. BY SURETY:
Attach copy bearing seal of Power of Attorney or documentation supporting
Corporate Officer’s authority to issue surety bond.
(SEAL) By: ___________________________
Surety Name
Attorney-in-Fact
___________________________________
Date
Typed Name
My Power of Attorney is recorded in the Clerk’s Office of the Circuit Court of
________________________, Virginia, in Deed Book _________________, Page ____________,
or Instrument __________________, and has not been revoked.
_________________________________
__
Attorney-in-Fact
AFFIDAVIT AND ACKNOWLEDGEMENT OF ATTORNEY-IN-FACT
COMMONWEALTH OF VIRGINIA
(or, alternatively, Commonwealth or State of _____________________) CITY/COUNTY OF
____________________________________, to wit:
I, the undersigned notary public, do certify that __________________________ personally appeared
before me in the jurisdiction aforesaid and made oath that he/she is the attorney-in-fact of
________________________________________________________, the Surety, that he/she is duly
authorized to execute on its behalf the foregoing Bond pursuant to the Power of Attorney noted
above, and on behalf of said Surety acknowledged the aforesaid Bond(s) as its act and deed.
Given under my hand this ____________ day of _________________________, 20___.
SEAL)
__________________________________(
Notary Public
My Commission expires: _______________________, 20___.
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III. BY ISSUING AGENT:
1. Attach copy of Agency License and Assignment Card from
Bureau of Insurance.
2. Attach verification of individual’s authority to sign on behalf
.
of Agency
Insurance Agency Issuing Surety Bond (provide the following information):
Agency name: ________________________________________________________________
Authorized agent: _____________________________________________________________
Agent address: ________________________________________________________________
Office telephone number: _______________________________________________________
IV. DIVISION APPROVAL:
ACCEPTED:
___________ Date_______________________
Division of Mineral Mining
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