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U.S. Department of the Interior OMB Control No.: (Minerals Management Service)

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U.S.A. forms for Minerals Management Service

BROWSE MINERALS MANAGEMENT SERVICE (VA) FORMS

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U.S. Department of the Interior
Bureau of Ocean Energy Management
OMB Control No.: 1010-0176
Expiration Date: 03/31/2023
Bond No.:___________________ Bond Amount:___________________ Regional BOEM office:_______________
Bond Type:
□ Lease or Grant-Specific □ Supplemental □ Decommissioning
OUTER CONTINENTAL SHELF (OCS) RENEWABLE ENERGY
LESSEE'S, GRANTEE’S, AND OPERATOR'S BOND
The Surety is the Company 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.
The Principal is the Lessee, Grantee, or Designated Operator for Whom the Bond is Issued.
Name of Principal: ______________________________________________________
Mailing Address: ________________________________________________________
________________________________________________________
Schedule A: the lease or grant covered by this bond is the following: (Check one and enter Lease or Grant No.)
□ Commercial Lease No. :_________________________________
□ Limited Lease No: _____________________________________
□ Right-of-Way (ROW) Grant No. :__________________________
□ Right-of-Use and Easement (RUE) Grant No. :________________
□ Other (Specify):________________
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 exceptions or limitations identified in the attached rider.
Definitions
For the
purposes of this
document:
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. as
amended).
An Instrument includes individually or collectively any lease, operating agreement, designation of
operator or agent, permit, license, right-of-way, right-of-use and easement or project 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 corporation, a State, a political subdivision of a State,
any association of individuals, corporations, States, or subdivisions of States, or an Agency of the United
States.
By signing below, the Principal verifies that the information above is correct and agrees to the following:
The Principal, as agent on behalf of all lessees, grantees, and operators will fulfill all Obligations for the entire lease or
grant to the same extent as though the Principal were the sole lessee, grantee, or operator for the lease or grant described in
Schedule A.
Form BOEM-0005 (March 2020) Previous Editions are Obsolete PAGE 1 OF 3
By signing below, the Surety verifies that the information above is correct and agrees to the following:
1. The Surety does hereby absolutely and unconditionally bind itself to the United States of America acting through and
by the Bureau of Ocean Energy Management (BOEM), or such other official designated by the Secretary of the
Interior for this purpose, for the performance of all present and future Obligations.
2. The Surety agrees to meet all existing and future Obligations of the Principal on the lease or grant described in
Schedule A at a cost not to exceed __________________.
3. The Surety will be responsible for all Obligations of the Principal in existence at the time this document becomes
effective and all Obligations that accrue after that date and until all Obligations are met or until the Regional Director
terminates the period of liability of this bond.
4. If the Regional Director terminates the period of liability of this bond, the Surety will remain responsible for
Obligations that accrued during the period of liability until the Regional Director issues a written cancellation of the
bond in favor of the Surety.
5. If this bond is cancelled, the Regional Director may reinstate this bond as if no cancellation had occurred if any
payment of any obligations of the Principal(s) is rescinded or must be restored pursuant to any insolvency, bankruptcy,
reorganization, or receivership, or should the representation of the Principal that it has paid its financial Obligations or
performed the other Obligations of the lease or grant in accordance with BOEM specifications be materially false and
the BOEM relied upon such representation in canceling the bond.
6. The Surety waives any right of notice of this bond taking effect and agrees that this bond will take effect upon delivery
to BOEM.
7. The Surety's Obligations will remain in full force and effect, even if:
(a) Any person assigns all or part of any interest in an Instrument covered by this document.
(b) Any person modifies an Instrument or Obligation under an Instrument in any manner including modifications that
result from a suspension; suspension or changes in rent or operating fee; modification of regulations or
interpretations of regulations; or creation of any mortgage, pledge, or other grant of security interest in the
Instrument.
(c) Any person, event, or condition terminates any Instrument covered by this bond, whether the termination is by
operation of law or otherwise.
(d) The BOEM takes or fails to take any action in enforcing, as against any party to the Instrument, the payment of
rent or operating fees or the performance of any other covenant, condition or agreement of the lease or grant, or
giving notice of or making demand with respect to such nonperformance.
(e) The Surety suffers any loss by reason of any law limiting, qualifying, or discharging the Principal's Obligation.
8. The Surety agrees to be bound under this bond as to the interests in any Instrument retained by the Principal when the
BOEM approves the transfer of any or all of the Instrument or interest in the Instrument.
9. In the event of any default under a lease or grant, the Surety must perform the Obligations of the Principal upon
demand by the BOEM.
10. If the BOEM decides to commence suit to enforce its rights, it may commence and prosecute any claim, suit, action, or
other proceeding against the Principal and Surety, or either of them, whether or not the BOEM joins the lessees,
grantees or any other party.
11. In the event there is more than one Surety for the Principal's performance of the Obligations, as to any Instrument, the
Surety's Obligation and liability under this bond is on a “solidary” or “joint and several” basis along with other
guarantors or sureties.
12. The Surety agrees to notify the BOEM and the Principal within 5 business days of any action filed alleging the
insolvency or bankruptcy of the Surety or the Principal, or alleging any violation that would result in suspension or
revocation of the Surety's charter or license to do business, or if the U.S. Treasury decertifies the Surety.
13. The Surety's Obligation and liabilities under this Bond are binding upon the Surety's successors and assigns. Nothing
in this document permits assignment of the Surety's Obligation without the written consent of the BOEM.
14. The Surety hereby waives any defenses to liability on this bond based on an unauthorized Principal signature.
Form BOEM-0005 (March 2020) Previous Editions are Obsolete PAGE 2 OF 3
_____________________________________ ___________________________________
Name of Surety Name of Principal
_____________________________________ ___________________________________
Signature of Person Executing for Surety Signature of Person Executing for Principal
_____________________________________ ___________________________________
Name and Title Typed or Printed Name and Title Typed or Printed
_____________________________________ _____________________________________
Business Address Business Address
Signed on this _____ day of _____________, 20____, in
the State of ______________, in the presence of:
_____________________________________
Signature of Witness for Surety
_____________________________________
Name Typed or Printed
_____________________________________
Street Address
_____________________________________
City, State and ZIP
Signed on this _____ day of _____________, 20____, in
the State of ______________, in the presence of:
_____________________________________
Signature of Witness for Principal
_____________________________________
Name Typed or Printed
_____________________________________
Street Address
_____________________________________
City, State and ZIP
Note: The party signing 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. When the Surety is a corporation, an authorized corporate officer must sign the bond and attest to it
over the corporate seal.
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 hold the surety liable for the obligations and liability of the Principal (lessee, grantee 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 1 hour 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,
Bureau of Ocean Energy Management, 45600 Woodland Road, Sterling, Virginia 20166.
Form BOEM-0005 (March 2020) Previous Editions are Obsolete PAGE 3 OF 3
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Completed 26 September 2021

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