STATE OF ARIZONA



1557020-15240ARIZONA DEPARTMENT OF ENVIRONMENTAL QUALITYSURETY BOND GUARANTEEING PERFORMANCEOFCLOSURE AND/OR POST-CLOSURE CAREAQUIFER PROTECTION PERMIT AQUIFER PROTECTION PERMITS00ARIZONA DEPARTMENT OF ENVIRONMENTAL QUALITYSURETY BOND GUARANTEEING PERFORMANCEOFCLOSURE AND/OR POST-CLOSURE CAREAQUIFER PROTECTION PERMIT AQUIFER PROTECTION PERMITS-381635-190500Date bond executed: _______________________________Effective date: ____________________________________Surety's Bond Number:-13335154305Permittee: Legal name and business address of the person required to obtain an aquifer protection permit under Arizona Revised Statutes (A.R.S.) §49-241 and to demonstrate financial assurance under A.R.S. §49-243: State of incorporation: ________________________________Authorized to do business in Arizona on date of execution of Surety Bond as:□Domestic or Foreign Corporation must have an A.R.S. §10-128 Certificate of Good Standing and a designated Statutory agent in Arizona for service of process □Limited Liability Company must have an A.R.S. §29-614 Certificate of Good Standing (Member Managed or Manager Managed) and a designated Statutory agent in Arizona □Limited Partnership, Limited Liability Partnership, or Limited Liability Limited Partnership certificate or certificate of registration on file at Arizona Secretary of State and Statutory agent in Arizona for service of process A.R.S. §§ 29-308 and 29-349□Individual or Sole Proprietorship doing business under a Certificate of Trade Name registered at Secretary of State00Permittee: Legal name and business address of the person required to obtain an aquifer protection permit under Arizona Revised Statutes (A.R.S.) §49-241 and to demonstrate financial assurance under A.R.S. §49-243: State of incorporation: ________________________________Authorized to do business in Arizona on date of execution of Surety Bond as:□Domestic or Foreign Corporation must have an A.R.S. §10-128 Certificate of Good Standing and a designated Statutory agent in Arizona for service of process □Limited Liability Company must have an A.R.S. §29-614 Certificate of Good Standing (Member Managed or Manager Managed) and a designated Statutory agent in Arizona □Limited Partnership, Limited Liability Partnership, or Limited Liability Limited Partnership certificate or certificate of registration on file at Arizona Secretary of State and Statutory agent in Arizona for service of process A.R.S. §§ 29-308 and 29-349□Individual or Sole Proprietorship doing business under a Certificate of Trade Name registered at Secretary of State8255270510Surety:Legal name and business address: Authorized to do business in Arizona on date of execution of Surety Bond as:□Domestic or Foreign Corporation A.R.S. §10-128 Certificate of Good Standing and A.R.S. §10-501 Statutory agent in Arizona for service of process□Limited Liability Company A.R.S. §29-604 Statutory agent in Arizona for service of process and A.R.S. §29-614 Certificate of Good Standing□Limited Partnership, Limited Liability Partnership, or Limited Liability Limited Partnership certificate or certificate of registration on file at Arizona Secretary of State and Statutory agent in Arizona for service of process A.R.S. §§ 29-308 and 29-349andDate of issuance of current A.R.S. §20-216 Certificate of Authority to transact Insurance as granted by the Director of the Arizona Department of Insurance: [Month/Date/YEAR]Listed as an acceptable Surety on U.S. Department of the Treasury's Listing of Approved Sureties (Department Circular 570) on the effective date of this bond:□YES□NO00Surety:Legal name and business address: Authorized to do business in Arizona on date of execution of Surety Bond as:□Domestic or Foreign Corporation A.R.S. §10-128 Certificate of Good Standing and A.R.S. §10-501 Statutory agent in Arizona for service of process□Limited Liability Company A.R.S. §29-604 Statutory agent in Arizona for service of process and A.R.S. §29-614 Certificate of Good Standing□Limited Partnership, Limited Liability Partnership, or Limited Liability Limited Partnership certificate or certificate of registration on file at Arizona Secretary of State and Statutory agent in Arizona for service of process A.R.S. §§ 29-308 and 29-349andDate of issuance of current A.R.S. §20-216 Certificate of Authority to transact Insurance as granted by the Director of the Arizona Department of Insurance: [Month/Date/YEAR]Listed as an acceptable Surety on U.S. Department of the Treasury's Listing of Approved Sureties (Department Circular 570) on the effective date of this bond:□YES□NOBeneficiary:Arizona Department of Environmental Quality1110 W. Washington StreetPhoenix, Arizona 85007 Facility Name:Facility Address: Property Identification Number: (Assessor’s Parcel Number)This bond provides for performance of all the covered items listed in Arizona Administrative Code (A.A.C.) R18-9-201(B)(5):Closure Bond:$Post-Closure Bond:$Total Penal Sum of Bond:$The Parties hereby agree that:[Name of permit applicant]__________________________________________, (“Permittee”), is hereby acknowledged as the Permittee. [Surety Bondholder], ______________________ a [type of entity]____________________, is organized and existing under the laws of the State of ___________________ and authorized to transact business in the State of Arizona (“Surety” or “Obligor”). The Arizona Department of Environmental Quality is a State of Arizona Agency (“ADEQ” OR “Beneficiary””).WHEREAS, the Permittee is required under terms and conditions of the Arizona Environmental Quality Act to obtain an Aquifer Protection Permit (“APP Permit”) to operate a discharging facility. In addition to the APP Permit, the Permittee shall demonstrate financial assurance for [OPTION: construction, operation, maintenance,] closure, and to ensure proper post-closure care of the facility and compliance with the conditions of the permit; and WHEREAS, no later than the Licensing Time-frame (LTF) deadline applicable pursuant to Title 18, Chapter 1, Article 5 of the Arizona Administrative Code, **, ****, the Arizona Department of Environmental Quality (“ADEQ”) intends to issue to [***PERMITTEE NAME***********] (hereinafter referred to as the "Permittee"), Aquifer Protection Program Permit (APP) [NUMBER] (“Permit”). As a prerequisite for permit issuance, ADEQ requires Permittee to demonstrate financial assurance to meet its facility [OPTION: construction, operation, maintenance,] closure and post-closure obligations in Arizona Revised Statutes (“A.R.S.”) § 49-243(N) and Arizona Administrative Code (“A.A.C.”) R18-9-A201(B)(5) and R18-9-A203. Permittee has designated that this Surety Bond and a Standby Trust Agreement shall be used to fund [or partially fund] its facility [OPTION: construction, operation, maintenance,] closure and post-closure financial assurance obligations. Approval of the financial assurance demonstration does not constitute issuance of Aquifer Protection Program Permit [NUMBER]. WHEREAS, Permittee has requested and Surety hereby issues a surety bond (“BOND”) in the penal sum of $_____________________________, to the benefit of ADEQ to guarantee performance of closure and post-closure requirements of Permittee and for the related Aquifer Protection Permit costs. As the Surety, we bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly and severally to performance as required under the Surety Bond and Standby Trust Agreement. Where the Sureties are corporations acting as co-sureties, we, the Sureties, bind ourselves in such sum "jointly and severally" only for the purpose of allowing a joint action or actions against any or all of us, and for all other purposes each Surety binds itself, jointly and severally with the Permittee, for the payment of such sum only as is set forth opposite the name of such Surety. If no limit of liability is indicated, the limit of liability shall be the full amount of the penal sums.WHEREAS, the discharging facility known as____________________________________ (“Facility”), is located at __________________________________________; andWHEREAS, said Permittee is required to provide the ADEQ financial assurance listed above under Total Penal Sums of Bond in the amount at least equal to the current [OPTION: construction, operation, maintenance] closure and post-closure care cost estimate as provided in the APP permit, as a condition of the permit; and WHEREAS, said Permittee shall establish a Standby Trust Fund as is required when a Surety Bond is used to provide such financial assurance. Under the terms of the Surety Bond, all amounts paid by the Surety(ies) under the bond pursuant to an Order of the Director of the Arizona Department of Environmental Quality shall be deposited directly into the Standby Trust Fund in accordance with A.A.C. R18-9-A203(C)(2). Any such Surety shall also meet the Department of Insurance requirements as set forth in A.R.S. Title 20, Chapter 2; and WHEREAS, this Surety Bond has been submitted to demonstrate financial competence in compliance with A.R.S. Title 49, Chapter 2, Article 3 and A.A.C. R18-9-A201(B)(5) for [OPTION: construction, operation, maintenance,] closure and post-closure; andWHEREAS, this Surety Bond arises in the State of Arizona. Surety shall maintain an active Certificate of Authority to transact insurance from the Arizona Department of Insurance. The Director of ADEQ shall instruct the Surety Bondholder to release the balance of the Surety Bond to the Permittee when the Director determines the Permittee has satisfied all requirements of the APP Permit or pursuant to Paragraph g. of this Surety Bond.NOW, THEREFORE, Permittee shall faithfully perform closure and post-closure requirements, including monitoring in accordance with the closure and post-closure requirements and cost estimates updates as required in the issued APP permit. The Permittee shall submit a cost estimate for closure and post-closure under the APP Permit. The Permittee shall update the estimated closure and post-closure costs for the duration of the permit on a periodic basis. The Permittee shall update closure and post-closure costs in accordance with the schedule in the permit but not more frequently than every five years. Permittee shall update closure and post-closure costs to: adjust for inflation; as necessary to reflect increased or decreased costs resulting from changes to the facility or to the facility closure strategy or plan or to any other relevant condition related to the facility for which this surety bond guarantees closure or post-closure in accordance with the closure plan or other requirements of the Aquifer Protection Permit. Permittee shall additionally update closure and post-closure costs as such plans and permit may be amended from time to time, pursuant to all applicable laws, statutes, rules and regulations.The Permittee shall apply for an amendment to the APP permit pursuant to A.A.C. R18-9-A203(E) and (F) if the Permittee changes a financial assurance mechanism or if the Permittee’s revision of the closure strategy results in an increase in the estimated cost under R18-9-A201 (B)(5). Permittee has elected to use the instant bond and Standby Trust Fund as its combined financial assurance mechanism. The Permittee shall provide a copy of the Standby Trust Agreement to the ADEQ Director as evidence of compliance with A.A.C. R18-9-A203(B)(3)(c) and R18-9-A203(C)(2) on the date of execution of this Surety Bond.Liability on Bond ObligationUnder the terms of the bond, the Surety(ies) shall become liable on the bond obligation only when the Permittee has failed to fulfill the conditions and has been notified as described below:ClosureThe ADEQ Director shall provide written notice to the Permittee and Surety of the Permittee’s default under its Aquifer Protection Permit closure requirements. The Permittee shall commence to cure the default within thirty (30) days after service of such written notice. The Permittee shall cure the default in a prompt, continuous and diligent manner within a reasonable time after commencement.The ADEQ Director shall give written notice to the Surety and the Permittee that the Permittee has been found in violation of the closure requirements for the discharging facility for which this bond guarantees performance and has failed to cure under paragraph 1 above. Within thirty (30) days of such written notice, the Surety shall either cure the violations of the closure requirements as identified in the Notice in accordance with the approved closure plan and other permit requirements or shall deposit payment(s) of funds up to the Total Penal Sum of the Bond for the facility directly into the Standby Trust Fund as directed by the ADEQ Director in a written Order. If the Director issues a written Order, on the date of issuance the Director shall also provide a copy of it to the Trustee of the Standby Trust Fund.Post-Closure The ADEQ Director shall provide written notice to the Permittee and Surety of the Permittee’s default under its Aquifer Protection Permit post-closure requirements. The Permittee shall commence to cure the default within thirty (30) days after service of such written notice. The Permittee shall cure the default in a prompt, continuous and diligent manner within a reasonable time after commencement.The ADEQ Director shall give written notice to the Surety and the Permittee that the Permittee has been found in violation of the post-closure care requirements for the discharging facility, for which this bond guarantees performance of post-closure care. Within thirty (30) days of such written notice, the Surety shall either cure the violations of the post-closure requirements as identified in the Notice in accordance with the approved post-closure care plan and other permit requirements or shall deposit payment(s) of funds for the Total Penal Sum of the Bond for the facility directly into a Standby Trust Fund as directed the ADEQ Director in a written Order. If the Director issues a written Order, on the date of issuance the Director shall also provide a copy of it to the Trustee of the Standby Trust Fund. Loss of Financial CapabilityThe Director shall provide written notice to Surety and Permittee if he believes that the Permittee will lose financial capability under the financial assurance mechanism chosen by the Permittee. The Permittee shall, within thirty (30) days after the date of receipt of the Director’s written notice, submit evidence that the Permittee is meeting its financial assurance demonstration. As an alternative, the Permittee may provide a substitute financial assurance mechanism to meet its financial assurance demonstration. The Permittee shall obtain the ADEQ Director’s written approval of such modification in a permit amendment.If upon the ADEQ Director’s review of the submitted financial assurance documentation, the Director believes that the Permittee has failed to meet the financial assurance requirements for the facility, the Director shall give written notice to the Surety and the Permittee that the Permittee has failed to meet financial assurance requirements for the discharging facility, for which this bond guarantees performance of closure or post-closure care. Within thirty (30) days of such written notice, the Surety shall deposit payment of funds up to the Total Penal Sum of the Bond for the facility directly into the Standby Trust Fund as directed by the ADEQ Director in a written Order. If the Director issues a written Order, on the date of issuance the Director shall also provide a copy of it to the Trustee of the Standby Trust Fund.If the Permittee fails to respond within the thirty (30) days, as required by paragraph 1. above, the Director shall give written notice to the Surety and the Permittee that the Permittee has failed to meet financial assurance requirements for the discharging facility, for which this bond guarantees performance of closure and post-closure care. Within thirty (30) days of such written notice, the Surety shall deposit payment of funds up to the Total Penal Sum of the Bond for the facility directly into the Standby Trust Fund as directed by the ADEQ Director in a written Order. If the Director issues a written Order, on the date of issuance the Director shall also provide a copy of it to the Trustee of the Standby Trust Fund. In the alternative, the Surety may promptly remedy the default.Substitution of Financial Assurance MechanismIf the Permittee seeks to amend a permit under R18-9-A211(B), the Permittee shall submit a financial assurance demonstration for all facilities covered by the amended APP permit. Any such substitution further requires written approval by the ADEQ Director. Permittee shall maintain this original financial responsibility mechanism until approval of the amendment to the APP permit by the Director in writing.The Director shall give written notice of approval or disapproval of the substitution of the financial assurance mechanism within ninety (90) days after receipt of the proffered substitution of financial responsibility. If the Director accepts the substitution, the original financial responsibility mechanism shall be null and void; otherwise such financial mechanism shall remain in full force and effect. Cancellation of Surety BondThe Surety may cancel the bond by sending written Notice of Cancellation by certified mail to the Permittee and the ADEQ Director. Such cancellation shall not occur during the ninety (90) days, beginning on the date of receipt of the notice of cancellation by both the Permittee and the ADEQ Director, as evidenced by the return receipts. If the Surety cancels the bond, the Permittee shall provide alternate financial assurance within sixty (60) days of receiving the notice of cancellation.The Director shall provide written notice to Surety and Permittee within thirty (30) days of receipt of the Notice of Cancellation that the Permittee has failed to provide alternative financial assurance as specified in Arizona Administrative Code R18-9-A203(E) or Permittee failed to obtain written approval of such financial assurance from the ADEQ Director during the 90-day period following receipt by both the Permittee and the Department of a Notice of Cancellation of the bond. Pursuant to A.A.C. R18-9-A201(C)(2), within sixty (60) days the Surety shall either provide for performance of all the covered items listed in R18-9-A201(B)(5) by the surety, or by payment into a standby trust fund of an amount equal to the penal amount if the permittee fails to perform the required activities as directed by the ADEQ Director in accordance with A.A.C. R18-9-A203(C)(2).If the ADEQ Director provides written notice of default to the Permittee and the Surety, and the Permittee fails to commence to cure the default within thirty (30) days after service of such written notice, or if the default is not cured promptly in a continuous and diligent manner within a reasonable time after commencement the Surety shall promptly remedy the default. The Surety shall either perform closure or post-closure care in accordance with the approved closure or post-closure care plan and other permit requirements or place funds for the Total Penal Sum of the Bond for the facility directly into a Standby Trust Fund as directed by the ADEQ Director in accordance with A.A.C. R18-9-A203(C)(2) .Notice Except for bankruptcy notices, written notices to be given under the Surety Bond Agreement shall be given by certified U.S. mail, return receipt requested, to the party entitled thereto at its address set forth below, or at such address as the party may provide to the other parties in writing from time to time a follows:PERMITTEE:[NAME******][Mailing Address][County][Town] AZ [Zip Code]SURETY:[NAME******] Bank[Mailing Address][County][Town][State][Zip Code]BENEFICIARY: Arizona Department of Environmental Quality Attention: Manager, Aquifer Protection Unit 1110 West Washington Street Phoenix, Arizona 85007Arizona Department of Environmental Quality Attn: Assistant Director of Business and Finance 1110 W. Washington Phoenix, Arizona 85007Surety Bankruptcy NoticesThe SURETY and PERMITTEE agree that in the event the SURETY declares bankruptcy, closes or is placed in receivership, any proceeds received for the benefit of the PERMITTEE on any account maintained with the SURETY, shall first be applied to fund the bond obligation to the ADEQ. The SURETY shall notify the PERMITTEE and the ADEQ Director in writing within 10 (ten) days after its filing for bankruptcy, closing of business or being placed into a receivership. PERMITTEE shall demonstrate to the ADEQ Director within 30 (thirty) days after the SURETY filing for bankruptcy, closing of business OR RECEIVERSHIP of an alternative financial assurance mechanism. Permittee Bankruptcy NoticesThe Permittee shall notify the Director within five (5) days after the filing of a bankruptcy by Permittee at the following address: Arizona Department of Environmental Quality Attention: Director 1110 West Washington Street 6th Floor Phoenix, Arizona 85007Amendments to Applicable Laws, Statutes, Rules and Regulations. The Surety(ies) hereby waive(s) notification of amendments to applicable laws, statutes, rules and regulations and agrees that no such amendment shall in any way alleviate its(their) obligation on this bond.The liability of the Surety(ies) shall not be discharged by any payment or succession of payments hereunder, unless and until such payment or payments shall amount to the Total Penal Sum of the Bond, which is at least equal to the current closure, post-closure care or corrective action cost but in no event shall the obligation of the Surety(ies) hereunder exceed the amount of said Total Penal Sum of the Bond. Permittee Termination of BondThe Permittee may terminate this bond by sending written notice to the Surety provided, however, that no such notice shall become effective until the Surety receives written authorization for termination and release of the bond from the ADEQ Director. The Permittee shall maintain evidence of all financial assurance mechanisms used to demonstrate financial responsibility for the duration of the permit. This Surety bond is governed by and construed in accordance with the laws of the State of Arizona.In Witness Thereof, the Permittee and Surety(ies) have executed this Surety Bond and have affixed their seals on the date set forth above.The persons whose signatures appear below hereby certify that they are authorized to execute this Surety bond on behalf of the Permittee and Surety(ies) on the date this Surety Bond was executed.PERMITTEE[Signature(s)]_____________________________[Names(s)]_______________________________[Titles]__________________________________ [Corporate seal]State of Arizona????????????????????? ???????)???????????????????????????????????????????????????? ? )?????????????????????????????????????????????????????????????????????????????????? County of ______________??????? ??)?On this ______ day of ____________________, 20____, before me personallyappeared __________________________________(name of signer), whom Iknow personally, and acknowledged that he/she executed the same.??(seal)?_______________________________Notary PublicCORPORATE SURETY (ies)[Name and Address]_________________________[State of Incorporation]_______________________Liability Limit: $____________________________[Signature]________________________________[Corporate seal][Name and Title_________________________State of Arizona????????????????????? ????????)?????????????????????????????????????????????????????? )?????????????????????????????????????????????????????????????????????????????????? County of ______________??????????)?On this ______ day of ____________________, 20____, before me personallyappeared __________________________________(name of signer), whom Iknow personally, and acknowledged that he/she executed the same.??(seal)?_______________________________Notary Public[For Every co-surety, provide signature(s) and other information in the same manner as for Surety above.]Bond Premium: $______________Please attach to this Bond a certified copy of the Surety's power of attorney authorizing execution of this Bond by Surety's attorney-in-fact and a copy of the fully executed and effective Standby Trust Agreement. ................
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