Permit No. Page 1 of 4 Bond No. _______________________ 

United States Department of the Interior

OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT

SURETY BOND FOR CORPORATION

 

 

KNOW ALL PERSONS BY THESE PRESENTS, THAT THE UNDERSIGNED

_____________________________________________________________________________

(Name of Corporation - Permittee)

 ,

(Street Address) (City) (State) (ZIP)

a Corporation organized and existing under the laws of the State of as 

Principal, and ____________________________________________________________,

(Name & Address of Surety Company)

organized and existing under the laws of the State of _____________________________ and 

licensed to do business in the State of ______________________________, as Surety, are held 

and firmly bound unto the United States Department of the Interior, Office of Surface Mining 

Reclamation and Enforcement (OSM) in the sum of 

____________________________________________________________

__________________________________________________ ($ ),

for the payment of which sum we hereby jointly and severally bind ourselves, our successors, 

and assigns.

THE CONDITION OF THE ABOVE OBLIGATION is such, that:

Whereas, the above named Principal has submitted Permit Application No. ,

including a mining and reclamation plan, to conduct and reclaim surface coal mining operations, 

as defined pursuant to the Surface Mining Control and Reclamation Act of 1977, 30 U.S.C. 

§1201 et seq., (the Act) and its attendant regulations; and

Whereas, the Principal has chosen to file this performance bond as a guarantee that the 

reclamation of the land disturbed during this surface mining operation will be completed as 

required by the Act and 30 CFR Chapter VII, and as specified in the Permit as issued;

Whereas, the Surety, and their successors and assigns agree to guarantee the obligation 

and to indemnify, defend, and hold harmless OSM from any and all losses and expenses which 

OSM may sustain as a result of the Principal’s failure to comply with the condition of the 

obligation;

Whereas obligations guaranteed by this performance bond shall be in effect for the 

following described lands approved as the permit area or increment upon which initial or 

succeeding operations will be conducted: _______________________________________

_________________________________________________________________________
Permit No. Page 2 of 4 Bond No. _______________________ 

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________;

(If more space is needed use an attachment signed by the Surety)

Now, if the Principal faithfully completes all reclamation and abatement requirements set 

forth in the Act, in 30 CFR Chapter VII, and in its Permit, including the mining and reclamation 

plans, then this obligation shall be void; otherwise, it shall remain in full force and effect:

(a) beginning on the date of the approval and issuance of Permit No.__________ and 

extending until all reclamation, restoration, and abatement work pursuant to the Act, 

30 CFR Chapter VII, and the permit has been completed to the satisfaction of OSM; 

and 

(b) until the bond is released pursuant to 30 CFR §800.40, replaced in accordance with 

30 CFR §800.30, or until the permit has been sold, reassigned or otherwise 

transferred in accordance with 30 CFR §774.17; and

(c) for a minimum period of years, notwithstanding the requirements of subparagraphs (a) and (b) above, it being further understood that if the Principal performs 

any augmented seeding, fertilization or other supplemental reclamation work on the 

site prior to bond release, the period of liability under this bond shall begin again 

subject to the exception found in 30 CFR §816.116(c)(4) or 30 CFR §817.116(c)(4).

The failure of the Principal to fulfill the obligations specified by the Act, 30 CFR Chapter 

VII, and its permit, shall result in a forfeiture of this performance bond according to the 

procedures described in 30 CFR §800.50.

The Surety shall not cancel this bond at any time for any reason, including non-payment 

of premium or bankruptcy of the Principal during the period of liability. The amount of the 

Surety’s liability may be adjusted by OSM pursuant to 30 CFR §800.15 for lands covered by this 

bond which have not been disturbed by the Principal, upon application by the Principal pursuant 

to 30 CFR §774.13 for revision of the Permit to delete such acreage, and approval by OSM of 

such revision.

The Surety will give prompt notice to the Principal and to OSM of any notice received or 

action filed alleging the insolvency or bankruptcy of the Surety, or alleging any violations of 

regulatory requirements which could result in suspension or revocation of the Surety’s license to 

do business.

In the event the Surety becomes unable to fulfill its obligation under the bond for any 

reason, notice shall be given immediately to the Principal and to OSM.

Upon the incapacity of the Surety by reason of bankruptcy, liquidation, insolvency, or 

suspension or revocation of its license, the Principal shall be deemed to be without bond 

coverage in violation of 30 CFR §800.11 and shall be subject to the requirements described in 30 

CFR §800.16(e)(2).
Permit No. Page 3 of 4 Bond No. _______________________ 

IN WITNESS WHEREOF, the Principal and Surety have hereunto set their signatures 

and seals as of the dates set forth below. This bond shall be effective this _____ day of 

_____________, 20__.

PRINCIPAL

Date __________________________ _______________________________________ (Corporation/Permittee)

Affix Seal By: ____________________________________

Corporate Official1

Title: ____________________________________

Attorney-in-Fact1

ACKNOWLEDGEMENT OF CORPORATE PERMITTEE

On this ______ Day of ______________________, 20 , before me, a Notary Public 

in and for the County of _____________________, in the State of __________________, 

appeared _______________________personally known to me to be the person whose name is 

subscribed to the forgoing instrument and who, being by me duly sworn, did say that he/she 

executed the same for the purposes therein contained.

IN WITNESS WHEREOF, I have hereunto set my hand and official seal on the day, 

month, and year aforesaid.

My Commission Expires: ______________________________________

(Notary Public in aforesaid County and State)

SURETY

Date: ____________________________ ____________________________________

(Corporate Surety)

(Affix Seal) By: ________________________________

Title: ______________________________

(Attorney-in-fact1)

1

Where one signs by virtue of Power of Attorney or Corporate Resolution for a Surety, or corporate 

Principal, a certified copy of the Power of Attorney or Corporate Resolution must be filed with this bond.

NOTE: If applicable, include the name, address, and phone number of the Agent representing 

the Surety Company.
Permit No. Page 4 of 4 Bond No. _______________________

ACKNOWLEDGEMENT OF CORPORATE SURETY

On this ______Day of _________________________,20 , before me, a Notary 

Public in and for the County of _____________________, in the State of ________________, 

appeared ___________________________to me personally known, who being by me duly 

sworn, did say that he/she is _________________ of, , the 

corporate surety named in and which executed the within instrument, and that the seal affixed to 

said instrument is the corporate seal of said corporation, and that said instrument was signed, 

sealed and delivered in behalf of said corporation by authority of its Board of Directors, and 

he/she, as such officer, acknowledged said instrument to be the free act and deed of said 

corporation for the uses and purposes of said instrument as therein set forth. 

IN WITNESS WHEREOF, I have hereunto set my hand and official seal on the day, 

month, and year aforesaid. 

My Commission Expires: ______________________________________ 

(Notary Public in aforesaid County and State) 

Paperwork Reduction Act Notice

We use the information required by this form to ensure that the requirements for a surety bond under 30 CFR 800.20 

have been met. You must provide the requested information to obtain a benefit (a surety bond). Under 30 CFR 

842.16, the information collected is a matter of public record.

The time needed to complete this form and related forms and submit the requested information to obtain a surety 

bond will vary depending on individual circumstances. We estimate that the average time will be 12 hours per 

response. This number includes the time spent reviewing instructions, learning about the regulations, gathering and

maintaining information, and completing and reviewing the forms. If you have comments concerning the accuracy 

of this estimate or suggestions for simplifying the forms or instructions, you may write to the Information 

Collection Clearance Officer, Office of Surface Mining Reclamation and Enforcement, 1849 C Street, NW, Room 

4559, Washington, DC 20240.

Under the Paperwork Reduction Act of 1995 (44 U.S.C. 3501 et seq.), you are not required to respond to, nor will 

you be subject to a penalty for a failure to comply with, a collection of information unless it displays a currently 

valid OMB control number. 

OMB Control No. 1029-0043, expires 10/31/2021