## 47723 Federal Register/ Vol. 78, No. 151 / Tuesday, August 6, 2013 / Notices including the Alabama, Tombigbee, and Cahaba River systems. Recent collections of the species have been restricted to the lower Alabama River below R.F. Henry Lock and Dam to the confluence of the Tombigbee River, as well as to the lower Cahaba River near its confluence with the Alabama River; however, incidents of such collections are extremely rare. The last capture of an Alabama sturgeon was on April 3, 2007, by biologists at the Alabama Department of Conservation and Natural Resources (ADCNR). The species was last observed on April 23, 2009, by ADCNR biologists. The Alabama sturgeon is one of the rarest species of fish in the nation and may be close to extinction.

Restoring an endangered or threatened animal or plant to the pointwhere it is again a secure, selfsustaining member of its ecosystem is a primary goal of our endangered species program. To help guide the recovery effort, we prepare recovery plans for most listed species. Recovery plans describe actions considered necessary for conservation of the species, establish criteria for downlisting or delisting, and estimate time and cost for implementing recovery measures.

The Act requires the development of recovery plans for listed species, unless such a plan would not promote the conservation of a particular species. Section 4(f) of the Act requires us to provide a public notice and an opportunity for public review and comment during recovery plan development. The draft of this recovery plan was available for public comment from April 12 through June 11, 2012 (77 FR 21993). We considered the information received via public comments as well as from peer reviewers in our preparation and approval of this final recovery plan. We also edited some sections of the draft recovery plan to reflect these comments; however, no substantial changes were made to the draft plan. Recovery Plan Components

The objective of this plan is to provide a framework for the recovery of the Alabama sturgeon so that protection under the Act is no longer necessary. Delisting of the species is not currently foreseeable due to extreme curtailment of range and extensive modification to the riverine habitats. Therefore, this recovery plan establishes criteria for downlisting the Alabama sturgeon from endangered to threatened.

Downlisting of the Alabama sturgeon may be considered when the following criteria are met: (1) A population consisting of approximately 500 sexually mature Alabama sturgeon is shown to be surviving and naturally reproducing in the Alabama/Cahaba Rivers; (2) population studies show that the Alabama sturgeon population is naturally recruiting (consisting of multiple age classes), sustainable over a period of 20 years (2–3 generations), and no longer requires hatchery augmentation; and (3) an agreement is in place that ensures adequate flows are being delivered down the Alabama River for successful development of sturgeon larvae and passage of the fish both upstream and downstream at dams on the Alabama River. Authority

The authority for this action is section 4(f) of the Endangered Species Act, 16 U.S.C. 1533 (f).

Dated: July 8, 2013. Leopoldo Miranda, Acting Regional Director, Southeast Region. [FR Doc. 2013–18914 Filed 8–5–13; 8:45 am] **BILLING CODE 4310–55–P** 

### DEPARTMENT OF THE INTERIOR **Bureau of Land Management [LLMTC 00900.L16100000.DP0000]**  

### Notice of Public Meeting, Eastern **Montana Resource Advisory Council AGENCY** 

### : Bureau of Land Management, Interior. **ACTION**

### : Notice of Public Meeting. **SUMMARY**

### : In accordance with the Federal Land Policy and Management Act (FLPMA) and the Federal Advisory Committee Act of 1972 (FACA), the U.S. Department of the Interior, Bureau of Land Management (BLM) Eastern Montana Resource Advisory Council (RAC) will meet as indicated below. **DATES**

### : The next regular meeting of the Eastern Montana RAC will be held on September 5, 2013 in Billings, Montana. The meeting will start at 8:00 a.m. and the public comment period will start at 11:00 a.m. and run for one hour. The meeting will adjourn at around 3:30 p.m. **ADDRESSES**

### : The meeting location will be announced in a news release. **FOR FURTHER INFORMATION CONTACT**

### : Mark Jacobsen, Public Affairs Specialist, BLM Eastern Montana/Dakotas District, 111 Garryowen Road, Miles City, Montana, 59301, (406) 233–2831, mark

_ jacobsen@blm.gov. Persons who use a telecommunications device for the deaf (TDD) may call the Federal Information Relay Service (FIRS) at 1– 800–677–8339 to contact the above individual during normal business hours. The FIRS is available 24 hours a day, 7 days a week to leave a message or question with the above individual. You will receive a reply during normal business hours. **SUPPLEMENTARY INFORMATION**

### : The 15- member council advises the Secretary of the Interior through the BLM on a variety of planning and management issues associated with public land management in Montana. At these meetings, topics will include: Eastern Montana—Dakotas District, Miles City and Billings Field Office manager updates, Field Office Resource Management Planning updates, individual council member briefings and other topics that the council may raise. All meetings are open to the public and the public may present written comments to the council. Each formal RAC meeting will also have time allocated for hearing public comments. Depending on the number of persons wishing to comment and time available, the time for individual oral comments may be limited. Individuals who plan to attend and need special assistance, such as sign language interpretation, or other reasonable accommodations should contact the BLM as provided above.

Dated: July 24, 2013. Diane M. Friez, Eastern Montana—Dakotas District Manager. [FR Doc. 2013–18915 Filed 8–5–13; 8:45 am] **BILLING CODE 4310–DN–P** 

### DEPARTMENT OF THE INTERIOR **Bureau of Ocean Energy Management [OMB Control Number 1010–0106;**  **MMAA104000]** 

### Information Collection: Forms for Oil **Spill Financial Responsibility for Offshore Facilities; Proposed**  **Collection for OMB Review; Comment Request**  **ACTION**

### : 60-day notice. **SUMMARY**

### : To comply with the Paperwork Reduction Act of 1995 (PRA), the Bureau of Ocean Energy Management (BOEM) is inviting comments on the proposed revision of forms associated with a collection of information that we will submit to the Office of Management and Budget (OMB) for review and approval. The information collection request (ICR) concerns the forms used for paperwork requirements under 30 CFR 553, Oil Spill Financial Responsibility for Offshore Facilities.


## 47724 Federal Register/ Vol. 78, No. 151 / Tuesday, August 6, 2013 / Notices
**DATES**

### : Submit written comments by October 7, 2013. **ADDRESSES**

### : Please send your comments on this ICR to the BOEM Information Collection Clearance Officer, Arlene Bajusz, Bureau of Ocean Energy Management, 381 Elden Street, HM– 3127, Herndon, Virginia 20170 (mail); or arlene.bajusz@boem.gov (email); or 703–787–1209 (fax). Please reference ICR 1010–0106 in your comment and include your name and return address. **FOR FURTHER INFORMATION CONTACT**

### : Arlene Bajusz, Office of Policy, Regulations, and Analysis at (703) 787– 1025. The revised forms are printed at the end of this notice. **SUPPLEMENTARY INFORMATION**

### : OMB Control Number: 1010–0106.

Title: 30 CFR 553, Oil Spill Financial Responsibility for Offshore Facilities.

Forms: BOEM–1016 through 1023 and BOEM–1025.

Abstract: On May 1, 2013, BOEM released a notice inviting public comment on the information collection renewal of requirements for BOEM’s Oil Spill Financial Responsibility (OSFR) regulations under 30 CFR 553 (78 FR 25472). The BOEM uses the information collected under these regulations to verify compliance with section 1016 of the Oil Pollution Act of 1990, as amended (OPA), and to confirm that applicants can pay for cleanup and damages resulting from oil spills and other hydrocarbon discharges that originate from Covered Offshore Facilities (COFs). Since May, BOEM has proposed revising the forms used with this collection and is providing the 60- day public comment period for the revisions with this notice.

BOEM is splitting the function of some forms and revising others to clarify the responsibilities and financial obligations of responsible parties and applicants, as described in the Outer Continental Shelf Lands Act, and to better align the terminology and liability with the provisions of OPA. These revisions will better protect the Federal Government from potential disputes and litigation by clarifying that the primary relationship is between the responsible party and guarantor and that the designated applicant/operator is intended to function primarily in an administrative capacity. The revisions will also better align BOEM’s process with that of the U.S. Coast Guard’s National Pollution Fund Center, thereby reducing the burden on industry in complying with potentially conflicting guidance on oil spill responsibility, particularly with respect to offshore facilities that also function as vessels. Below is a description of each affected form, as well as any change in the burden. The revised forms are also printed at the end of this notice. Until OMB approves these revisions, the current forms remain in use and can be located at http://www.boem.gov/AboutBOEM/Procurement-BusinessOpportunities/BOEM-OCS-OperationForms/BOEM-OCS-OperationForms.aspx.

Form BOEM–1016, Designated Applicant Information Certification. This form remains essentially the same except for updating the choices of forms and clarifying the administrative role of the designated applicant. No change in the 1-hour burden is expected.

Form BOEM–1017, Appointment of Designated Applicant. This form remains essentially the same except for changing the title, clarifying the administrative role of the designated applicant, and adding a column to record depth ranges, when applicable. No change in the 9-hour burden is expected.

Form BOEM–1018, Self-Insurance Information. The original form posed potential confusion because it served two purposes, both to provide evidence of self-insurance (for responsible parties) and as an indemnity (executed by persons other than the responsible party). Thus, the form has been split into two forms (BOEM–1018 and BOEM–1023). BOEM–1018 focuses on self-insurance only and is reworded to more closely align with the requirements of OPA, adding an agreement to update/renew expiring or terminated instruments and a signature section. No change in the 1-hour burden is expected.

Form BOEM–1019, Insurance Certificate. The language and agreements in this form have been reworded for compliance with OPA, to clarify that the insurer is responsible for OPA liabilities of the responsible parties, and to add an agreement to update/renew expiring or terminated instruments. No change in the 120-hour burden is expected.

Form BOEM–1020, Surety Bond. The language and agreements in this form have been reworded for compliance with OPA, to clarify that the Surety is responsible for OPA liabilities of the responsible parties, and to add an agreement to update/renew expiring or terminated instruments. No change in the 24-hour burden is expected.

Forms BOEM–1021, Covered Offshore Facilities, and BOEM–1022, Covered Offshore Facility Changes. These forms remain essentially the same except for rewording of the subtitles to match the other forms and adding a provision for rights-of-way. There is no change in the 1-hour burden for BOEM–1022; however, based on respondent input we are increasing the burden for BOEM– 1021 from 3 to 6 hours.

Form BOEM–1023, Financial Guarantee. This new form replaces the indemnity agreement (previously part of BOEM–1018) with a provision that an affiliated firm, such as a corporate parent, may promise to satisfy any claims against the responsible parties. It also adds an agreement to update/renew expiring or terminated instruments and a signature section. The hour burden is estimated as 1.5 hours.

Form BOEM–1025, Independent Designated Applicant Information Certification. This new form allows a designated applicant, who is not also a responsible party, to continue to agree to be jointly and severally liable under OPA until BOEM promulgates regulations that will repeal this requirement. We estimate the burden hour to be 1 hour.

We will protect information from respondents considered proprietary under the Freedom of Information Act (5 U.S.C. 552) and its implementing regulations (43 CFR part 2) and under regulations at 30 CFR 550.197, ‘‘Data and information to be made available to the public or for limited inspection.’’ No items of a sensitive nature are being collected. Responses are mandatory.

Frequency: On occasion or annual basis.

Description of Respondents: Holders of leases, permits, and rights of use and easement in the Outer Continental Shelf and in State coastal waters and those who will appoint designated applicants to process their OSFR paperwork. Other respondents will be the designated applicants’ insurance agents and brokers, bonding companies, and guarantors.

Public Disclosure Statement: The PRA (44 U.S.C. 3501, et seq.) provides that an agency may not conduct or sponsor a collection of information unless it displays a currently valid OMB control number. Until OMB approves a collection of information, you are not obligated to respond.

Comments: Before submitting an ICR to OMB, PRA section 3506(c)(2)(A) requires each agency ‘‘. . . to provide notice . . . and otherwise consult with members of the public and affected agencies concerning each proposed collection of information . . .’’. Agencies must specifically solicit comments to: (a) Evaluate whether the proposed collection of information is necessary for the agency to perform its duties, including whether the information is useful; (b) evaluate the


## 47725 Federal Register/ Vol. 78, No. 151 / Tuesday, August 6, 2013 / Notices accuracy of the agency’s estimate of the burden of the proposed collection of information; (c) enhance the quality, usefulness, and clarity of the information to be collected; and (d) minimize the burden on the respondents, including the use of automated collection techniques or other forms of information technology.

Agencies must also estimate the nonhour cost burdens to respondents or recordkeepers resulting from the collection of information. Therefore, if you have costs to generate, maintain, and disclose this information, you should comment and provide your total capital and startup cost components or annual operation, maintenance, and purchase of service components. You should describe the methods you use to estimate major cost factors, including system and technology acquisition, expected useful life of capital equipment, discount rate(s), and the period over which you incur costs. Capital and startup costs include, among other items, computers and software you purchase to prepare for collecting information, monitoring, and record storage facilities. You should not include estimates for equipment or services purchased: (i) Before October 1, 1995; (ii) to comply with requirements not associated with the information collection; (iii) for reasons other than to provide information or keep records for the Government; or (iv) as part of customary and usual business or private practices.

We will summarize written responses to this notice and address them in our submission for OMB approval. As a result of your comments, we will make any necessary adjustments to the burden estimates in our submission to OMB.

Public Availability of Comments: Before including your address, phone number, email address, or other personal identifying information in your comment, you should be aware that your entire comment—including your personal identifying information—may be made publicly available at any time. While you can ask us in your comment to withhold your personal identifying information from public review, we cannot guarantee that we will be able to do so.

Dated: July 31, 2013. Deanna Meyer-Pietruszka, Chief, Office of Policy, Regulations, and Analysis. **BILLING CODE 4310–MR–P**


## 47726 Federal Register/ Vol. 78, No. 151 / Tuesday, August 6, 2013 / Notices


### PAPERWORK REDUCTION ACT STATEMENT BUREAU OF OCEAN ENERGY MANAGEMENT OIL POLLUTION ACT OF 1990 OIL SPILL FINANCIAL RESPONSIBILITY FOR OFFSHORE FACILITIES The Paperwork Reduction Actof 1995 (44 U.S.C. 3501 et seq.) requires us to inform you thatthe Bureau of Ocean Energy Management (BOEM) collectsthis information to: 1. Provide a standard method for establishing eligibilityfor oil spill financial responsibility (OSFR) for offshore facilities; 2. Identify and maintain a record ofthose offshore facilities that have a potential oil spill liability; 3. Establish and maintain a continuous record, over the liability term specified in Title I ofthe Oil Pollution Act of 1990, offinancial evidence and instruments established to pay claimsfor oil spill cleanup and damages resulting from operations conducted on offshore facilities and the transportation of oil from offshore platforms and wells; 4. Establish and maintain a continuous record of Responsible Parties, asdefined in Title I ofthe Oil Pollution Act of 1990, and theiragents or Authorized Representatives for oil spill financial responsibility for offshore facilities; and 5. Establish and maintain a continuous record, overthe liabilityterm specified in Title I ofthe Oil Pollution Act of 1990, of persons tocontact and U.S. Agents for Service of Processfor claims associated with oil spills from offshore facilities. The BOEM will routinely use the information to: 1. Ensure compliance of offshore lessees and ovvners and operators of offshore facilities with Title I of the Oil Pollution Act of 1990; 2 Establish eligibility of applicantsfor OSFR; and 3. Establish a reference source of names, addresses, and telephone numbers of Responsible Parties for offshore facilities and theirAuthorized Representatives and Guarantors for claims associated with oil pollution from designated offshore facilities. Responses are mandatory (33 U.S.C. 2716). No confidential or proprietary information is required to be submitted. The BOEM considers oil spill financial responsibility demonstrations, including supporting audited financial statements, to be public information open for review underthe Freedom of Information Act (5 U.8.C. 552). An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currentlyvalid Office of Managementand Budget (OMB) Control Number. The public reporting burden for an application for certification of oil spill financial responsibility is listed below. The burden includesthe time for reViewing instructions, gathering and maintaining data, and completing and reviewing the application. The average burden for each ofthe forms and required information that could comprise a submission is:
Form BOEM-1016, DeSignated Applicant Information Certification

....................... 1 hour Form BOEM-1017, AppOintment of DeSignated Applicant

.............,............., ..... 9 hours Form BOEM-1 018, Self-Insurance Information

...................................................1 hour Form BOEM-1019, Insurance Certificate

........................................................ 120 hours Form BOEM-1020, Surety Bond

......................................................................24 hours Form BOEM-1 021, Covered Offshore Facilities

...................................................6 hours Form BOEM-1022, Covered Offshore Facility Changes

........................................ 1 hour Form BOEM-1023, Financial Guarantee

.............................1.5 hours Form BOEM-1025, Independent Designated Applicant Information Certification

..1 hour

Comments regarding the burden estimate or any other aspect ofthis form should be directed tothe Information Collection Clearance Officer, Bureau of Ocean Energy Management, 381 Elden Street, Herndon, VA 20170. (Month/year)

## 47727 Federal Register/ Vol. 78, No. 151 / Tuesday, August 6, 2013 / Notices


### DESIGNATED APPLICANT INFORMATION CERTIFICATION CERTIFICATION OF OIL SPILL FINANCIAL RESPONSIBILITY IN ACCORDANCEWITH THE REQUIREMENTS OF THE OIL POLLUTION ACT OF 1990 (TYPE OR PRINTALL INFORMATION EXCEPT SIGNATURES)
1. Designated Applicant:

_________**---:==~=~=-------** COMPANY LEGAL NAME BOEM COMPANY NUMBER
ADDRESS BOEM COMPANY REGION
CITY STATE ZIP CODE ( ) CONTACT PERSON AREA CODE and TELEPHONE NUMBER ( ) CONTACT PERSON'S TITLE AREA CODE and FAX NUMBER

E-MAIL ADDRESS

• Self-Insurance (BOEM-1018) $**--------~---------** • FinancialGuarantee**(BOEM~1023)$ ~--------------~**  • Surety Bonds (BOEM-1020) $



# ------------------- • Insurance (BOEM-1019) $



# ------------------- • Other $


# ------------------ TOTAL AMOUNT $


# ------------------- 3. The Designated Applicant, for all ofthe Responsible Parties whose Designated Applicant authorizations (form BOEM-1017) are on file or attached, agreesto establish and maintain oil spill financial responsibility (OSFR), underthe Oil Pollution Act of 1990, as amended, 33 U.S.C. 

### § 2701 

### etseq., for all said Responsible Parties. This OSFR will be maintained continuously for those leases, permits, rights of use and easement, and pipeline segments identified in form(s) BOEM-1017 on file or attached. Iwill immediately notifythe Responsible Parties of any claims that I receive. Iwill immediately notify the BOEM OSFR program if information on this form changes. Icertify the information contained herein, including all the information on the attached forms, is complete, true, and correct to the best of my information and knowledge.

NAME OF AUTHORIZED REPRESENTATIVE
TITLE OF AUTHORIZED REPRESENTATIVE 

### 4. The Designated Applicant's U.S. Agentfor Service of Process is:

( ) AREA CODE and TELEPHONE NUMBER

FORM BOEM-1016 (Monthlyear) Previous Editions are Obsolete. ADDRESS
CITY ( ) AREA CODE and FAX NUMBER SIGNATURE
DATE

NAME BOEM COMPANY NUMBER
STATE ZIP CODE
E-MAILADDRESS

PAGE 1 OF 1

## 47728 Federal Register/ Vol. 78, No. 151 / Tuesday, August 6, 2013 / Notices


### APPOINTMENT OF DESIGNATED APPLICANT CERTIFICATION OF OIL SPILL FINANCIAL RESPONSIBILITY IN ACCORDANCE WITH THE REQUIREMENTS OF THE OIL POLLUTION ACT OF 1990 (TYPE OR PRINTALL INFORMATION EXCEPT SIGNATURES) 

### 1. Designated Applicant:

__________ -:::-::==-:-=:=-:-:-":':":"':=-

______ _ COMPANY LEGAL NAME BOEM COMPANY NUMBER
ADDRESS BOEM COMPANY REGION
CITY STATE ZIP CODE 

### 2. Responsible Party:

___________ -:-:..,..,."..,..,.,.,.,,.,..,,,.,,.,.,....,.,...,.,,.,,,,..

___ _ COMPANY LEGAL NAME BOEM COMPANY NUMBER
ADDRESS BOEM COMPANY REGION
CITY STATE ZIP CODE
CONTACT PERSON CONTACT PERSON'S TITLE ( ) ( ) AREA CODE and TELEPHONE NUMBER AREA CODE and FAX NUMBER E·MAILADDRESS 3. I, the undersigned, serving as the Authorized Representative ofthe Responsible Party named in section 2, do hereby appoint and authorize the Designated Applicant identified in section 1 to act on behalf ofthe Responsible partyto obtain a certification of oil spill financial responsibility (OSFR) for each covered offshore facility at the locations described in section 5, andto establish and maintain OSFR on the Responsible Party's behalf forthese specified covered offshore facilities in accordance with 30 CFR Part 553 and in the amounts specified by the Bureau ofOcean Energy Management (BOEM). On behalfofthe Responsible Party, I explicitly agree that the Responsible Party be strictly liable, jointly and severally, together with the other Responsible Parties for each covered offshore facility described in section 5, for all oil spill removal costs and damages in accordance with the Oil Pollution Act of 1990, as amended, 33 U.S.C. 

### § 2701 etseq. This appointment is effective beginning on
__________ 

# ==-______. I agree, on behalf ofthe DATE Responsible Party, that the Responsible Party will notify the BOEM oil spill financial responsibility program in writing when this appointment is canceled; thatthe Responsible Partywill concurrently appoint a substitute Designated Applicant; and that the Responsible Party shall be bound by the actions ofthe Designated Applicant hereby appointed until such time as BOEM receives such notice and a substitute DeSignated Applicant so appointed.

NAME OF AUTHORIZED REPRESENTATIVE
TITLE OF AUTHORIZED REPRESENTATIVE 

### 4. The Responsible Party's U.S. Agent for Service of Process is:

( ) AREA CODE and TELEPHONE NUMBER

FORM BOEM-1017 (MonthNear) Previous Editions are Obsolete. ADDRESS
CITY ( ) AREA CODE and FAXNUMBER SIGNATURE
DATE

NAME BOEM COMPANY NUMBER
STATE ZIP CODE
E·MAIL ADDRESS

PAGE 1 OF 2

## 47729 Federal Register/ Vol. 78, No. 151 / Tuesday, August 6, 2013 / Notices


### 5. Locations of Covered Offshore Facilities: STAte ..••..

# 'i

....

I;)R LEASE QCS

### '<l\Iti.B~R RI;GlON

... 

## i,

. i .••**Al'9IJO~ PQRn~N** **tlf~I!l>~~bl~l**



### FORM BOEM·1017 (Month/year) Previous Editions are Obsolete. 

# . DEPTH 

## RANGE**(lfA'pl>lj.cabl~)<**

### P:1~El.I

## tfE**SE~lvl~~~** IIIUMBER····



### PAGE20F 2

## 47730 Federal Register/ Vol. 78, No. 151 / Tuesday, August 6, 2013 / Notices


### U.S. Departmentofthe Interior Bureau ofOcean Energy Management OMB Control No.: xxxxxxx Expiration Date: xxxxxxxxx 

## SELF·INSURANCE INFORMATION RESPONSIBLE PARTY SELF-INSURANCE CERTIFICATION OF OIL SPILL FINANCIAL RESPONSIBILITY IN ACCORDANCE WITH THE REQUIREMENTS OF THE OIL POLLUTION ACT OF 1990 (TYPE OR PRINTALL INFORMATION EXCEPT SIGNATURES)


### 1. I, the undersigned, asthe Authorized Representative ofthe Responsible Party (described in section 6), certifiesthat the Responsible Party is acting in the capacity of a Self-Insurer, in accordance with the requirements of 30 CFR 553.41. 

### 2. The amount ofcoverage for which evidence of oil spill financial responsibility is being established by the Responsible Party using self-insurance is: 

# IFROM [

# ~ $ 

# [:OWERLlMI_T [ 

# I TO $ UPPER LIMIT (MUST BE COMPLETED)


### 3. This coverage is effective:

__ -"..,.."..",..

____and expires on the first calendar day ofthefifth month

DATE 

### afterthe close ofthe Self-Insurer'sfiscal year, which ends:

_________ _ DATE 

### 4. The Responsible Party providing evidence ofoil spill financial responsibility in the form of Self-Insurance is:

COMPANY LEGAL NAME BOEM COMPANY NUMBER

ADDRESS
CITY STATE ZIP CODE CONTACT PERSON FOR CLAIMS CONTACT PERSON'S TITLE

AREA CODE AND TELEPHONE NUMBER AREA CODEAND FAX NUMBER E-MAIL ADDRESS


### 5. The undersigned certifies on behalf ofthe Responsible Party thatthe requirements set forth in 30 CFR Part 553 and specifically 

### §§553.21 through 553.28 have been met. The undersigned further agreesthat the Responsible Party, pursuantto the requirements of30 CFR 553.15, will notify the BOEM oil spill financial responsibility program in the eventthe Responsible Party is no longer able to maintain evidence of oil spill financial responsibility as a Self-Insurer in the amounts stated in section 2 above.



### FORM BOEM-1018 (MonthNear) Previous Editions are Obsolete. PAGE 1 

### OF2

## 47731 Federal Register/ Vol. 78, No. 151 / Tuesday, August 6, 2013 / Notices


### 6. The Responsible Party, as Self-Insurer, acting through the Designated Applicant must, no laterthan the first calendar day ofthe fifth month after the close of your fiscal year, submit either a renewal ofthis Self-Insurance or other acceptable evidence offinancial responsibility.

NAME OF AUTHORIZED REPRESENTATIvE OF RESPONSIBLE PARTY

TITLE OF AUTHORIZED REPRESENTATIVE OF RESPONSIBLE PARTY



### 7. The Self-Insurer's U.S. Agent for Service of Process is:

NAME

ADDRESS

AREA CODEAND TELEPHONE NUMBER AREA CODEAND FAX NUMBER SIGNATURE

DATE

BOEM COMPANY NUMBER

E-MAIL ADDRESS



### 8. In witness whereof, the Designated Applicant andthe Self-Insurer have executed this instrument on the

____ _ dayof

__________. MONTH YEAR


### Designated Applicant for the Responsible Parties named herein:

SIGNATURE OFAUTHORIZED REPRESENTATIVE OF DESIGNATED APPLICANT

NAME OF AUTHORIZED REPRESENTATIVE OF DESIGNATED APPLICANT

TITLE OF AUTHORIZED REPRESENTATIVE OF DESIGNATED APPLICANT



### FORM BOEM-1018 (MonthlYear) Previous Editions are Obsolete. 

### PAGE20F2

## 47732 Federal Register/ Vol. 78, No. 151 / Tuesday, August 6, 2013 / Notices


### U.S. Departmentofthe Interior Bureau ofOcean Energy Management OMB Control No.: xxxxxxx Expiration Date: xxxxxxx 

### INSURANCE CERTIFICATE CERTIFICATION OF OIL SPILL FINANCIAL RESPONSIBILITY IN ACCORDANCE WITH THE REQUIREMENTS OF THE OIL POLLUTION ACT OF 1990 (TYPE OR PRINTALL INFORMATION EXCEPT SIGNATURES)


### 1. Designated Applicant:

__________**-:-:=~,..,..".,,,..,.,...,.,..,.,_::_=_-------** 

## ________ _ COMPANY LEGAL NAME BOEM COMPANY NUMBER 

### 2. The amount of insurance coverage established by the named Insurers as evidence of oil spill financial responsibility (OSFR) for the Responsible Parties, identified in form(s) BOEM-1017 on file or attached, (hereafterthe Insured), as represented by the Designated Applicant, in compliance with the Oil Pollution Act of 1990, as amended, 33 U.S.C. 

### §§ 2701-2672 (hereafter the Act) and with Title 30 Code of Federal Regulations (CFR), part 553, for anyone incident is: FROM

### $.--:::==~=~=~;-­ STARTING AMOUNT ABOVE ANY DEDUCTIBLE OR EXCESS AMOUNT

## TO:$--~U~P~P~ER~L~IM~IT~O~F~---­ THIS INSURANCE LAYER 

### The following insurance option has been selected to provide this coverage: 

# o Full Option-Insurance is provided for the firstfull 

### $ million without deductible. 

# o Deductible Option-Insurance is provided for the amount of**$~**__ 

### million less the deductible amount of$

____. D Excess Option-Insurance is provided for the amount of

### $

___ million in excess ofthe amount of of 

### $ ____ million. 

### 3. This coverage is effective:

___ --:=:--__

### at and expires:

___ ::-::-:::=-__ DATE Central Standard Time DATE 

### at

_____

### ~~~~~----------- Centra! Standard Time
4. 

### The Insurer may at anytime cancel this insurance certificate by written notice of intent to cancel sent by certified mail to the Designated Applicant with copies (plainly indicating the original notice was sent by certified mail) to all Responsible Parties and to the BOEM oil spill financial responsibility program by certified mail. This instrument will remain in force and the undersigned will remain liable until the expiration date or until the earlier of (1) thirty calendar days after BOEM and the Designated Applicant receive a notification ofyour intentto cancel this insurance certificate; (2) BOEM receives other acceptable OSFR evidence from the Designated Applicant; or (3) all the COFsto which this Insurance Certificate applies have been permanently abandoned either in compliance with 30 CFR part 250 or the equivalent state requirements. The undersigned agrees that any termination ofthis Insurance Certificate will not affectthe liability ofthe Insurerfor any claims that arise from an incident (i.e., oil discharge or substantial threat of the discharge ofoil) that occurs on or before the effective date oftermination of this Insurance Certificate. 

### S. The named Insurers agree that any suit orclaimfor which the Responsible Parties identified in form(s) BOEM-1017, on file or attached, represented bythe aforementioned Designated Applicant may be liable underTitle I ofthe Act may be brought directly against the named Insurers for claims upto the amount of insurance coverage asserted by the U.S. government or by other claimants when a Responsible Party denies or fails to pay a claim on the basis of insolvency or a Responsible Party has petitioned fOf bankruptcy underTitle 11 ofthe U.S. Code. 

### 6. The undersigned further agrees notto use any defense exceptthose that would be available to a Responsible Party for whomthe insurance was provided or that the incident leading to the claim for removal costs or damageswas caused by willful misconduct ofa Responsible Party covered by this insurance. 

### FORM BOEM-1019 (MonthNear) Previous Editions are Obsolete. 

### PAGE 1 OFS

## 47733 Federal Register/ Vol. 78, No. 151 / Tuesday, August 6, 2013 / Notices


### 7. The undersigned Responsible Partyfurther agrees, pursuantto the requirements of 30 CFR 553.15, to notifythe BOEM oil spill financial responsibility program in the event the Responsible Party is no longer able to maintain evidence of oil spill financial responsibility to the extent stated in section 2 above. 8. The Designated Applicant must, no later than the first calendar day of the fifth month after the close ofthe Insurer's fiscal year or expiration if earlier, submit either a renewal ofthis insurance or other acceptable evidence offinancial responsibility. 

### 9. Insurance agent or brokerfor this Insurance Certificate:

COMPANY NAME BOEM COMPANY NUMBER
ADDRESS
CITY STATE COUNTRY (Ifnot U.S.A.) ZIP CODE ( ) ( ) AREA CODE and TELEPHONE NUMBER AREA CODE and FAX NUMBER E-MAIL ADDRESS



### 10. As an Authorized Representative ofthe insurance agent or broker identified above, Icertify that the information contained in this Insurance Certificate is accurate and correct, that quota shares total 100 percent for this Insurance Certificate, and that this Insurance Certificate and the named Insurers, complies with the requirements stated in 30 CFR 553.29. The identified insurance agent or broker agrees to maintain and provide to the Designated Applicant and BOEM, on demand, any delegations ofauthorityto a broker or an underwriterof another insurer or underwriting managerto bind a named Insurerto all risks and liabilities specified in Title Iofthe Act.

NAME SIGNATURE
DATE


### 11.The named Insurers, listed below, certifythat the Insured is insured by the named Insurers forthe offshore facilities, as specified below, against liability for removal costs and damagestowhich the Insured could be subjected under Title I ofthe Oil Pollution Act and 30 CFR 553 within the insurance layer specified. Thefollowing offshorefacility coverage option has been selected: 

## D General Option-All covered offshore facilities for which the named DeSignated Applicant serves in that capacity. 

## D Schedule Option- All covered offshore facilities on the Designated Applicant's attached information form and schedule of propertiesforms, effective

FORM BOEM-1019 (MonthlYear) Previous Editions are Obsolete. DATE



### PAGE 2 OF 

### 5

## 47734 Federal Register/ Vol. 78, No. 151 / Tuesday, August 6, 2013 / Notices


### 12. The named Insurers designate the following U,S, Agent for Service of Processforthis Insurance Certificate:

NAME BOEM COMPANY NUMBER
ADDRESS
CITY STATE ZIP CODE ( ) AREA CODE and TELEPHONE NUMBER E-MAIL ADDRESS



### 13. In witness whereof, the Designated Applicant forthe Responsible Parties and the named Insurers have executed this instrument on the

______day of

________' MONTH YEAR 

### Designated Applicantforthe Responsible Parties named herein:

SIGNATURE OF AUTHORIZED REPRESENTATIVE OF DESIGNATED APPLICANT

NAME OF AUTHORIZED REPRESENTATIVE OF DESIGNATEDAPPLICANT

TITLE OFAUTHORIZED REPRESENTATIVE OF DESIGNATEDAPPLICANT



### Named Insurers:

COMPANY NAME

ADDRESS

CITY



### FORM BOEM-1019 (MonthNear) Previous Editions are Obsolete, STATE ZIP CODE



### PAGE3 OF 

### 5

## 47735 Federal Register/ Vol. 78, No. 151 / Tuesday, August 6, 2013 / Notices


## 47736 Federal Register/ Vol. 78, No. 151 / Tuesday, August 6, 2013 / Notices


### U.S. Department ofthe Interior Bureau ofOcean Energy Management OBM Control No.: xxxxxxx Expiration Date: xxxxxxxxx 

### SURETY BOND CERTIFICATION OF OIL SPILL FINANCIAL RESPONSIBILITY IN ACCORDANCE WITH THE REQUIREMENTS OF THE OIL POLLUTION ACT OF 1990 (TYPE OR PRINTALL INFORMATION EXCEPT SIGNATURES)


### 1. Designated Applicant:

__________**.."..".=~":'"'=',...,..,..~=_-------_:::_:;;::::;:_;_=::_=_;_::_;:_;_:;_::_=** COMPANY LEGAL NAME BOEM COMPANY NUMBER 

### 2. Surety Company Bond Number:

___________________ ___ 

### 3. The Designated Applicant and Responsible Parties, identified in formes) BOEM-1017 on file orattached, and**_----:.,.-:-:-:==-===:-:~=_:_:_::_:_--,** a company created underthe laws of , and NAME OF SURETY COMPANY STATE authorized to do business in the United States, as Surety (hereinafter called Surety), are held and firmly bound unto the United States of America and other claimants for damages and removal cost liability underthe Oil Pollution Act of 1990, 33 U.S.C. 

### § 2701 

### etseq. (hereinafter called Act), inthe sum of

### $ , for AMOUNT which payment, we bind ourselves and our heirs, executors, administrators, successors, and assigns, jOintly and severally, underthe terms and conditions of Part 553 ofTitle 30 ofthe Code of Federal Regulations. This bond is hereby provided on behalf of the Responsible Partiesto comply with the requirements of33 U.S.C. 

### § 2716(c) and is offered to satisfy any claim made under OPA. 

### 4. The liability ofthe Surety will not be discharged by any payment or succession of payments hereunder, unless and until such payment or payments will amount in the aggregate to the penalty ofthe bond. In no event will the Surety's obligation hereunder exceed the amount ofthe penalty, provided the Suretyfurnishes timely written notice tothe Bureau of Ocean Energy Management (BOEM) oil spill financial responsibility (OSRP) program of all claims filed, judgments rendered, and payments made by the Surety underthis bond. 

### 5. This bond is effective the

___day of -:-:-::=.,----' ----::-;:-.:-::,--' 12:01 a.m., Eastern StandardTime NUMBER MONTH YEAR
as stated herein and will continue in force until terminated as hereinafter provided. The Surety may at any time terminate this bond by written notice of intent to cancel sent by certified mail to the Designated Applicant with copies (plainly indicating the original notice was sent by certified mail) to all Responsible Parties and to the BOEM oil spill financial responsibility program by certified mail. This surety bond will remain in force and the undersigned will remain liable until termination on the earlierof: (1) thirty calendar days after BOEM and the Designated Applicant receive a notification of an intent to cancel this Surety Bond; (2) BOEM receives other acceptable OSFR evidence from the Designated Applicant; or (3) all the COFs to which this Surety Bond applies have been permanently abandoned either in compliance with 30 CFR part 250 or equivalent state requirements. The Surety will not be liable in connection with an incident occurring after the termination ofthis bond as herein provided; but termination will not affect the liability of the Surety in connection with an incident occurring before the termination becomes effective. 6. The undersigned agree that any suit or claim for which the Responsible Parties identified in formes) BOEM-1 017,

on file or attached, represented by the aforementioned Designated Applicant may be liable underTitle I ofthe Act may be brought directly against the Suretyfor claims upto the amount ofthe penalty asserted bythe U.S. government or by other claimants when a Responsible Party denies or fails to pay a claim on the basis of insolvency or a Responsible Party has petitioned for bankruptcy underTitle 11 ofthe U.S. Code. 7. The undersigned further agrees notto use any defense except those that would 

### be available to a Responsible

Party for whom the Surety was provided or thatthe incident leading to the claim for removal costs or damages was caused by willful misconduct of a Responsible Party covered by this Surety Bond.

FORM BOEM-1020(Monthlyear) Previous Editions are Obsolete. 

### PAGE 1 OF2

## 47737 Federal Register/ Vol. 78, No. 151 / Tuesday, August 6, 2013 / Notices


### 8. The undersigned further agrees that the Responsible Party, pursuantto the requirements of30 CFR 553.15, will notifythe BOEM oil spill financial responsibility program in the event the Responsible Party is no longer able to maintain evidence ofoil spill financial responsibility to the extent stated in section 3 above. g. The Designated Applicant must, no later than the first calendar day ofthe fifth month after the close ofyour

Financial Guarantor'sfiscal year ortermination if earlier, submit either a renewal ofthis Surety Bond or other acceptable evidence offinancial responsibility. 10. In witness whereof, the Designated Applicant and the Surety have executed this instrument on the

____ _ dayof

__________ __ MONTH YEAR

Designated Applicant:

SIGNATURE OF AUTHORIZED REPRESENTATIVE

------------------------- NAME OFAUTHORIZED REPRESENTATIVE

TITLE OF AUTHORIZED REPRESENTATIVE

Surety:

COMPANY NAME
ADDRESS



# --------------------------- CITY STATE ZIP CODE

NAME OFAUTHORIZED REPRESENTATIVE

TITLE OF AUTHORIZED REPRESENTATIVE

FORM BOEM-1020(Month/year) Previous Editions are Obsolete. 

### PAGE20F2

## 47738 Federal Register/ Vol. 78, No. 151 / Tuesday, August 6, 2013 / Notices


### COVERED OFFSHORE FACILITIES OMB Control No.: xxxxxxx Expiration Date: xxxxxxx

CERTIFICATION OF OIL SPILL FINANCIAL RESPONSIBILITY IN ACCORDANCE WITH THE REQUIREMENTS OF THE OIL POLLUTION ACT OF 1990 (TYPE OR PRINTALL INFORMATION EXCEPTSIGNATURES)
1. Designated Applicant:

__________**~==~~~_==_-------** COMPANY LEGAL NAME BOEM COMPANY NUMBER 

### 2. Thefollowing list comprises all ofthe

___**---:'7~:-=::-** ___ locations of covered offshore facilities to be covered NUMBER by my certification of oil spill financial responsibility.

NAME OF AUTHORIZED REPRESENTATIVE

TITLE 3. Locations ofcovered offshore facilities:

FORM BOEM-1021 (MonthlYear) Previous Editions are Obsolete. SIGNATURE OF AUTHORIZED REPRESENTATIVE

DATE

PAGE 1 OF2

## 47739 Federal Register/ Vol. 78, No. 151 / Tuesday, August 6, 2013 / Notices


### Locations of covered offshore facilities (continued):
RUEor POTENTIAL STATE ALIQUOT PIPELINE WORST

OR LEASE PORTION AREA BLOCK PERMIT ROW SEGMENT CASE OIL· NUMBER NAME NUMBER NUMBER NUMBER SPILL OCSREGION (IfApplicable) NUMBER DISCHARGE (In Barrels)

If additional space is required, additional copies ofthis page may be attached as continuation pages.



### FORM BOEM-1021 (MonthIYear) Previous Editions are Obsolete. 

### PAGE20F 2

## 47740 Federal Register/ Vol. 78, No. 151 / Tuesday, August 6, 2013 / Notices


### COVERED OFFSHORE FACILITY CHANGES CERTIFICATION OF OIL SPILL FINANCIAL RESPONSIBILITY IN ACCORDANCE WITH THE REQUIREMENTS OF THE OIL POLLUTION ACT OF 1990 (TYPE OR PRINTALL INFORMATION EXCEPT SIGNATURES)
1. Designated Applicant:

__________**-:-:-~~~~~=_-------** COMPANY LEGAL NAME BOEM COMPANY NUMBER 

### 2. The following list comprises all of

_________ ........--- changesto locations of covered offshore facilities NUMBER or potential worst case oil spill discharges listed in the previously submitted certification of oil spill financial responsibility of

_______ _ DATE NAME OF AUTHORIZED REPRESENTATIVE SIGNATURE OFAUTHORIZED REPRESENTATNE

TITLE DATE 3. Changes to locations ofcovered offshore facilities or potential worst case oil-spill discharges: 

### StATE

..... I<:;>R l.EASE i

....... AI.IQUQT AREA PORTION

.... NAME (IfApplicablet) 

### ..•. IilLOCK 

### .·..**NuN1SI:~** .'.

.'., POTENTIAl;,**~IPEl.IN~** .' W<?rt$T PERMI,. \ I RUEOR '.' SEGMENT**I~SE.OIl.i'**

### TY~EOF CHANGE

I 

### oeg NUMBER

REGION .'.

. NUMBER ROW.'

.... .. SPILt. I

... NUMBER

### NUNlBE~ PI.SCl:IARGE .'. .• ..' '.

.... • .." • ..'.

..**(lnB~rrelsr** ...... 

### <'NO/III)



# .... .•.• I····

*A = Addition, D = Deletion, and N = NewPotentialWorst Case Oil Spill Ifadditional space is required, additional copies ofthis page maybe attached as continuation pages.

FORM BOEM-1022 (MonthNear) Previous Editions are Obsolete. PAGE 1 OF 1

## 47741 Federal Register/ Vol. 78, No. 151 / Tuesday, August 6, 2013 / Notices


### U.S. Departmentofthe Interior Bureau ofOcean Energy Management 

## FINANCIAl..; GUARANTEE OMB Control No.: xxxxxxx Expiration Date: xxxxxxx

CERTIFICATION OFOIL SPILL FINANCIAL RESPONSIBILITY IN ACCORDANCE WITH THE REQUIREMENTS OF THE OIL POLLUTION ACT OF 1990 (TYPE OR PRINTALL INFORMATION EXCEPT SIGNATURES) 

### 1. Designated Applicant:

_________**-:-:'-:-:-:-:-:--:---:-~_:_::_-------- --=--::-::::-c:-:c--:-:c:-~=_::_::_=_==_-**  COMPANY LEGAL NAME BOEM COMPANY NUMBER 

### 2. The Responsible Parties, identified in form(s) BOEM-1017 on file or attached, and

__ --:-:-::-:=-=-==-:-__ , ENTITY 

### a created underthe laws of TYPE OF ENTITY STATE 

### and authorizedto do business in the United States, as Guarantor, (hereinafter called Guarantor), agree to be jOintly and severally liable to the United States of America and other claimants for damages and removal costs underthe Oil Pollution Act of 1990, as amended, 33 U.S.C. 

### § 2701 etseq. (hereinafter called OPA), in the sum indicated in section 4, forwhich payment our heirs, executors, administrators, successors, and assigns will also be liable, under the terms and conditions of Title 30 part 553 ofthe Code of Federal Regulations (CFR). This Guarantee is hereby provided on behalf ofthe Responsible Parties to comply with the requirements of33 U.S.C. 2716(c) and is offered to satisfy any claim made under OPA. 

### 3. For the purpose ofthis application, the undersigned is acting in the capacity ofa Financial Guarantor in accordance with the requirements of30 CFR 553.32. 

### 4. The amount of coverage for which evidence ofoil spill financial responsibility (OSFR) is being established is:



### 5. This coverage is effective:

_______and expires on the first calendar day ofthe fifth month after the DATE 

### close ofthe Financial Guarantor'sfiscal year, which ends:

_____ _ 

### 6. The Financial Guarantor mayat anytime give notice of intent to cancel this Guarantee bywritten notice sent by certified mail to the Designated Applicant with copies (plainly indicating the original notice was sent by certified mail) to all Responsible Parties and to the BOEM oil spill financial responsibility program by certified mail. This instrument will remain in force and the undersigned will remain liable until the expiration date above or until the earlier of: (1) thirty calendar days after Bureau ofOcean Energy Management (BOEM) and the Designated Applicant receive from the instrument issuer a notification of intent to cancel; (2) BOEM receives other acceptable OSFR evidence from your Designated Applicant; or (3) all the COFs to which the instrument applies are permanently abandoned in compliance with 30 CFR Part 250 or equivalent state requirements. The undersigned agrees that termination ofthis instrument will not affect the liability ofthe Financial Guarantorfor claims arising from an incident (I.e., oil discharge or substantial threat ofthe discharge of oil) that occurs on or before the effective date oftermination ofthis Guarantee.



### FORM BOEM·1023 (MonthNear) Previous Editions are Obsolete. 

### PAGE 1 OF4

## 47742 Federal Register/ Vol. 78, No. 151 / Tuesday, August 6, 2013 / Notices


### The undersigned agrees that any suit or claim for which any Responsible Parties identified in formes) BOEM-1017, onfile or attached, represented bythe aforementioned Designated Applicant may be liable under Title I ofthe Act may be brought directly against the Financial Guarantorfor claims up to the amount ofthe penalty asserted by the U.S. government or other claimants when a Responsible Party denies or fails to pay a claim on the basis of insolvency or a Responsible Party has petitioned for bankruptcy under Title 11 ofthe U.S. Code. The undersigned further agrees notto use any defenses exceptthose thatwould be available to a Responsible Partyfor whom the Guarantee was provided orthat the incident (Le., oil discharge or a substantial threat ofthe discharge of oil) leading to the claim for removal costs or damages was caused by willful misconduct of a Responsible Partyfor whom the Designated Applicant demonstrated OSFR. 

### 7. Financial Guarantor providing evidence of oil spill financial responsibility in the form of a Guarantee.

COMPANY LEGAL NAME BOEM COMPANY NUMBER

ADDRESS

CITY STATE ZIP CODE

CONTACT PERSON FOR CLAIMS CONTACT PERSON'S TITLE

AREA CODE AND TELEPHONE NUMBER AREA CODE AND FAX NUMBER E-MAIL ADDRESS 

### 8. The undersigned, as an Authorized Representative ofthe above-named Financial Guarantor, certifies on behalf ofthe Financial Guarantorthat the requirements setforth in 30 CFR Part 553, and specifically 

### §§553.20,553.23-28, 553.30 and 553.40 have been met, and further agrees that, the Financial Guarantor, pursuanttothe requirements of30 CFR 553.15, will notify the BOEM oil spill financial responsibility program in the eventthat the Financial Guarantor is no longer able to maintain evidence ofoil spill financial responsibility to the extent stated in section 4 above.

NAME

TITLE 

### 9. The Financial Guarantor's U.S. Agent for Service of Process is:

NAME

CITY

AREA CODE AND TELEPHONE NUMBER



### FORM BOEM-1023 (MonthNear) Previous Editions are Obsolete. ADDRESS

STATE

AREA CODEAND FAX NUMBER SIGNATURE

DATE

BOEM COMPANY NUMBER

ZIP CODE

E-MAILADDRESS



### PAGE20F4

## 47743 Federal Register/ Vol. 78, No. 151 / Tuesday, August 6, 2013 / Notices


### 10. The liability ofthe Financial Guarantor will not be discharged by any payment or succession of payments made, unless and until such payment or payments will amount in the aggregate to the amount ofthe Guarantee. In no event will the Financial Guarantor's obligation exceed the amount ofthe Guarantee, provided the Financial Guarantor furnishes timelywritten notice to the BOEM oil spill financial responsibility program ofall claims filed, judgments rendered, and payments made bythe Financial Guarantor underthis Guarantee. 

### 11.The Designated Applicant must, no later than the first calendar day ofthe fifth month after the close ofyour Financial Guarantor'sfiscal year or expiration if earlier, submit either a renewal ofthis Financial Guarantee or other acceptable evidence of financial responsibility. 

### 12. In witness whereof, the Designated Applicant for the Responsible Parties andthe Financial Guarantor have executed this instrument on the day of

_______ _ MONTH YEAR 

### Designated Applicant for the Responsible Parties named herein:

SIGNATURE OF AUTHORIZED REPRESENTATIVE

NAME OF AUTHORIZED REPRESENTATIVE

TITLE OF AUTHORIZED REPRESENTATIVE



### Financial Guarantor:

SIGNATURE

NAME

TITLE



### FORM BOEM-1023 (MonthlYear) Previous Editions are Obsolete. 

### PAGE30F4

## 47744 Federal Register/ Vol. 78, No. 151 / Tuesday, August 6, 2013 / Notices


## ~~~~~~ RESPONSIBLE PARTIES COVERED BY THIS AGREEMENT



### FORM BOEM·1023 (MonthlYear) Previous Editions are Obsolete. 

### PAGE40F4

## 47745 Federal Register/ Vol. 78, No. 151 / Tuesday, August 6, 2013 / Notices


### U.S. Departmentofthe Interior Bureau ofOcean Energy Management OMB Control No.: xxxxxxx Expiration Date: xxxxxxxx 

### INDEPENDENT DESIGNATED APPLICANT INFORMATION CERTIFICATION CERTIFICATION OF OIL SPILL FINANCIAL RESPONSIBILITY IN ACCORDANCE WITH THE REQUIREMENTS OF THE OIL POLLUTION ACT OF 1990 (TYPE OR PRINTALL INFORMATION EXCEPT SIGNATURES) Thisform is intended for use by Designated Applicants that are not also Responsible Parties, as defined in BOEM Regulations at 30 CFR part 553.



### 1. Designated Applicant: COMPANY LEGAL NAME BOEM COMPANY NUMBER

ADDRESS BOEM COMPANY REGION

CITY STATE ZIP CODE (--)----------- CONTACT PERSON AREA CODE AND TELEPHONE NUMBER

CONTACT PERSON'S TITLE AREA CODE AND FAX NUMBER

E-MAIL ADDRESS


### 2. Summary of Evidence ofOil Spill Financial Responsibility: As an Authorized Representative ofthe Designated Applicant, Iexplicitly agree that the Designated Applicant will bejointly and severally liable for claims, underthe Oil Pollution Act of 1990, as amended, 33 U.S.C. 

### § 2701 etseq., with the Responsible Parties forthe covered offshore facilities covered by this certification.

NAME OFAUTHORIZED REPRESENTATIVE OF DESIGNATEDAPPLICANT

TITLE OF AUTHORIZED REPRESENTATIVE OF DESIGNATEDAPPLICANT



### FORM BOEM-1025 (Month/year) Previous Editions are Obsolete. SIGNATURE

DATE



### PAGE 1 OF 1

## 47746 Federal Register/ Vol. 78, No. 151 / Tuesday, August 6, 2013 / Notices
[FR Doc. 2013–18923 Filed 8–5–13; 8:45 am] **BILLING CODE 4310–MR–C** 

### DEPARTMENT OF THE INTERIOR **Bureau of Ocean Energy Management [MMAA104000]**  

### Environmental Documents Prepared **for Oil, Gas, and Mineral Operations by the Gulf of Mexico Outer Continental**  **Shelf (OCS) Region AGENCY** 

### : Bureau of Ocean Energy Management (BOEM), Interior. **ACTION**

### : Notice of the Availability of Environmental Documents Prepared for OCS Mineral Proposals by the Gulf of Mexico OCS Region. **SUMMARY**

### : BOEM, in accordance with Federal Regulations that implement the National Environmental Policy Act (NEPA), announces the availability of NEPA-related Site-Specific Environmental Assessments (SEAs) and Findings of No Significant Impact (FONSIs). These documents were prepared during the period April 1, 2013, through June 30, 2013, for oil, gas, and mineral-related activities that were proposed in the Gulf of Mexico, and are more specifically described in the Supplementary Information Section of this notice. **FOR FURTHER INFORMATION CONTACT**

### : Bureau of Ocean Energy Management, Gulf of Mexico OCS Region, Attention: Public Information Office (GM 250E), 1201 Elmwood Park Boulevard, Room 250, New Orleans, Louisiana 70123– 2394, or by calling 1–800–200–GULF. **SUPPLEMENTARY INFORMATION**

### : BOEM prepares SEAs and FONSIs for certain proposals that relate to exploration, development, production, and transport of oil, gas, and mineral resources on the Federal OCS. These SEAs examine the potential environmental effects of proposed activities and present BOEM conclusions regarding the significance of those effects. The SEAs are used as a basis for determining whether or not approval of the proposals constitutes a major Federal action that significantly affects the quality of the human environment in accordance with NEPA Section 102(2)(C). A FONSI is prepared in those instances where BOEM finds that approval will not result in significant effects on the quality of the human environment. The FONSI briefly presents the basis for that finding and includes a summary or copy of the SEA.

This notice constitutes the public notice of availability of environmental documents as required under the NEPA Regulations. Activity/operator Location Date ATP Oil & Gas Corporation, Structure Removal, SEA ES/SR

13–094. Brazos, Block 544, Lease OCS–G 10226, located 31 miles from the nearest Texas shoreline. 01–Apr–13. ATP Oil & Gas Corporation, Structure Removal, SEA ES/SR

13–092. South Timbalier, Block 76, Lease OCS–G 04460, located 25 miles from the nearest Louisiana shoreline. 01–Apr–13. EPL Oil & Gas, Inc., Structure Removal, SEA ES/SR 13–091 .... Eugene Island, Block 247, Lease OCS–G 21111, located 57 miles from the nearest Louisiana shoreline. 02–Apr–13. LLOG Exploration Offshore, L.L.C., Exploration Plan, SEA R–

5839. Mississippi Canyon, Block 258, Lease OCS–G 24066, located 62 miles from the nearest Louisiana shoreline. 02–Apr–13. EMGS Americas LP, Geological & Geophysical Survey, SEA

L13–004. Central Planning Area of the Gulf of Mexico .............................. 04–Apr–13. Walter Oil & Gas Corporation, Exploration Plan, SEA R–5840 .... Central Planning Area of the Gulf of Mexico .............................. 04–Apr–13. Chevron U.S.A. Inc., Geological & Geophysical Survey, SEA

L13–003. Central Planning Area of the Gulf of Mexico, located 198 miles from the nearest shoreline. 04–Apr–13. Pisces Energy LLC, Structure Removal, SEA ES/SR 11–330 &

11–331. Eugene Island, Block 53, Lease OCS–G 00479, located 14 miles from the nearest Louisiana shoreline. 04–Apr–13. McMoRan Oil & Gas LLC, Structure Removal, SEA ES/SR 13–

084. West Cameron, Block 294, Lease OCS–G 04090, located 28 miles from the nearest Louisiana shoreline. 04–Apr–13. Shell Offshore Inc., Exploration Plan, SEA R–5856 ..................... Central Planning Area of the Gulf of Mexico, located 82 miles south of the nearest Louisiana shoreline. 05–Apr–13. Chevron U.S.A. Inc., Exploration Plan, SEA R–5845 ................... Central Planning Area of the Gulf of Mexico, located 221 miles south of the nearest Louisiana shoreline. 08–Apr–13. TESLA Offshore, LLC, Geological & Geophysical Survey, SEA

L13–008. Central Planning Ares of the Gulf of Mexico ............................... 08–Apr–13. ATP Oil & Gas Corporation, Structure Removal, SEA ES/SR

13–095. South Timbalier, Block 77, Lease OCS–G 04827, located 19 miles from the nearest Louisiana shoreline. 09–Apr–13. Anadarko Petroleum Corporation, Exploration Plan, SEA R–

5853. Central Planning Area of the Gulf of Mexico, located 224 miles from the nearest Louisiana shoreline. 10–Apr–13. White Oak Operating Company, L.L.C., Structure Removal, SEA

ES/SR 13–105. Chandeleur, Block 3, Lease OCS–G 25041, located 4 miles from the nearest Louisiana shoreline. 11–Apr–13. Fairfield Nodal, Geological & Geophysical Survey, SEA L12–003 Main Pass & Mississippi Canyon in the Central Planning Area of the Gulf of Mexico. 11–Apr–13. Energy XXI GOM, LLC, Structure Removal, SEA ES/SR 13–074 South Timbalier, Block 21, Lease OCS 00263, located 5 miles from the nearest Louisiana shoreline. 11–Apr–13. Hilcorp Energy GOM, LLC, Structure Removal, SEA ES/SR 13–

101. Vermilion, Block 39, Lease OCS 00206, located 10 miles from the nearest Louisiana shoreline. 11–Apr–13. Pisces Energy LLC, Structure Removal, SEA ES/SR 13–100 ..... West Cameron, Block 081, Lease OCS–G 01477, located 24 miles from the nearest Louisiana shoreline. 11–Apr–13. Cobalt International Energy, L.P., Exploration Plan, SEA R–5848 Central Planning Area of the Gulf of Mexico, located 137 miles south of the nearest Louisiana shoreline. 15–Apr–13. Century Exploration New Orleans, LLC, Structure Removal, SEA

ES/SR 11–046. West Cameron, Block 369, Lease OCS–G 00301, located 58 miles from the nearest Louisiana shoreline. 15–Apr–13.Shell Offshore Inc., Development Operations Coordination Document, SEA R–5746. Mississippi Canyon, Block 934, Lease OCS–G 07975, located 61 miles from the nearest Louisiana shoreline. 17–Apr–13. Century Exploration New Orleans, LLC, Structure Removal, SEA

ES/SR 10–194. Ship Shoal, Block 153, Lease OCS–G 18011, located 29 miles from the nearest Louisiana shoreline. 17–Apr–13.