DEP Form 62-730.900(4)(Q) "Hazardous Waste Facility Trust Fund to Demonstrate Liability Coverage" - Florida

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

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 29, 2006;
  • 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)(Q) 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)(q)
Form Title: HWF Liability Trust Fund
Effective Date: 1-29-06
DEP Application #
STATE OF FLORIDA
HAZARDOUS WASTE FACILITY TRUST FUND
TO DEMONSTRATE LIABILITY COVERAGE
TRUST AGREEMENT, the "Agreement", entered into as of _________________________
[Date]
by and between _______________________________________________________________ ,
[Name of the Owner or Operator]
a ______________________ _______________________________________ , the “Grantor”,
[Name of State]
[insert "corporation", "partnership", "association" or "proprietorship"]
and___________________________________________________________________________
[Name & Address of Corporate Trustee]
_____________________________________________________________________________,
_________________________________________________________________ , the "Trustee".
[Insert "incorporated in the State of __________________________" or "a national bank"]
WHEREAS, the Florida Department of Environmental Protection, "FDEP", an agency of the
State of Florida, has established certain regulations applicable to the Grantor, requiring that an
owner or operator of a hazardous waste management facility or group of facilities must
demonstrate financial responsibility for bodily injury and property damage to third parties caused
by sudden and/or nonsudden accidental occurrences arising from operations of the facility or
group of facilities.
WHEREAS the Grantor has elected to establish a trust to assure all or part of such financial
responsibility for the facilities identified herein.
WHEREAS the Grantor, acting through its duly authorized officers, has selected the above
mentioned trustee to be the Trustee under this agreement and the Trustee is willing to act as
trustee.
NOW THEREFORE, the Grantor and the Trustee agree as follows:
Section 1. Definitions. As used in this Agreement:
(a) The term "Grantor" means the owner or operator who enters into this Agreement and any
successors or assigns of the Grantor.
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DEP FORM 62-730.900(4)(q) effective 1-29-06
SAVE
PRINT
CLEAR
DEP Form # 62-730.900(4)(q)
Form Title: HWF Liability Trust Fund
Effective Date: 1-29-06
DEP Application #
STATE OF FLORIDA
HAZARDOUS WASTE FACILITY TRUST FUND
TO DEMONSTRATE LIABILITY COVERAGE
TRUST AGREEMENT, the "Agreement", entered into as of _________________________
[Date]
by and between _______________________________________________________________ ,
[Name of the Owner or Operator]
a ______________________ _______________________________________ , the “Grantor”,
[Name of State]
[insert "corporation", "partnership", "association" or "proprietorship"]
and___________________________________________________________________________
[Name & Address of Corporate Trustee]
_____________________________________________________________________________,
_________________________________________________________________ , the "Trustee".
[Insert "incorporated in the State of __________________________" or "a national bank"]
WHEREAS, the Florida Department of Environmental Protection, "FDEP", an agency of the
State of Florida, has established certain regulations applicable to the Grantor, requiring that an
owner or operator of a hazardous waste management facility or group of facilities must
demonstrate financial responsibility for bodily injury and property damage to third parties caused
by sudden and/or nonsudden accidental occurrences arising from operations of the facility or
group of facilities.
WHEREAS the Grantor has elected to establish a trust to assure all or part of such financial
responsibility for the facilities identified herein.
WHEREAS the Grantor, acting through its duly authorized officers, has selected the above
mentioned trustee to be the Trustee under this agreement and the Trustee is willing to act as
trustee.
NOW THEREFORE, the Grantor and the Trustee agree as follows:
Section 1. Definitions. As used in this Agreement:
(a) The term "Grantor" means the owner or operator who enters into this Agreement and any
successors or assigns of the Grantor.
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DEP FORM 62-730.900(4)(q) effective 1-29-06
(b) The term "Trustee" means the trustee who enters into this Agreement and any successor
trustee.
(c) The term “FDEP” means the Florida Department of Environmental Protection, an agency of
the State of Florida or any successor thereof.
Section 2. Identification of Facilities. This agreement pertains to the facilities identified on
attached Schedule A.
[On Schedule A, for each facility, list the EPA/DEP identification number, name and address of the facility(ies) and the amount of liability
coverage, or portions thereof, if more than one instrument affords combined coverage as demonstrated by this Agreement.]
Section 3. Establishment of Fund. The Grantor and the Trustee hereby establish a trust fund,
hereinafter the "Fund", for the benefit of any and all third parties injured or damaged by
__________________________ accidental occurrences arising from operation of the facility(ies)
[sudden and/or nonsudden]
covered by this guarantee, in the amounts of ____________ per occurrence and _____________
[up to $1 million]
[up to $2 million]
annual aggregate for sudden accidental occurrences and ________________ per occurrence and
[up to $3 million]
___________________ annual aggregate for nonsudden occurrences, except that the Fund is not
[up to $6 million]
established for the benefit of third parties for the following:
(a) Bodily injury or property damage for which _______________________________________
[Grantor]
is obligated to pay damages by reason of the assumption of liability in a contract or agreement.
This
exclusion
does
not
apply
to
liability
for
damages
that
_______________________________
[Grantor]
would be obligated to pay in the absence of the contract or agreement.
(b) Any obligation of ______________________________________________ under a workers'
[Grantor]
compensation, disability benefits or unemployment compensation law or any similar law.
(c) Bodily injury to:
(1) An employee of _______________________________________________ arising from, and
[Grantor]
in the course of, employment by ________________________________________________ ; or
[Grantor]
(2) The spouse, child, parent, brother or sister of that employee as a consequence of, or arising
from, and in the course of employment by _______________________________________ .
[Grantor]
This exclusion applies:
(A) Whether ____________________ may be liable as an employer or in any other capacity; and
[Grantor]
(B) To any obligation to share damages with or repay another person who must pay damages
because of the injury to persons identified in paragraphs (1) and (2).
(d) Bodily injury or property damage arising out of the ownership, maintenance, use or
entrustment to others of any aircraft, motor vehicle or watercraft.
(e) Property damage to:
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DEP FORM 62-730.900(4)(q) effective 1-29-06
(1) Any property owned, rented or occupied by ______________________________________ ;
[Grantor]
(2) Premises
that
are
sold,
given
away
or
abandoned
by
_________________________________
[Grantor]
if the property damage arises out of any part of those premises;
(3) Property loaned to __________________________________________________________ ;
[Grantor]
(4) Personal property in the care, custody or control of ________________________________ ;
[Grantor]
(5) That particular part of real property on which ________________________________ or any
[Grantor]
contractors
or
subcontractors
working
directly
or
indirectly
on
behalf
of
____________________
[Grantor]
are performing operations, if the property damage arises out of these operations.
In the event of combination with another mechanism for liability coverage, the fund shall be
considered _________________________ coverage.
[insert "primary" or "excess"]
The Fund is established initially as consisting of the property, which is acceptable to the Trustee,
described in Schedule B attached hereto. Such property and any other property subsequently
transferred to the Trustee is referred to as the Fund, together with all earnings and profits
thereon, less any payments or distributions made by the Trustee pursuant to this Agreement. The
Fund shall be held by the Trustee, IN TRUST, as hereinafter provided. The Trustee shall not be
responsible nor shall it undertake any responsibility for the amount or adequacy of, nor any duty
to collect from the Grantor, any payments necessary to discharge any liabilities of the Grantor
established by the FDEP.
Section 4. Payment for Bodily Injury or Property Damage. The Trustee shall satisfy a third party
liability claim by making payments from the Fund only upon receipt of one of the following
documents:
(a) Certification from the Grantor and the third party claimant(s) that the liability claim should
be paid. The certification must be worded as follows:
Certification of Valid Claim
The undersigned, as parties ____________________________________________________ and
[Grantor]
______________________________________________________________________________
[Name and Address of Third Party Claimant(s)]
______________________________________________________________________________
_____________________________________________________________________________,
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DEP FORM 62-730.900(4)(q) effective 1-29-06
hereby certify that the claim of bodily injury and / or property damage caused by a
_________________________________________ accidental occurrence arising from operating
[insert “sudden” or “nonsudden”]
_______________________________________________ hazardous waste treatment, storage or
[Grantor's]
disposal facility should be paid in the amount of $ ____________________________________.
___________________________________
______________________________________
[Signature of the Grantor]
[Signature(s) of the Claimant(s)]
(b) A valid final court order establishing a judgment against the Grantor for bodily injury or
property damage caused by sudden or nonsudden accidental occurrences arising from the
operation of the Grantor's facility or group of facilities.
Section 5. Payments Comprising the Fund. Payments made to the Trustee for the Fund shall
consist of cash or securities acceptable to the Trustee.
Section 6. Trustee Management. The Trustee shall invest and reinvest the principal and income,
in accordance with general investment policies and guidelines which the Grantor may
communicate in writing to the Trustee from time to time, subject, however, to the provisions of
this section. In investing, reinvesting, exchanging, selling and managing the Fund, the Trustee
shall discharge his duties with respect to the trust fund solely in the interest of the beneficiary
and with the care, skill, prudence and diligence under the circumstance then prevailing which
persons of prudence, acting in a like capacity and familiar with such matters, would use in the
conduct of an enterprise of a like character and with like aims; except that:
(i) Securities or other obligations of the Grantor, or any other owner or operator of the facilities,
or any of their affiliates as defined in the Investment Company Act of 1940, as amended, 15
U.S.C. 80a-2.(a), shall not be acquired or held unless they are securities or other obligations of
the Federal or a State government;
(ii) The Trustee is authorized to invest the Fund in time or demand deposits of the Trustee, to the
extent insured by an agency of the Federal or State government; and
(iii) The Trustee is authorized to hold cash awaiting investment or distribution uninvested for a
reasonable time and without liability for the payment of interest thereon.
Section 7. Commingling and Investment. The Trustee is expressly authorized in its discretion:
(a) To transfer from time to time any or all of the assets of the Fund to any common
commingled, or collective trust fund created by the Trustee in which the fund is eligible to
participate, subject to all of the provisions thereof, to be commingled with the assets of other
trusts participating therein; and
(b) To purchase shares in any investment company registered under the Investment Company
Act of 1940, 15 U.S.C. 81a-1 et seq., including one which may be created, managed,
underwritten, or to which investment advice is rendered or the shares of which are sold by the
Trustee. The Trustee may vote such shares in its discretion.
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DEP FORM 62-730.900(4)(q) effective 1-29-06
Section 8. Express Powers of Trustee. Without in any way limiting the powers and discretions
conferred upon the Trustee by the other provisions of this Agreement or by law, the Trustee is
expressly authorized and empowered:
(a) To sell, exchange, convey, transfer, or otherwise dispose of any property held by it, by public
or private sale. No person dealing with the Trustee shall be bound to see to the application of the
purchase money or to inquire into the validity or expediency of any such sale or other
disposition;
(b) To make, execute, acknowledge, and deliver any and all documents of transfer and
conveyance and any and all other instruments that may be necessary or appropriate to carry out
the powers herein granted;
(c) To register any securities held in the Fund in its own name or in the name of a nominee and
to hold any security in bearer form or in book entry, or to combine certificates representing such
securities with certificates of the same issue held by the Trustee in other fiduciary capacities, or
to deposit or arrange for the deposit of such securities in a qualified central depositary even
though, when so deposited, such securities may be merged and held in bulk in the name of the
nominee of such depositary with other securities deposited therein by another person, or to
deposit or arrange for the deposit of any securities issued by the United States Government, or
any agency or instrumentality thereof, with a Federal Reserve bank, but the books and records of
the Trustee shall at all times show that all such securities are part of the Fund;
(d) To deposit any cash in the Fund in interest-bearing accounts maintained or savings
certificates issued by the Trustee, in its separate corporate capacity, or in any other banking
institution affiliated with the Trustee, to the extent insured by an agency of the Federal or State
government; and
(e) To compromise or otherwise adjust all claims in favor of or against the Fund.
Section 9. Taxes and Expenses. All taxes of any kind that may be assessed or levied against or in
respect of the Fund and all brokerage commissions incurred by the Fund shall be paid from the
Fund. All other expenses incurred by the Trustee in connection with the administration of this
Trust, including fees for legal services rendered to the Trustee, the compensation of the Trustee
to the extent not paid directly by the Grantor, and all other proper charges and disbursements of
the Trustee shall be paid from the Fund.
Section 10. Annual Valuations. The Trustee shall annually, at least 30 days prior to the
anniversary date of establishment of the Fund, furnish to the Grantor and to the Secretary of the
FDEP a statement confirming the value of the Trust. Any securities in the Fund shall be valued
at market value as of no more than 60 days prior to the anniversary date of establishment of the
Fund. The failure of the Grantor to object in writing to the Trustee within 90 days after the
statement has been furnished to the Grantor and to the Secretary of the FDEP shall constitute a
conclusively binding assent by the Grantor barring the Grantor from asserting any claim or
liability against the Trustee with respect to matters disclosed in the statement.
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