U.S. Department of the Interior OMB Control No. 1010-0006
Bureau of Ocean Energy Management, OMB Approval Expires: xx/xx/xxxx
Regulation and Enforcement
Cover Page
OUTER CONTINENTAL SHELF (OCS)
MINERAL LESSEE'S OR OPERATOR'S BOND
BOEMRE Form MMS-2028
This form dated Mo/Year supersedes all previous versions of form MMS-2028
Paperwork Reduction Act of 1995 (PRA) Statement: The PRA (44 U.S.C. 3501 et seq.) requires us to inform you that BOEMRE collects this information to hold the surety liable for the obligations and liability of the Principal (lessee or operator). Responses are mandatory. No proprietary information is collected. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB Control Number. Public reporting burden for this form is estimated to average 15 minutes per response, including the time for reviewing instructions, gathering and maintaining data, and completing and reviewing the form. Direct comments regarding the burden estimate or any other aspect of this form to the Information Collection Clearance Officer, Mail Stop 5438, Bureau of Ocean Energy Management, Regulation and Enforcement, 1849 C Street, NW, Washington, DC 20240.
BOEMRE Form MMS-2028 (Mo/Year – Supersedes all previous editions of form MMS-2028 which may not be used). Page 1 of 3
U.S. DEPARTMENT OF THE INTERIOR
Bureau of Ocean Energy Management, Regulation and Enforcement
Bond No._________________________ Lease No. _______________________________
Bond Type_________________________ Amount_________________________________
OUTER CONTINENTAL SHELF (OCS) MINERAL LESSEE'S OR OPERATOR'S BOND
The Surety is the entity Guaranteeing Performance. Name of Surety: ______________________________________________________________ Mailing Address: _____________________________________________________________ _____________________________________________________________ If a Corporation, Incorporated in the State of: _____________________; County or Parish of: ______________________________ ┓Check here if Surety is certified by U.S. Treasury as an acceptable surety on Federal Bonds and listed in the current U.S. Treasury Circular No. 570. |
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The Principal is the Lessee or Designated Operator for Whom the Bond is Issued. Name of Principal: ____________________________________________________________ Mailing Address: ______________________________________________________________ ______________________________________________________________ |
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Schedule A, the region or leases covered by this bond, is composed of: (Check one and add legal description) ┓ The following region:____________________________________________________________________________ ┓ The following lease(s): ___________________________________________________________________________ ___________________________________________________________________________________________. |
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In addition to the Obligations of the Principal during the period of liability of this bond, the Surety also accepts the following Obligations: (Check one) ┓ No Obligations other than the Obligations of the Principal during the period of liability of this bond. ┓ All Obligations of all previous Sureties or guarantors even if the Obligations are not Obligations of the Principal during the period of liability of this bond. ┓ All Obligations of all previous Sureties or guarantors even if the Obligations are not Obligations of the Principal during the period of liability of this bond with the following exceptions or limitations (use an attached rider). |
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Definitions
For the purposes of this document:
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A Principal includes an entity holding an interest in the oil & gas lease in one or more of the following ways: (1) as an approved record title owner of all or a portion of the lease, (2) as an approved operating rights owner of all or a portion of the lease, or (3) as a designated operator or designated agent in all or a portion of the lease. A Lessee includes an approved record title owner of all or a portion of the lease or an approved operating rights owner of all or a portion of the lease. An Obligation includes any obligation arising from any regulations of the Department of the Interior or any Instrument issued, maintained, or approved under the OCS Lands Act (43 U.S.C. 1331 et seq.). An Instrument includes individually or collectively any lease, operating agreement, designation of operator or agent, storage agreement, compensatory royalty agreement, transfer of operating rights, permit, license, or easement, whereunder the Principal has the right, privilege, or license to conduct operations on the OCS. A Person includes an individual, a public or private entity, a State, a political subdivision of a State, any association of individuals, corporations, States, or subdivisions of States, or a government agency. |
By signing below, the Principal verifies that the information above is correct and agrees to the following: Unless as otherwise indicated on Schedule A, the Principal will fulfill all Obligations for the entire leasehold and to the same extent as though the Principal were the sole lessee for all leases in Schedule A or for all leases for which the Principal has an interest within a region designated in Schedule A. |
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By signing below, the Surety verifies that the information above is correct and agrees to the following:
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BOEMRE Form MMS-2028 (Mo/Year – Supersedes all previous editions of form MMS-2028 which may not be used). Page 2 of 3
Obligations of the lease in accordance with BOEMRE specifications be materially false and BOEMRE relied upon such representation in canceling the instrument.
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_____________________________________ Name of Surety
_____________________________________ Signature of Person Executing for Surety
_____________________________________ Name and Title (typed or printed)
_____________________________________ Business Address
_____________________________________ Business Address |
_____________________________________ Name of Principal
_____________________________________ Signature of Person Executing for Principal
_____________________________________ Name and Title (typed or printed)
_____________________________________ Business Address
_____________________________________ Business Address |
Signed on this ________ day of _______________ , 20______, in the State of _____________, in the presence of:
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_____________________________________ Signature of Witness
_____________________________________ Name (typed or printed)
_____________________________________ Address
_____________________________________ Address |
_____________________________________ Signature of Witness
_____________________________________ Name (typed or printed)
_____________________________________ Address
_____________________________________ Address |
Note: The person executing for the Surety must attach a corporate resolution and power of attorney stating his or her authority to undertake this Obligation, pursuant to the acts of the corporate board of directors and the laws of the State of incorporation. The corporation executing this bond as Surety and the Principal, if a corporation, must affix their corporate seals.
BOEMRE Form MMS-2028 (Mo/Year – Supersedes all previous editions of form MMS-2028 which may not be used). Page 3 of 3
File Type | application/msword |
File Title | Form MMS-2028(January 2001) |
Author | mirabelj |
Last Modified By | blundon |
File Modified | 2011-03-16 |
File Created | 2011-03-16 |