BOEM-0006 OCS Renewable Energy Lease or Grant Designation of Opera

U.S. Department of the Interior
Bureau of Ocean Energy Management

OMB Control No.: 1010-0176
Expiration Date: xx/xx/20xx

OUTER CONTINENTAL SHELF (OCS) RENEWABLE ENERGY LEASE OR GRANT
DESIGNATION OF OPERATOR
The lessee or grantee identified below is, on the records of the Bureau of Ocean Energy Management, a holder of the
following lease or grant (check box and enter number):

□ Lease Number: ______________

□ Grant Number: ______________

or

Regional BOEM Office:
and hereby designates:
Name:
as the operator and local agent (designated operator) with full authority to act on the lessee’s or grantee’s behalf to
perform activities to comply with the OCS Lands Act, terms of the lease or grant, and applicable regulations. The
designated operator agrees to comply with all terms and conditions of the lease or grant and regulations governing
those activities and may be held liable and subject to penalties for its failure to comply during the time it was operator,
notwithstanding its subsequent resignation. The Regional Supervisor or his representative may serve the designated
operator written or oral instructions in securing compliance with the applicable regulations. This designation of
operator is made with respect to the block(s) and/or aliquot part(s) described in Exhibit “A” attached hereto and made a
part hereof.
It is understood that this designation of operator does not relieve the lessee or grantee of responsibility for compliance
with the terms of the lease, grant, laws, and applicable regulations. It is also understood that this designation of
operator does not constitute an assignment of any interest in the lease or grant. In case of default on the part of the
designated operator, the lessee or grantee will make full and prompt compliance with all regulations, lease terms, or
orders of the Secretary of the Interior or their representative. If there is a change in the designated operator, the
lessee or grantee must provide written notice to the Regional Supervisor and identify the new designated operator
within 72 hours. The lessee or grantee is the operator and responsible for compliance until BOEM approves
designation of the new operator. The designated operator shall comply with the Department of the Interior’s
nonprocurement debarment and suspension regulations as required by 2 CFR Part 1400 and shall communicate the
requirement to comply with these regulations to persons with whom it does business related to this designation by
including this term in its contracts and transactions.

_______________________________________

_______________________________________

Name of Lessee/Grantee

Name of Operator

______________________________________
Qualification Number of Lessee/Grantee

______________________________________
Qualification Number of Operator

By: ________________________________
Signatory Name:
Signatory Title:

By: _________________________________
Signatory Name:
Signatory Title:

___________________________________
Execution Date

_____________________________________
Execution Date

Paperwork Reduction Act of 1995 (PRA) Statement: The PRA (44 U.S.C. 3501 et seq.) requires us to inform you that BOEM collects this
information to be informed of who is authorized to act on behalf of the lessees to fulfill their obligations under the OCS Lands Act, lease, and
applicable regulations, and who is authorized to receive notices and comply with regulatory orders issued. Responses are mandatory (43 U.S.C.
1331 et seq.). No proprietary information is collected. An agency may not conduct or sponsor, and you are 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 1 hour per
response, including the time for reviewing instructions, gathering and maintaining data, and completing and reviewing the form. You may direct
comments regarding the burden estimate or any other aspect of this form to the Information Collection Clearance Officer, Bureau of Ocean Energy
Management, 45600 Woodland Road, Sterling, Virginia 20166.

Form BOEM-0006 (Month Year) Previous Editions are Obsolete.

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EXHIBIT “A”
OUTER CONTINENTAL SHELF (OCS)
RENEWABLE ENERGY LEASE OR GRANT
DESIGNATION OF OPERATOR
□ Lease Number: _______________
or

□ Grant Number: _______________
The Designation of Operator is made with respect to the following described block(s) and/or aliquot
part(s) of the referenced lease or grant:

Area Name or
Protraction Diagram

Block

Subdivision or Aliquot Part
(If entire block, enter “All”)

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Form BOEM-0006 (Month Year) Previous Editions are Obsolete.

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