DEP Form 62-730.900(4)(D) "Hazardous Waste Facility Corporate Guarantee for Liability Coverage" - Florida

What Is DEP Form 62-730.900(4)(D)?

This is a legal form that was released by the Florida Department of Environmental Protection - a government authority operating within Florida. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 5, 1995;
  • The latest edition provided by the Florida Department of Environmental Protection;
  • 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 fillable version of DEP Form 62-730.900(4)(D) by clicking the link below or browse more documents and templates provided by the Florida Department of Environmental Protection.

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DEP Form # 62-730.900(4)(d)
Form Title HW Facility Corporate Guarantee
Effective Date January 5, 1995
DEP Application No.
STATE OF FLORIDA
HAZARDOUS WASTE FACILITY CORPORATE GUARANTEE
FOR LIABILITY COVERAGE
Guarantee made this
by
,
Date
Name of Guaranteeing Entity
a business corporation organized under the laws of
, herein referred to
If incorporated within the United States insert "the state of
and insert name of state; if incorporated
outside the United States insert the name of the country in which incorporated, the principle place of business within the United States,
and the name and address of the registered agent in the state of the principle place of business.
as guarantor. This guarantee is made on behalf of our subsidiary
of
0wner or Operator
Business Address
to any and all third parties who have sustained or may sustain bodily injury or property damage caused by
accidental occurrences arising from operation of the
Insert "sudden" or "nonsudden" or "both sudden and nonsudden"
facility(ies) covered by this guarantee.
Recitals
1
Guarantor meets or exceeds the financial test criteria and agrees to comply with the reporting
requirements for guarantors as specified in 40 CFR 264.147(g) and 265.147(g), as adopted by reference
in Section 62-730.180, Florida Administrative Code (F.A.C.).
2.
owns or operates the following hazardous waste
Owner or Operator
management facility(ies) covered by this guarantee:
List for each facility: EPA Identification Number, name, and address; and if guarantor is incorporated outside the United States list the name and address of the
guarantor's registered agent in each state in which a facility covered by this guarantee is located.
EPA/DEP I.D. No.
Name
Address
This corporate guarantee satisfies RCRA third-party liability requirements for
accidental occurrences in above-named owner or operator facilities
Insert "sudden" or "nonsudden" or "both sudden and nonsudden
for coverage in the amount of $
for each occurrence and $
Insert dollar amount
Insert dollar amount
annual aggregate.
DEP FORM 62-730.900(4)(d)
Page 1 of 4
3.
For value received from
, guarantor guarantees to any
Owner or Operator
and all third parties who have sustained or may sustain bodily injury or property damage caused by
accidental occurrences arising from operations of the
Insert "sudden" or "nonsudden" or "both sudden and nonsudden”
facility(ies) covered by this guarantee that in the event that
Owner or Operator
fails to satisfy a judgment or award based on a determination of liability for bodily injury or property
damage to third parties caused by
accidental
Insert "sudden" or "nonsudden" or "both sudden and nonsudden”
occurrences, arising from the operation of the above-named facilities, or fails to pay an amount agreed
to in settlement of a claim arising from or alleged to arise from such injury or damage, the guarantor will
satisfy such judgment(s), award(s), or settlement agreement(s) up to the limits of coverage identified
above.
4.
Guarantor agrees that if, at the end of any fiscal year before termination of this guarantee, the guarantor
fails to meet the financial test criteria, guarantor shall send within 90 days, by certified mail, notice to the
Florida Department of Environmental Protection (FDEP) Secretary and to
that guarantor intends to provide alternate liability
Owner or Operator
coverage as specified in Subpart H of 40 CFR Parts 264.147 or 265.147 as adopted by reference in
Section 62-730.180, F.A.C., as applicable, in the name of
Owner or Operator
Within 120 days after the end of such fiscal year, the guarantor shall establish such liability coverage
unless
has done so.
Owner or Operator
The guarantor agrees to notify the FDEP Secretary by certified mail of a voluntary or involuntary
5.
proceeding under Title 11 (Bankruptcy), U.S. Code, naming guarantor as debtor, within 10 days after
commencement of the proceeding.
6.
Guarantor agrees that within 30 days after being notified by the FDEP Secretary or their designee of a
determination that guarantor no longer meets the financial test criteria or is disallowed from
continuing as a guarantor, guarantor shall establish alternate liability coverage as specified in 40 CFR
Parts 264.147 or 265.147, as adopted by reference in Section 62-730.180, F.A.C., in the name of
unless
has done so.
Owner or Operator
Owner or Operator
7.
Guarantor reserves the right to modify this agreement to take into account amendment or modification
of the liability requirements set by 40 CFR 264.147 and 265.147, provided that such modification shall
become effective only if the FDEP Secretary or his designee does not disapprove the modification within
30 days of receipt of notification of the modification.
8.
Guarantor agrees to remain bound under this guarantee for so long as
Owner or Operator
must comply with the applicable requirements of 40 CFR 264.147 and 265.147, as adopted by reference
in Section 62-730.180, F.A.C., for the above-listed facility(ies), except as provided in paragraph 9 of this
agreement.
9.
Guarantor may terminate this guarantee by sending notice by certified mail to the FDEP Secretary and
to
provided that this guarantee may not be terminated unless
Owner or Operator
DEP FORM 62-730.900(4)(d)
Page 2 of 4
and until
obtains, and the FDEP Secretary or their designee
Owner or Operator
approves alternate liability coverage complying with 40 CFR 264.147 and/or 265.147, as adopted by
reference in Section 62-730.180, F.A.C.
10
. Guarantor hereby expressly waives notice of acceptance of this guarantee by any party.
11
. Guarantor agrees that this guarantee is in addition to and does not affect any other responsibilit
y or
liability of the guarantor with respect to other covered facilities.
12
. Exclusions
This corporate guarantee does not apply to:
i.
Bodily injury or property damage for which the owner or operator is obligated to pay damag
es by
reason of the assumption of liability in a contract or agreement. This exclusion does not a
pply to
liability for damages that the owner or operator would be obligated to pay in the absence of
the
contract or agreement.
ii. Any obligation of the owner or operator under a workers' compensation, disability benefits,
or
unemployment compensation law or any similar law.
iii. Bodily injury to:
[A] An employee of the owner or operator arising from and in the course of, employment by
the
owner or operator; or
[B] The spouse, child, parent, brother or sister of that employee as a consequence of, or ari
sing from
and in the course of employment by the owner or operator.
Th
e exclusion applies:
(1)
Whether the owner or operator may be liable as an employer or in any other capacity; and
(2) To any obligation to share damages with or repay another person who must pay damages because of
the injury to persons identified in paragraphs [A] and [B].
iv. Bodily injury or property damage arising out of the ownership, maintenance, use, or entrustment
to others of any aircraft, motor vehicle or watercraft.
v. Property damage to:
[A] Any property owned, rented, or occupied by the owner or operator;
[B] Premises that are sold, given away or abandoned by the owner or operator if the property
damage arises out of any part of th
ose premises;
[C] Property loaned to the owner or op
erator;
[D] Personal property in the care, cust
ody or control of the owner or operator;
[E] That particular part of real property
on which the owner or operator or any contractors or
subcontractors working directly or indirectly on behalf of the owner or operator are
performing operations, if the property damage arises out of these operations.
DEP FORM 62-730.900(4)(d)
Page 3 of 4
I hereby certify that the wording of this guarantee is substantially identical to the wording specified in 40
CFR 264.151(h)(2), as adopted by reference in Section 62-730.180, F.A.C. except for the references to the FDEP
and the F.A.C.
Effective date:
Name of Guarantor
Authorized Signature for Guarantor
Name of Person Signing
Title of Person Signing
Signature of Witness or Notary:
DEP FORM 62-730.900(4)(d)
Page 4 of 4
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