FORM OP-8 BOND NUMBER _____________
Rev. 6/01 OPERATOR CODE __________
(OBVERSE)
STATE OF WEST VIRGINIA
DEPARTMENT OF ENVIRONMENTAL PROTECTION
OFFICE OF OIL AND GAS - BLANKET BOND FOR OIL OR GAS WELLS,
LIQUID INJECTION WELLS OR WASTE DISPOSAL WELLS
KNOWN ALL MEN BY THESE PRESENTS:
(1)That we, _________________________________________________________________
(2)__________________________________________________________________________
As Principal, and (3)________________________________________________________
(4)__________________________________________________________________________
a firm and/or a corporation authorized to do business in the State of West Virginia, as Surety, are held and firmly bound unto the State of West Virginia in the just and full sum of (5)_____________________ dollars ($__________) to the payment whereof well and truly to make, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents.
WHEREAS, the above bound Principal in pursuance of the provisions of Chapter 22, Article 6, of the Code of West Virginia, 1931, as amended, and the regulations promulgated thereunder, has made or intends to make application to the Chief of the Office of Oil and Gas, Department of Environmental Protection, the State of West Virginia for a permit to perform well work (as defined in Chapter 22, Article 6), on oil or gas wells and/or liquid injection wells and/or waster disposal wells, or has acquired or purchased, or shall hereafter acquire or purchase such wells, or has been or shall be assigned operating responsibility for such wells located in West Virginia; and
WHEREAS, THE Obligee as a condition precedent to the issuance of such Permit or release of other obligation has required the Principal to furnish a SURETY BOND acceptable to the Obligee guaranteeing the performance of said provisions of Chapter 22, Article 6, of the Code of West Virginia, 1931, as amended, and the regulations promulgated thereunder;
NOW THEREFORE, the condition of this obligation is such that if the Principal, its personal representatives, successors, heirs and assigns shall in performing well work (as defined in Chapter 22, Article 1) or operating such wells shall furnish all reports, information and affidavits as may be required by the Department of Environmental Protection, Office of Oil and Gas, documenting that said wells have been plugged and abandoned in accordance with Chapter 22, Article 6, of the Code of West Virginia, 1931, as amended, and the regulations promulgated thereunder, then this obligation to be void; otherwise to remain in full force and effect.
This bond shall be effective from the (11)_______ day of _______________, 19_____, until released by the Department of Environmental Protection.
IN WITNESS WHEREOF the said Principal has hereunder set his or its hand and affixed his or its seal, and the said surety has caused its corporate name to be signed hereto and its corporate seal to be hereunto affixed by its duly authorized officer or agent this instrument this (12)_______ day of ________________, 19_____.
(15)Principal (13) __________________________________________ (Seal)
Corporate Seal
(Principal)
(14) By:_______________________________________
(Title)
(Must be President or V. President)
(18) Surety (16) __________________________________________ (Seal)
Corporate Seal (Surety)
(17) By:_______________________________________
19)Countersigned:_______________________________________
(Resident West Virginia Agent)
(20)Address:_______________________________________
(21)Telephone:_______________________________________
(REVERSE)
Acknowledgement by Principal (if Individual or Partnership)
(22) STATE OF ________________________________
(23) County of ___________________________, to wit:
I, (24)_______________________________ a Notary Public in and for the
county and state aforesaid, do hereby certify that
(25)__________________________________________ whose name is signed
to the foregoing writing has this day acknowledged the same before me
in my said county.
Given under my hand this (26) ______ day of _____________, 19_____.
(27) Notary Seal (28) ___________________________________
Notary Public
My Commission expires on (29)_______ day of _____________, 19_____.
Acknowledgement by Principal (if Corporation)
(30) STATE OF _______________________________________
(31) County of ______________________________________, to wit:
(32) I, ___________________________________, a Notary Public in and
for the county and state aforesaid, do hereby certify that
(33)__________________________________ who, as (34)____________________,
signed the foregoing writing for (35)__________________________________,
a corporation, has this day, in my said county, before me, acknowledged
the said writing to be the act and deed of the said corporation.
(36) Given under my hand this the _______ day of _____________, 19_____.
(37) Notary Seal (38) _____________________________________________
Notary Public
(39) My Commission expires on the _______ day of _____________, 19_____.
Acknowledgement for Surety
(40) STATE OF _____________________________________
(41) County of ____________________________________, to wit:
(42) I, ________________________________, a Notary Public in and for the
county and state aforesaid, do hereby certify that
(43)_______________________________, who as (44)_______________________,
signed the foregoing writing for (45)__________________________________,
a corporation, has this day, in my said county, before me, acknowledged
the said writing to be the act and deed of the said corporation.
(46) Given under my hand this _______ day of _____________ญญ, 19ญญญญญ_____.
(47) Notary Seal (48)___________________________________________
Notary Public
(49) My Commission expires on the _______ day of _____________, 19_____.
Sufficiency in Form and Manner
of Execution Approved.
Dated this ____ day of _____________, 19___.
By:_______________________
Asst. Attorney General
__
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