·DEPARTMENT OF THE 

MAR 1 o 1989 

1. Purpose. 'Ihls directive provides policy an:i cperational 

guidelines to all Office of SUrface Mi.ni.rq Reclamation an:l 

En£orc:eJOOnt {OOMRE) arployees for the irrplementation of 0SMRE 

ard Department of the Treasucy requ.iralents for the 

aoceptaooe, retention an::l. return of perfornan:e borrls in 

=nnection with the issuance of IDi.nirq permits by OOMRE for 

11lining cperations SUbject to a Federal prcyram arrl cperations 

on Federal an::l,/ar Irrlian lards, 'Ihls directive does not awly 

to the boniing requirements for ininirq permits Where a state 

agercy is the regulatory authority. 

2. Surrmmr. 'Ihis Diiective provid<ks procedures for dealin;r with 

perfornance borrls. It includes illustrations of different 

bon:l forms, receipt forms arrl power of attmney fo:rniS to 

be used in connection with reclamation performanc:e l:orrls. 

3. Definitions. 

a, Bond Approyin;r Offigrr, 'Ihe head of an executive 

departJnent or Government establisbrrent: or an offioor designated 

either by law or regulation to aw=ve bonds. 

b. An llrlemnity agreement in a sum certain 

payable authority, executed by the pennittee as 

principal and is supported by the performm:;:e guarantee of a 

cotpOration licensed to do business as a surety in the state mere 

the cperation is located. 

c. 

incre>oont 

will initiate cperations, 

cperations are corrlucted. 

A borrl to oover an identifie:l 

permit area upon 1\hidl. the operator 

or an iroClemeJLt(s) where sncceecling 

d. A bord to cover specific activities of 

CFR 800.40. 

be released accordl.rq to the definiti= of 30 

e. Collateral P.ond. An inlemnity agreemerrt in a sum certain 

executed by the permittee as principal W'hich is suwortect by the 

dep:>sit with the regulatory authority of one or IUOre of the 

following: 
{2) Negotiable bonds of the united states, a state, = a 

rmicipality, en::iorse:i to the oWer of, an:i placed in the possession 

of, the regulatory authority; 

(3) Negotiable certificates of dgmsit, made payable or 

assigned to the :re;rulatory authority an:l. placed in its possession or 

held by a federally - insured bank; 

(<) 

= """'=""' · of any bank organized 

states, payable 

only to the regulatory autb.=ity upon presentation; 

property in ,,, fi.WOr "<~~~;,;,~~ 

( 6) other ilwes'bnent - grade '1'tftl '¥"Nrities havin;; a 

rating of 11M., AA, = A or an equivalent ratio; iSSUEd by a 

nationally :recogn.ize::l securities :ratin;r service, en::iorse:i to the 

order of, an:i placed in the possession of, the U'qlllatory autb.=ity. 

f. Self-bon:l means an iniemnity ag:reerrent in a sum certain 

executed by the applicant, or by the applicant an:i any co:rpo:rate 

guararrtor, an:i made payable to the regulatory authority, with = 

withcut separate surety. 

4. l'QJ.icv/Procedures 

a. Policy. 

(1) OSMRE's acoeptanoe of surety bonis is subject to 

Treasury Deparbnent regulations at 31 em 223 and Treasury 

Circular 297. OSMRE's acceptance, re:::eipt, an:i return, of 

collateral borrl securities, such as U.s. negotiable bonis, 

Treasury notes, and other public debt obligations 

guaranteed by the United states, are subject to Depart:ment 

of Treasury regulations at 31 CFR 225 an:i Treasury 

Ci=lar 154. 

(2) The awlicable Treasury regulations TI!qllire that 

surety bonis only be ac:cepted by F'€rleral agencies if they 

have been cbtaina:l. fran surety =rpanies certified as 

acceptable by the Oeparboont of the Treasury (31 CFR 223). 

Additionally, Treasury regulations require that negotiable 

bonis, notes = other obligations iss11e::l or guaranteed. by 

the United states, and accepted by Federal agencies as 

security in lieu of surety or sureties on performance 

bonds, must be accepted, retained and returned in 

accordance with applicable Treasury stan:ia:rds (31 CFR 225 

' 
and Treasury Circular 154) , 

(3) To ensure that the Treasury requirements are met with 

regard to surety ooms, or other securities accepted in 

lieu of surety, borrl awroving officers will be designated 

in each office accepting bon::l.s for m:inirg permits issued 

by OSMRE as a regulatory authority. 

b. Responsibilities 

'Ihe designated borrl 

for the iirplernentation 

the fll:O. ebrres -.,,;;;~ directive. Bon:l awroving 

officers may delegate , urrler this directive. 

' . """""""' 

(1) After approval of a permit awlication, but prior to 

issuaoc:e of a coal m:inirg permit, the awJ_icarrt nust file 

a reclamation perto:rna:nce borrl with the Office of SUrface 

Kinin; Feclamation and Enf0l:'0!3l'ellt (OOMRE) • Pursuant to 

30 CFR 800, the follwing forms of reclamation bcn:'l.ing 

inst:rtnrents are allCJNable: surety bonds; collateral bonds 

inclu:l.ing cash, negotiable u.s. bonds, letters of crOOit, 

perfected first-lien searrity interests in real pn:perty, 

ather investment-grade securities having an "A" rating or 

higher; and, self bords. 

'lhe attached borrl fonns (Illustrations 1-22) are 

general in nature and nay need to be m:xiifie:l. to 

refle:::t awlicable state contract, uniform CbiLUioercial 

Cbde (11.C.C.), or surety law. 'lhe fonns should be 

reviewed by the app;ropriate Field Solicitor's Office 

for use in a particular State. 

Bon:l approving officers will be responsible for the 

acccmp1ishmerrt of the following matters which 

are more =np1etely set forth in the Treasw.y 

regulations (31 CFR 223 and 225), and the OSMRE 

regulations (30 CFR 800) : 

a. Surety Bon:ls. Before ~' the bon::l aw=ving 

officer nust review surety ooms offered by the mining 

permit awlicarrt and rra.ke the follwing determinations: 

(1) 'lhe surety canpany is include:l. on the =t 

current list of surety CO!Lpanies acceptable on Fe:l.eral 

borrls (Treasw.y Deparbnent. Circular 570 and suwlements 

' 
]:Ublished in the Federal Register l'lhlch in::ludes lioensirg information) , 

(2) A surety bond has been executed in the 

awropriate format for the jurisdiction sud!. as the 

exaJq;Jles offered as Illustrations 1, 2, or 3. If changes 

are made to an existin:J bond, the use of forms such as in 

Illustrations 18 or 19 are recamended. 

( 3 l nre axoco.mt of the OOrxi does not exceed the 

un:lerwritirq lilnitation pmvic!En in Treasury Circular 570. 

(4) 'Ihe surety catpmy has a certificate of 

authority to operate in the state where the minirg operation is to be perforned. 

{5) 'Ihe surety bond axoco.mt equals lotlat is require::l 

to =ver the term of the permit, increment or phase bord 

ca1culate:i. 

(6) lhe permit area or iiK::l:ememt(s) of the permit 

are acx:urately described on the boni, or if a Ii'laSe bon:l., 

the scope of work to be guaranteed is described in detail. 

If a t:base or i.nc:reoont is pz• tcsed for an existing boni, 

use forms such as Illustrations 18 or 19. 

b. Collateral Bords. 

'!his sectic~1 applies to negotiable bonls, notes or other 

d:lligations issued or guaranteed by the United states as 

security in SUf{lOrt of an in::temnity agreement borrl. When 

these kirxls of instruments are posted as coJ.laten!l boOOs 

un::le.r 30 em 800.21, the boni awrov:ing officer shall be 

responsible for the ao::xxrplishment of the follc:Mirg requirements: 

(1) Ensure that United states bonds, Treasuey notes, 

or other p.lblic debt d:lligations of the United states, or 

obligations are unconditionally guaranteed as to both 

intel:est and principal by the United states and are in a 

sum equal at their par value to the amount of the 

perfm:mmce borrl required to be furnished. 

(2) Prepare a receipt of the negotiable bonds, notes 

or other d:lligations an:i retulTL it to the minirg permit applicant. lhe receipt should be in the format of the 

exmrples provided as Illustrations 4A or 4B. 

(3) Secure fran the in::lividual, partnership or 

=rporation offerirg the securities, an irrevocable p::o.rer 

of attomey and agreement executed essentially in the 

format of the exarrples provided as Illustrations 5, 6, and 

'· 

' 
(4) Secure fran the in::lividlJal, partnership or 

corporation, an exa.::uted collateral band an:1 irrlEmlity 

agreement in the format of the exa!q;lle provided as 

Illustrations 9, 10 or 11. 

(5) If the se:::urities are subsequently deposited l:1j 

OOMRE in a Federal depositary for safekeepin;, ootain a 

:rnceipt fran the depositary essentially in the format of 

the example providei as Illustration 4. 

(6) Ensure that a pertonrance borrl record form is 

prepared in the format of the example provided as 

Illustration SA. lhis form should ba filed with the 

original permit bcn:l(s). 

(7) When collateral boiX:l. is released an:1 the 

socurities are returned to the mining pennitt.ee at the 

conclusion of cperations under the permit, ootain a 

receipt fran the pennitt.ee in the fonuat of the example 

provided as Illustration 8ll or 8C. 

(8) Ensure that the irdividual, partnership or 

COifXJiation require::l to furnish the borrl has en:lorse:l the 

securities to the order of CISMRE an:1 that the power of 

attorney an:1 agrearent are sufficient an:1 execute::l. in 

conformity with the rules established l:1j Treasury in 31 

em 225. OOMRE regulations at 30 CFR 800.5 require t:hese 

se:::urities to be made payable to the order of OOMRE. 

(9) Bonds or notes other than cash accepted l:1j lxln::l. 

awr=J.n; officers will be held at the risk of the holdin; 

bond awrovin;J officer unless they are deposited by them 

with authorized depositaries. In those locations where a 

Federal Reserve Bank is not available, the bond approvirg 

officer can anange for designation of an authorized 

depositary by Treasury. 'Ihis is done by submittinJ a 

written request to the Department of he Interior, Office 

of Financial Management in Washington, D.C. 'Ihe request 

should set f=l:h the name an:1 location of the proposed 

depositary arrl the type an::l am:JUJ'lt of deposits prcp;>sed. 

'Ihe Office of Financial Managerrent will forward the 

request to Treasury an:1 return Treasury's resp:mse to the 

:requestinJ office. 'Ihe approval process requires 

aw=xbnately 45 days (see 331 m 2.3.0, for a more 

detailed discussion of the process) . 

(10) When the obligor submits a written request to 

the boiX:l. approving officer, the borrl approvirq officer 

will detadl interest =upons, if appropriate, and provide 

them to the obligor as the coupons mab.lre. Most 

securities will be book-errtiy deposits where interest 

«=rues aut:orratically arrl coupons are not isSUEd. 

(11) All bond receipts given to the obligor l:1j 

' 
CSHRE, received from an authorized dep:sit of b:cds or 

notes, or received from the d::lligor upon the return of 

b:cds or nates, shw.ld be executed in duplicate and one 

ccpy shaJ.l.d be rraintained in a separate security file 

(not the in::lividual permit file) for audit purposes. 

c. other Collaternl Bonds. This section applies to 

certificates of dep:Jsit {CD's), real property, letters of 

cra:llt or cash posted as security to support an inimnity 

agreement b:ni. Before acceptance, the 0000 app=ring 

officer will determine that the offered collateral lx!nd is 

in conformity with the followin;r requirerrents: 

(1) That collateral boo:ls conform to the standards 

specified in 30 CFR 800.21. 

(2) A collateral bond an:i 

has been executed in the 

Illusttations 9, 10 or 11. 

indemnity agreement form 

awropriate format of 

(3) If an irrev=able letter of credit is offered as 

collateral, it will be executed in the format of 

Illustration 20. 'lhe bond aw=vin;r officer is 

respo11sil:lle for ensuring that letters of credit are 

replaced within 30 days of their expiration \<~hen notified 

l:1j the bank that it will not be reJ'leWOO; if not replacE'd, 

the fUnds due the united states urrler the letter of credit 

must be drawn before the terminaticn date of the letter of 

credit. 

(4) Certificates of dep:Jsit (CD's) offered as collateral 

can either be assigned to QClMRE or made payable to OOMRE. 

In either case, the CO's must be issued l:1j a bank insured 

by the FDIC. If the CO's are assigned to OOMRE, an 

assignment of dep:Jsit form in the format of Illustrations 

U, 13 or 14 must be executed by the pennittee an:i the 

issuirg bank. 

(5) If real property is offered as oollateral, 

ensure that the title certificate, first nortgage or deed 

of tnlst, an:i certified property appraisal are attached as 

a part of the collateral bond and irrlemnity agreamnt. 

(Soo Illustration 21) 

(6) 'lhe bond value of all oollateral must be 

evaluated at mid-term p;nnit review. If the value of the 

collateral has depreciated, the pennittee must provide 

additional funds to corrpensate for the decreased value. 

'lhe value of collateral nay be evaluated at any time 

h~. 

(7) All cash sul:mitted by an obligor as security for 

a boOO rust be converted to a money order and forwarded to 

the Division of Financial Management in DenVer for 
deposit. 'Ihe m:mey roost be delivered to arxi foi."Wiil."dej by 

the designated =llection officer in the office. A 

receipt such as that in Illustration 4 should be given to 

the pemit awlicant When cash has been receiVEd. When 

the OOn::l has been released, the cash is returned to the 

permittee in the form of a goverrment d'IB:::k. '!he OOMRE 

official Who issnes the check should obtain a receipt from 

the pemittee in the format of the ex<mple provided as 

Illustration SB. 

d. 

officer 

""""""" 

acceptance, the bond ar:provirg' 

that self-bc:tW conform to the 

in 30 CFR 800.23. 

(1) '!he bond ar:provirg' official will ensure that the 

pemittee arxi any guarantor will haVe exea.lte:l a self-bond 

agreement, an indemnity agreenent an::l. guarantor agreement 

in the format of Illustrations 151 161 an::l. 17. 

5. Reportirg Requirenent:s. No report:iJ'g :requhaueuts established. 

6. Effect on other lklcurnent:s. None. 

7. Re:fenmoes. 

a. 30 CfR 800 - B:lrd arxi Insurance Requirements for SUrface 

Coal Minin;J arxi Reclamation cperations umer Regulatocy PI03La!t1S. 

b. 31 CFR 225 - Acceptance of Bonds, Notes or other 

Obligation Issued Guaranteed by the United states as Security in 

Lieu of SUrety or SUreties on Penal Borrls ('Ireasw:y circular No. 

154). 

c. Treasury Circular 570 - Surety ~ Acceptable on 

Federal Bonds. 

d. 31 usc 93 - SUreties aro Surety Bonds. 

e. 31 CFR 223 - Surety CC:tlpmies lbirg' B.lsiness with the 

United states. 

f. 30 USC 1259 - Perfocnance Bonds. 

g. D;easury Circnl ar 297 - Regulations Gavenlirg' surety 

Coltpanies !bing Business with the United states 

8. Effective Date. Upon Issuance. 

9. Contact. Division of Technical Services, 343-1475. 

10. Keywords. Performance bards, surety, =llateral, escrow, letter of credit, self-bord. 

' 
11. Al:perrlioos. 'lhe followirg are illustrations: 

Illustration 1, 2, an:'i 3: SUrety Bond Forms for Part:.nership, COrporation, an:'i Sole Proprietorship. 

Illust:re.tions 4 an:'i 4A: Receipt Fonns f= Bon:ls = Collateral. 

Illustrations 5, 6, an:'i 7: P::lwer of Attorney FoillS. 

Illust:re.tion SA: Performance Bond Form. 

Illustration SB: Release Authorization Form. 

Illust:re.tion SC: Security Receipt Form. 

Illustrations 9, 10, and 11: Collateral Borrl Fonns. 

Illustrations 12, 13, and 14: Assignment Forms. 

Illustrations 15, 16, and 17: Self-bon:i Fonns. 

Illustrations 18 and 19: Borrl Riders. 

Illustration 20: letter of Credit Fonn. 

Illustration 21: Trust Deed Form. 

Illustration 22: Escrow Agreement Form. 

' 
Permit No. __ _ Illustration 1 

(Page 1 of 4) 

Partnership 

UNITED STATES DEPARIMENI' OF 'lHE lNIERIOR 

OFFICE OF SURFACE MINING REcrNIATIOO liND Em'ORCEMENr (OSMRE) 

BcrdNo. __ _ 

KMCl'l' ALL MEN B'l 'IHESE PRESENI'S, 'mAT 'lHE UNIERSIGm:l 

(Street Ad:ll'es.s) (City) (state) (Zip) 

a partnership, as Principal, ard 

---------=~~~~=====>----' (Name and Ad:kess of SUrety ChJI1an¥) organized 

an:i liOE!llSOO ard to existing do b.Js1ness UOOer in the the laws state ot the~;s-~~;o';;;;-::-::==~ ot , as 

Surety, are held an:i firmly bourrl unto the United states of Aloorica 

(C6MRE) in the sum of .7:""-~"";:;:;c-;:c-,;::;:o;:-;;;;o-;:;"':c;:;.:;-,;:c:;:;,;­ ~;-:c;:;;=:;-;:c:ocd for the pa}'IOOJit of '<ihich Sllll\ we hereby jointly ard severally bind ourselves, our snccessors, an:i assigns. 

'lHE OONDITION OF 'lHE AOOVE OHLIGM'ICN is such, that: 

Whereas the aboVe named Principal has submitted Permit 

fii:plication No. , incluiirg a minirg and reclamation plan, to COOOuct arrl reclailn a surface coal mining operations, as 

defined ~ to the SUrface Mi.nin;J Control ard Ra::l.a!m.tion Act 

of 1977, 30 u.s.c. §1201 et ga., (the Act) and its atteruant 

regulations; arrl 

Whereas, the Principal has chosen to file this performance l::ond 

as a guanmtee that the reclamation of the lard disturbed during 

this surface minirg q>eration will be cx:upleted as required by the 

Act an:i 30 C.F.R. Chapter VII, and as specified in the Perntit as 

issued; 

Whereas, the SUrety, and their successors ard assigns agree to 

guarantee the obligation an:\ to in::Jemnity, deferrl, an::l. hold haDnless 

the united states Office of SUrface Mi.nin;J Ra::lamation and 

EnforoenEnt (OOMRE) from any an:\ all losses ard expenses which OSMRE 

may sustain as a result of the Principal's failure to caq;>ly with 

the condition of the cbligation; 
Permit No. -- Illustration 1 

(Page 2 of 4) 

Partnership 

~ obligations guarantea;:l by this perfoDtmloe bard shall be in 

effect for the foll<:Min:] describa:j lards awroved as the pennit area 

or incrnment UFOI1 loiDiah initial or &~XPeedin:] cperations win be 

corducted: . . . • . 

-----------------------' 

Na.i, if the Principal faithfUlly ccupletes all reclamation and 

abaten'ent requiiE!lieJils set forth in the Act, in 30 C.F.R. Olapter 

VII, and in its Permit, inclu:ti.n;J the minin;J and reclamation plan, 

then this obligation shall be void; ot:hel:wise, it shall remain in 

full force and effect: 

(a) beginnirq on the date of the awravaJ. and 1ssuan::e of 

Permit NO. and exten:ti.n;J until all 

reclamation, restoration, and abatement work pursuant to 

the Act, 30 C.F.R. 01apter VII, and the pennit has been 

corrplete:l to the satisfactioo of Office of Sl.lrface Mining 

Reclamation and Enforcement; and, 

(b) until the bon::l. is released p..lrS\.Iant to 30 C.F.R. §800.40, 

replaced in accordanoe with 30 C.F.R. §800.30, or until 

the pennit has been sold, reassigned or otherwise 

transferred in ac:cordarx:e with 30 C.F.R. §774.17; and, 

(C) for a minino.un period of _ years, rct:withstarrling the 

requirements of sub-paragraphs (a) and (b) above, it being 

further urDerst:oc:d that if the Obligor perfon'rS any 

augmented seeding, fertilization or other ~emental 

reclamation work on the site prior to bon;l. release, the 

period of liability un:ier this bonl. shall begin again 

subject to the exception foun:i in 30 C.F.R. 

§816.116(c)(4) or §817.116(c)(4). 
Permit No. ---- illustration 1 

(Page 3 of 4) 

Partnership 

me failure of the Principal to fulfill the obligations 

specified by the Act, 30 C.F.R. Olapter VII, ani its penuit, shall 

result in forfeiture of the =ll.ateral ~ with this pertonrance 

bcm:l accordin3" to the procedures described in 30 C.F.R. §800.50. 

The SUrety shall not ~ this bon:l. at any tiJne f= any 

reason, includin3" non-payment of premium or bankruptcy of the 

Principal durin3" the period of liability. 'Ihe amount of the 

SUrety's liability may be adjustEd by CSMilE ~to 30 C.F.R. 

§800 .15 f= lanis =vered by this bc:n:i whidl haVe not been disturbed 

by the Principal, upon aW].icatic:Cl by the l'rin:::ipal prrsuant to 30 

C.F.R. §774.13 f= revision of the Permit to delete such acreage, 

and approval by OSMRE of sud1. revision. 

'lhe SUrety will give prrnpt notice to the Principal ani to 

OSMRE of any notice received = action filed alleginl the insolvency 

= bankruptcy of the SUrety, = allegin;J any violations = 

regulatory requirements which cxo..tld result in suspension = 

revocation of the SUrety's license to do business. 

In the event the Surety becomes unable to fulfill its 

obligations urder the bond f= any reasoc~, notice shall be given 

imnediately to the Principal ani to OSMRE. 

Upon the incapacity of the Surety by reason of bankruptcy, 

insolvency, or suspension = revocation of its license, the 

Principal shall be deemed to be without bond coverage in violation 

of 30 C.F.R. §800.11, ani subject to enfozceneut actions des=:ibed 

in 30 C.F.R. §800.16(e)(2). 

IN Wl'mESS 'IHEREDF, the Principal ani Surety have hereunto set their 

signatures and seals as of the dates set forth belcw-. 

Me ___ _ 

(Partnership - Permittee) 

,,_,, 

"'"• ----

Byo 

Title: 

[Note: Where cne signs by virtue of PcMer of Attorney for a 

SUrety the f\::Jwer of Attomey DUSt be filed with this bon:l..] 
Permit No. __ _ Illustrati.crl 1 

(Page 4 of 4 

-

On tltiB __ day of , 19 , before me, a Notary 

Public in and for the county of , in the state of 

1tlho ""'""''""=~, beirq by rre 

a~ duly sworn, did say that hejshe to me is personally a partner ~. of 

c;:;;c;o.;;;;;;;--;;;;,-;' the partnership named in the foregoirq inst.:rume.nt, and that hejshe, l::eing authorized so to do, executed the 

toregoirq inst.nment on behalf of said partnership. 

IN wrrnESS WHEREOF, I have hereunto set my hard and official 

seal on the day, =nth and year aforesaid. 

My Cb!mlission El!pires: 

Notacy Pclblic in and for said 

county and state 

Where negotiable securities are USOO. as oollatera.l, a 

COI!pleted Fa'iER OF A~ AND l\GREEMENI' m.lSt 00 

attached. 

on this __ day of , 19 , before me, a Notacy 

Public in and for the County of , in the state of 

.;;;;:;;-;;oc.:;:<' appeare::I to me personally :kn<:mn, who beirq by me duly sworn, did say that he/she is a partner 

of , the partnership named in the foregoing 

instnlment, and that he/she, beirq authorized so to do, execLrt:ed the 

foregoiiB instrument on behalf of said partnership. 

IN WITNESS WHEREOF, I have hereunto set my hand and official 

seal on the day, =nth and year aforesaid. 

My Cb!mlission Expires: 

Notacy Public in and for said 

county and state 

Please identify the agent actirq en behalf of the surety, 

if applicable. 

~'------------------ """"'---------- ~; _______________________________ ___ 
Permit No. Illustration 2 

(Page 1 of 5) 

D:»::pcrration 

UNITED STATES lEPARIMENI' OF 'IHE INTERICR 

OFFICE: OF SURFACE MINm:; ~ AND Em\JRCEMENl' (CSMRE) 

Bon:i No. __ _ 

(Name of Coq::oration - Permittee) 

==~==~----~~--~==~-=~' (Street Address) (City) (State) (Zip) 

a cor:poration organized arrl exi.stirg urder the laws of the state of 

, as Principal, arrl 

(Name an:l_ Nldress of SUrety Conpany) 

organized arrl existing urder the laws of the state of 

arrl licensed to do b.Jsiness in the state of , as 

SUrety, are held and firmly bourxl unto the united states of Aioorica 

(OSMRE) in the Stnn of 

for the payment of which sum we hereby 

jointly arrl severally bind ourselves, cur suo s:rrs, arrl assigns. 

'lHE o::tiDITION OF 'lHE AB.JVE OBLIGil.TICN is such, that: 

Whereas the above namOO. Principal has sui:mdtted Permit 

AwJ_ication No. , inclu:iim a nrl.nin; arrl nclamation 

plan, to con::hlct arrl reclaim a surface coal mining operations, as 

defined p.rrsuant to the SUrface Minin:J Control arrl Reel amation Act 

of 1977, 30 u.s.c. §1201 et ~·, (the Act) arrl its atterrlant 

regulations 1 arrl 

Mlereas, the Principal has dlooen to tile this perfonranr:>e bon:i 

as a guarantee that the reel amation of the larrl disbJrbed during 

this surface rninirg cperation will be crnp1eted as ~ by the 

Act arrl 30 C.F.R. Chapter VII, arrl as specified in the Permit as 

"'""""' 

1-berea.s, the SUrety, arrl their ruocessors and assigns agree to 

guarantee the OOligation and to i.ndermify, deterrl, arrl hold harmless 

the United states Office of SUrface Minin;J Reclamation arrl 

Enforcement (QSMRE) trcrn 

any arrl all losses an::I expenses which OSMRE may sustain as a result 

of the Principal's failure to C<:lllply with the condition of the 

obligation 1 
J?ennit No. Illustration 2 

(Page 2 of 5) 

Cbi:LOQLation 

Whereas obligations guaranteed by this perfornance hord shall 

be in effect for the follCMing described lan:ls af¥tova::l as the 

pennit area or incteuenl upon whidl initial or ~ operations 

will be conducted: • . • • • 

NcM, if the Principal faithfully ornpletes all reclamation and 

abatement requirements set forth in the Act, in 30 C.F.R. Chapter 

VII, and in its J?ennit, including the minin:;r and rEClamation plan, 

then t:his obligation shall be void; otherwise, it shall remain in 

f'ull force arrl effect: 

(a) l:e]innirq on the date of the awroval and issuan::e of 

Permit No. an:i ext:eo::ting until all 

reclamation, restoration, an:i abatement work p.rrsuarrt to 

the Act, 30 C.F.R. Chapter VII, an:i the pennit has been 

ornpleted to the satisfaction of Office of SUrface Ml.nin;J 

Reclamation an:i Enforcemeut; and, 

(b) until the boni is released p.JrSUal1t to 30 C.F.R. §800.40, 

replac:OO in accordance with 30 c.F.R. §800.30, or until 

the permit has been sold, reassigned or otherwise 

transferred in accordance with 30 C.F.R. §774.17; and, 

(c) for a minilmnn pericd of years, notwit:hst.an::lirJ] the 

requirements of sub-~ (a) and (b) above, it being 

further umerstood. that if the Principal performs any 

augrrerrte:j seectin;J, fertilization or other suwlmoontal 

reclamation work on the site prior to bord release, the 

pericd of liability 1.lrder this bon:l shall begin again 

subject to the exception fourrl in 30 C.F.R. §816.116(c) (4) 

or §817.116(c) (4). 

'Ihe failure of the Principal to fUlfill the obligations 

specified by the Act, 30 C.F.R. Chapter VII, and its permit, shall 
Permit No. ----- Illustration 2 

(Page 3 of 5) 

Cbrnoration 

result in a forfeiture of this perfanrarn::! bard aooonling to the 

procedures describe::l in 30 C.F.R. §800.50. 

'!he SUrety shall nat cancel this bard at any time far any 

reason, including non-payment of premium or bankruptcy of the 

Principal during the period of liability. 'Ihe anv::urrt of the 

SUrety's liability may be adjusted by OOHRE p.lrSilal1t to 30 C.F.R. 

QSOO .15 far larrls covered by this ban::l which have nat been disturbed 

by the Principal, up:>n applicatim by the Principal p.rcsuant to 30 

C.F.R. §774.13 far revision of the Permit to delete such a=eage, 

ani awroval by OSMRE of such revision. 

'Ihe Surety will give pt'O!tpt notice to the Principal ani to 

OSMRE of any notice received or action file::i alleging the insolvency 

or bankruptcy of the SUrety, or alleging any violations or 

regulatory requirements llhich could result in suspension or 

:revocatim of the SUrety's license to do business. 

In the event the SUrety becanes unable to fUlfill its 

cbligatians under the bard far any reason, natioe shall be given 

imroodiately to the Principal an:i to OSMRE. 

Upon the incapacity of the SUrety by reason of bankruptcy, 

insolvency, or suspension or revocation of its license, the 

Principal shall be deemed to be wit:hc:ut bard C!CM'!TIIgE! in violation 

of 30 C.F.R. §800.11, an:i subject to enfan:ernerrt actions describe::l 

in 30 C.F.R. §800.16(e)(2). 

rn WTINESS 'lHEREDF, the Principal and SUrety have hereurrta set their 

signatures an:i seals as of the dates set forth below. 

"'"''-----

"'"''----

(Corporation - Bertnittee) 

''"--~====~-­ (Corporate Officer) 

Title:'----------------

,,.,_, 

ey,, ________ ___ 

Title: _______________ _ 

[Nate: Where one signs by virtue of Power of Attorney far a 

SUrety Crnpany sudJ Power of Attorney nust be filed with this 

oom.J 
Permit No. Illustration 2 

Page 4 of 5 

Cortountiw 

I\lblic on in this anl. __ for day 

the of County ~~~~;·;';';·;"'~foz~e;re~, of , ~a~N~ot;rry~~:;~ in the state 

of , appeared 

to me personally known who, being by me duly swom, did say that 

hefshe is , the corpmation IIMied of in -=~==~===c-.;co and Which executEd the 

witllin instrument, and that the seal affixed to said instrumerrt is 

the CC!l:.'pOnrt:ion seal of said corpmation, anl. that said instrumerrt 

was signEd, sealed anl. delivered in behalf of said cxn:p:n;ation by 

authority of its Board of Directors, and hejshe, as such officer, 

acknc:Mledge:l said instrument to be the free act anl. deed of said 

corporation for the uses and purposes of said instrumerrt as therein 

set forth. 

rn WI'lNESS WHEREOF, I have hereunto set my han:l and official 

seal on the day, month, and year afOJ: said. 

My Ct:mnission EMpires: 

Notary Public in aro. for said 

County an1 state 

Public On in this arxl __ 

for day 

the of County ~:~~~~·~'~';~·;be~~fo~~~i~~·;•~"""'Y~~~~~ of , in the state 

of , aJ:t)E!<Ired 

to me personally known who, being by me duly swom, did say that 

he/she is of 

' the =rpxation IIMied inc...,=c""""=·=c===,~oo 

the within instrument, and that the seal affixed to said instrument 

is the =rporation seal of said corporation, an1 that said 

~t was signed, sealed arrl delivered in behalf of said 

=rporation by authority of its Board of Directors, an1 hejshe, as 

such officer, ackr=lledge:l said instrument to be the free act and 

deed of said ootporation for the uses an1 purposes of said 

instrumerrt as therein set forth. 
Pennit No. illustration 2 

Page 5 of 5 

Coi.wration 

IN wrmESS WHEREOF, I haVe herewrt:o set my harrl arrl official 

seal on the day, m:.mth, arrl year aforesaid. 

My o:mnission Expires: 

Notary 1\lblic in arrl f= said 

-------- Ccurrty arrl state 

NOI'E: Please identify the agent acting on behalf of the surety, it 

awlicable. 

""""''------------ffiOOE'----

~·-----------------
Permit No, Illustration 3 

(Page 1 of 4) 

Sole prrnrietQT"'hip 

UNITED STATES OEPJ\RlMENT OF 'lHE INI'ERIOR 

OFFICE OF SURFACE MINING REcrAMATI<N AND ~ (OOM!lE) 

"""" No •. _____ _ 

KNCW ALL MEN BY 'IHESE PRESENl'S, 'lliAT 'IHE UNDERSI~ 

---c==""==..----"'l>l•c__=;:-;:;======--· (Nane of Individual) (Name of C'.anpany - Permittee) 

(Street Ad:iress) (City) (state) (Zip) 

a sole prrprietorship, as Principal, and 

(Na!oo and Mdrnss of SUrety Cmpany) 

and organized lioensed and to existing do business under the laws of the•sta~:te~o;';;;:;:;;;;:_;:";;- in the state of ;:: , as 

SUrety, are held and firmly boun:i urrto the United states of America 

(CGMRE) in the sum of--------------------

($ ) for the payrrent of which sum we hereby jointly and 

severally bind ourselves, mr Sl"XY'SSOrs, and assigns, 

'!HE rom:tTION OF '!HE AEOVE OBLIGliTION is sud!., that: 

Whereas the above narred Principal has sul:mi:tted Bsrmit 

Jq:plication No. , includin;r a mining and reclamation 

plan, to conduct and reclaim a surface coal minin;J operation, as 

defined p.u:-suant to the Surface Mining control and Reclamation 

Act of 1977, 30 u.s.c. §1201 Jilt~., (the Act) and its atterrlant 

regulations; and 

Whereas, the Principal has chosen to file this perfQl:'manee 

bond as a guarantee that the reclamation of the land disb!rbEd 

durin:J this surface rninin:J cperation will be o::&IJlleted as 

required by the Act and 30 C.F.R. 01apter VII, and as specified 

in the Flermit as issue:\; 

Whereas, the SUrety, and their eo•ooessors and assigns 

agree to guarantee the obligation and to irrlerrnify, defend, and 

hold harmless the united states office of SUrface Minin:J 

Reclamation and Enforoe:me11L (OSMRE) :fran any and all losses and 

expenses which OSMRE may sustain as a result of the Principal ' s 

failure, to comply with the ccniition of the obligation; 
Permit No. --- Illustration 3 

(Page 2 of 4) 

Sole PrwrWgrsh:ip 

Whereas cbligaticns guarantee:i by this perfcrrtWlCE! bond shall be 

in effect for the fcllCMin;J described lands awrovOO- as the permit area 

or incremerrt: upon ltlhidl initial or S1.lOOE!E!din;J cperatiaJS will be 

ccrx:lucted: 

---------------' 

NCM therefore, if the Obligor faithfUlly ca!'lpletes all reclamation 

am abatement requireloont..s set forth in the Act, in 30 C.F .R. Cllapter 

VII, arrl in its Permit, includin;J the mining am reclamation plan, then 

this cbligation shall be void; otherWise, it shall ramin in full force 

arrl effect: 

(a) begimin;J on the date of the approval arrl ~ of Permit No. 

""":;c:::;:;o- arrl extendin;J until all reclamation, restoration, an:i 

abatement work pursuant to the Act, 30 C.F.R. Chapter VII, arrl the 

permit has been canpleted to the satisfaction of Office of SUrface 

Minin;J Reclamation arrl Enforcement; an:i, 

{b) until the bcrrl is released pursuant to 30 C.F.R. §800.40, replace::l. 

in accordance with 30 C.F.R. §800.30, or until the permit has been 

sold, reassigned or otherwise transferred in accordance with 30 

C.F.R. §774.17; and, 

(c) for a minilrum pericd of __ years, nctwit:hstardin;J the 

requimmE!ltt:.s of s\lb-paragrai:tl (a) arrl {b) alJcve, it beirg further 

urrlerstocrl that if the Principal performs any augnented s-p1ing, 

fertilization or other supplemental reclamation work on the site 

prior to bond release, the period of liability urrler this bond 

shall begin again subject to the exception frunl. in 30 C.F.R. 

§816.116(c)(4) or §817.116(c)(4). 

'lhe failure of the Principal to fulfill the obligations specified 

by the Act, 30 C.F.R. Olapter VII, and its permit, shall result in 

forfeiture of this performance bcrrl ao::xml.in;J to the procedures 

described in 30 C.F.R. §800.50. 
Fennit No. ___ _ Illustraticn 3 

(Page 3 of 4) 

Sole Proprietorship 

'lhe Surety shall not canoel this lxln::l. at any tilne for any reason, 

includirg non-payment of premium or bankruptcy of the Principal durin;J the 

period of liability. 'Ihe al'OCIUI1t of the surety's liability may be adjuste:i 

~ OEMRE pursuant to 30 C.F.R. §800.15 for lards cavere:l by this bc:ni .mich 

hmre not been disturbed by the Principal, up:lll awlicaticn by the 

Principal pursuant to 30 C.F.R. §774.13 for the revision of the Permit to 

delete sud! acreage, ani approval by OSMRE of such revision. 

'lbe SUrety will give p:raupt notice to the Principa.l ani to CSMRE of any 

notice received or action filed allegin;J the insolvency or bankruptcy of 

the Surety, or allegin;J any violations or regulatory requ:iremerrts ..nidi 

could result in suspension or revocation of the surety's license to do 

business. 

In the event the Surety be<::laooEl unable to fulfill its d:lligations 

urD.er the bond for any reason, notice shall be given :inmediately to the 

Principal an::l to OOMRE. 

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

or suspension or revocation of its license, the Principal shall be deelned 

to be without bond coverage in violation of 30 c.F.R. §800.11, an::l subject 

to enfo:rceneut actions descr':ibad in 30 C.F.R. §800.16(e)(2). 

IN WI'rnESS IME:REOF, the Principal and Surety hmre hereunto set their 

signature this __ day of 19_ 

n.te ___ _ 

(Cottpany - Permittee) 

''" (Individual - Sole Proprietor) 

n.te ___ _ 

(SUrety) 

''" 

Title: 

[Note: Where one signs by virtue of ~ of Attorney for a Surety 

the F\:wer of Attorney must be filed with this lxln::l..] 
Permit No. ---- Illustration 3 

(Page 4 of 4) 

Sole Proprietorship 

en this day of , 19_, before me, a Notary Public in 

an:1 for the County of , in the state of , 

a~ perscnally :knchm to me to be the person M1ose 

name is subscribed to the foregoirg i.nstrumsnt an:1 who, t:eing by me duly 

sworn, did say that he/she executed the same for the ~ therein 

contained. 

IN WTINESS WHEREDF, I have her9.lnto set my hand an:1 official seal on 

the day, =nth and year aforesaid. 

Notary Public in an:1 for said 

County an:l_ state 

~OF SURElY 

On this day of , 19_, before me, a Notary Public in 

an:1 for the County of , in the state of , awearoo- to me perscnally Jcno;m, who beirq by me duly 

sworn, did say that he/she is of , 

""""'"="'==c.c--= , the OOJ1Xlration named in arxi which executed the within instrument, an:1 that the seal affixed to said instrumerrt: is the 

corponltion seal of said =putation, an:1 that said instrurrent was signed, 

sealed and delivered in behalf of said =poraticn by auth=ity of its 

Board of Directors, an:1 he/she, as sudl officer, ackncMledged said 

instrument to be the free act arxi deed of said oorporaticn for the uses and 

p.n:pases of said instrument as therein set forth. 

IN WI'lNESS WHEREDF, I have hereunto set my hand ani official seal on 

the day, =nth an:1 year aforesaid. 

Notary Public in an:1 for said 

"""""' '"" stam 

NOI'E: Please identify the agent actirg on behalf of the surety, if 

ar:plioable. 

"'-"""' """"''-------- 

___________________________________ _ 
Permit No. --- Illustration 4 

RECE:IPl' OF DEFOSITARY FOR SECURITIES DEFOSITED BY ~ OHICER 

{City) (state) 

'!he 1ll"dersi.gned hereby ackrlrNle:iges receipt fran ~=o--=c.== (Name an:l. Official 

---c;;;o.;c;;;;>;;;;;;;:;;;;:;;;;;,;o;-;;;c,-;;;;;--, of the securities hereinafter 

title of borrl-awrcvlig officer) 

descri.ba:l., dep:;Gited by c;,;;;;;;-;;,-;;;;cc;;;;;----- , as security in 

(Name of cbligor) 

suwort of an in:iannity agreetrent, filed with o::x.mE ~ 

"'c=cocc=cco.o=~' for ____ co===c~<=~<e~7e=cc=cc=o==>C--------- (B.Ireau = office) (Description of obligation secured) 

Said 

______ securities , 11 an:l. are are registered'- assigned iin~tbe"""'M~~~·we;;.o~f_:;;::::;::;;:::;;:;::=== • 

(state form of assignment) 

Title of 

securities 

""- or 

registered 

Total faoe 

"""""' 

lhe above-des=ibed securities will be retuma:i only to = on the written 

order of said bond-approvllg officer =his SI'OCE!Ss= in offioe, upon 

presentation an:l. surrerder of the =iginal of this receipt. 'Ihis receipt is 

executed in duplicate an:l. is not assignable. 

(signature of oepcsitary) 

11 'Ihis information to be tumishe::l only in case of registered securities. 
Illustration 4A 

'IOl'AL B:tiD AM:.UNT: -----

RJRKlSE: 

ln a=rrlance with 30 CFR 942.800 of the Tennessee Federal PI:C>3Laiii, the 

Office of SUrface Minirg" Reclamation ani EnfOl:'O£'fl'e!1t (OSMRE) has received the 

reclamation perfonnance boJxi described abmre. 'Ihe Principal has filed, arrl 

OSMRE has aCCE'pted, this perfonnance bond as a guarantee that the reclamation 

of the land dis'blrbed durirg" this surface minin;J cperation will be o::tTplete:i 

as requirEd 'rlj the SUrface Minirg" Control ani Reclamation Act of 1977 (30 usc 

1201 et ~.) ani 30 CFR SUb::hapter J, ani as specified in the awrovOO 

Permit, inclu:lirg" the MinirB ani Reclamation Plan. 

RECE:lVED BY: 

(Name & Title) 

(Signature) 
illustration 4B 

llECEIPl' OF ~ OFFICER 

(City) (state) (I:e.te) 

'!he urdersigned hereby acknc:wle:iges receipt of the securities 

hereinafter described, deposited as security in lieu of surety on 

--,;;;;;;:;;;;;-,;;;;-;;,-,;:;;;c.---' (~iption of bc:n::l) filed with ~~~~~-- (Department) 

~~~~~~­ (Bureau = Office) 

Said securities are registered in the name of --------

and are assigned i'iO<mO.c;;;;s>:gno;;tt, (Form of assiyJuo.ellt) 

Title of Coupon = Total Face Serial Interest 

securities registered lurount Denomination NUmber Dates 

This receipt is executed in duplicate, arrl the original llllSt be 

surrerdered by the obligor before the alxNe described notes = bords 

&posited are reb.nne:l to him = her. This receipt is not 

assignable. 

(Signature arrl official 

title of bond <lM?IOVing 

officer) 
Permit No. Illustration 5 

(Page 1 of 2) 

Bple Proprif'tP!'1¥llp 

IJNTim STATES IEPARIMENr OF 'IHE Dll'ERIOR 

OFFICE OF SURFACE lmiTNG RECI»>ATICN AND ENFORCfMEN1' 

RN:M ALL MEN BY "IHESE I'RESENI'S, that I, the urrlersigned, of 

(Name of ~ - Permittee) 

(street Address) (City) 

do hereby constitute an::! appoint (state) (Zip) 

(Name an::! official title of lxn:l.-awrovirg officer) 

and hisjher s"'xessors in office, as attorney for me an::! in my name 

to collect or to sell, assign, an::! transfer certain securities, 

certificates of deposits or ather instruments described as follows: 

such negotiable securities havin} been dEposited by me, as security 

for the faithfUl performance of any an::! all of the corrlitioos or 

stip..tlations of a certain obligation entered into by me with the 

united states, under date of , with 

(I:e.te Collateral Borrl Signed) 

respect to Permit No. cc-;c-==-' wen is hereby made a part hereof, ani I agree that, in case. of any default in the performance 

of any of the con:litions and stipulations of such lliUer- taldn:;J, my 

said attorney shall have fUll power to oollect said securities or 

any part thereof, or to sell, assign, and transfer said securities 

or any part thereof without notice, at public or private sale, tree 

fran any equity of re:lenpti_on and withcut appraisanent or vaJ.uation, 

notice an:l right to rec:lean bein:J waived, arxi to awly the proceeds 

of such sale or oollection, in whole or in part, m the satisfaction 

of any damages, derrmDs, or deficiency arisin;J by reason cf such 

default, as my said attorney may deem best; arrl the UOOersigne:i 

fUrther agrees that the authority herein gnurt:ed is i.rrevo:::able. 
Wnllit No. __ _ Illustration 5 

(Page 2 of 2) 

Sole Proprietorship 

And I hereby for myself, ley heirs, executors, administrators 

an::l. assigns, ratify and confirm lllhatever my said attorney shall do 

by virtue of these presents. 

ill WI'INESS liiHEEID)F, 

signature t:his __ _ the ct>ligor has hereunto set his/her 

day of , 19 __ • 

(Cl::u{:any - Permittee) 

''" ---,;;;=~=-=~==-­ (In:lividual - Sole Pn::prietor) 

On t:his day of 19 , before me, a 

Notary PUblic in an::l. fer the oomty of , in the 

state of , appeared 

personally ~ to me to be the person l<ihcse name is subscribed the 

foregoirq ins"tnnrent an:i llho, beirq by me duly swam, did say that 

he/she executed the same for the PJrPOSE'5 therein aorrtained. 

ill WI1NESS WHEREOF, I hlNe hereunto set my hanl and official 

seal en the day, roonth, an::l. year aforesaid. 

My o:mnission Expires: 

Notary Public in an:l for said 

Ct;mlty and State 

Securities must be described by issuirq institution, 

title, date of maturity, rate of interest, denctnination, 

serial number, an::l. \oJhether CC>.lpOll or :te;JisterOO. 
Illustratioo. 6 

(Page 1 of 2) 

Cmp;!fation 

1JNITEl) STATES IEPARIMENT OF 'IHE INI'ERICR 

OFFICE: OF SURFACE MINmG RECliiMATICN liND ~ 

(Name of Co:r::porati.oo. - Pemittee) 

a corporation duly incorpozated under the laws of the state of 

;oc:;;;;;"';c-;;o-;co;; , in pursuance of a resolution of the board of 

directors of said corporation, passed en the day of 19_, 

does hereby constitute an:i appoint 

(Na!re an:i official title of bon:i-awrcvin;J officer) 

and hisjher successors in office, as attorney f= said ooJ:pOraticn, 

f= an:i in the name of said corpozation to oollect = to sell, 

assign, and transfer certain searrities, certificates of deposits or 

other instruments described as follows:'---------------------------

such negotiable securities haVin;J been depositei by it, as security 

f= the faithful perfonnance of any an:i all of the =nlitions = 

stip.llations of a certain obligation entered into by it with the 

unitei states, under date of 

~=~===~=~==;--, with respect to Permit No. ___ __ (Drt.e Collateral Eond Signed) 

l'llhich is hereby made a part hereof, and the un:iersigned agrees that, 

in case of any default in the perfonnance of any of the conUtions 

and stipulations of such undertaking, its said attorney shall have 

full ~ to oollect said securities or any part thereof, or to 

sell, assign, an:i transfer said securities or any part thereof 

withco.:!t notice, at public or private sale, free frcrn any equity of 

nrlemption and without appraisement = valuati0r1, notice and right 

to redeem beliq waive:l, and to awlY the proceeds of sudl sale or 

oollection, in whole or in part, to the satisfaction of any damages, 

demands, or deficiency arisin;J by reason of sudl default, as my said 

attorney may deem best 1 and the un:iersigned further agrees that the 

authority herein granted is irrevocable. 
Permit No. __ _ Illustration 6 

(Page 2 of 2) 

COJ:OOJ:ation 

An:i said corporaticn for itself, its "'xressors an:l. assigns, 

ratifies arrl =firms whatever its said attorney shall do by virtue 

of these presents 

IN WI'INFSS WHEREOF, the Cbligor has hereurrto set its signature 

this day of _____ , "--

(Corporati.cn - Permittee) 

~·----~==~~~~--­ (Coip:n:ate Officer) 

Title: 

On this day of , 19 , before me, a 

Notmy Public in and for the Count¥ ot , in the 

state of , a~ to me 

personally lmc:Mn who, be!.irrJ by me duly sworn, did say that he/she is 

<;q;;;;;t'iO;iCo;;<rl-r;;-,;rr; of , the ootp:n:ation naJred in arrl which execLrt:ed the within instrument, arrl 

that the seal affixed to said instrument is the oorporaticn seal of 

said corporation, arrl that said instrurnerrt was signa1, sealed an:l. 

delivered in behalf of said corporation by authority of its Boanl of 

Directors, and hejshe, as such officer, ac:kn::Mledged said instrument 

to 

~ 

be the free act and deed of said corporation for the uses arrl 

of said instrument as therein set forth. 

rn WI1NESS WHERIDF, I have hereurrto set my hand and official 

seal on the day, llDlll:h, and year aforesaid. 

My cartnission e:pires: 

Notmy f\lblic in and for said 

County an:l. State 

Securities must be described by issuin;J institution, 

title, date of :maturity, rate of interest, 

derxxnination, serial number, arrllolhether =upon or 

registered. 
Illustration 7 

(Page 1 of 2) 

Partnership 

UNITED STATES DEPARIMENl' OF 'IHE INIEUOR 

OFFICE OF SURFACE mNIN:; RECU\MATICN AND EmURCEMENr 

I<NCM ALL MEN BY 'IHESE PRESENI'S, that I, the urx:lersigned, 

carryin;J on business in the partnen;hip together l.1I"Xler the firm name 

ani style of 

(Name of Partnership Permittee) 

(street Address) (City) (state) (Zip) 

do hereby constitute an:i awaint 

Name an:i official title of bcnl.-cq:provin;J officer) 

an:i hisjher su=essors in office, as attorney of me an:i each 

partner, ani of our said firm of --,;;;;;;;;c,.,-;;;;;;;;;;;;>;i;;;c:-;;;;;;;,;+;;;;;- (Name of Partnership - Permittee) 

in the name or names ani on behalf of us ani our said finn, to 

collect, or to sell, assign ani transfer certain securities, 

certificates of deposits or other instrurrents described as follows: 

such negotiable securities havin;J been dep:lsited by us, as security 

for the faithful perfm:nence of any ani all of the conditions or 

stip.llations of a certain cbligatim entered into by us with the 

United states, urrler date of , with 

respect to Permit No. , (Date Cbllateral Bon:i Signed) 

which is hereby made a part hereof, an:l. we agree that, in case of 

any default in the perforrrarx:e of any of the con::titions an:l. 

stipulations of such undert.aJ.dn], our said attorney shall have full 

pcMer to collect said securities or any part thereof, or to sell, 

assign, and transfer said securities or any part thereof without 

notice, at public or private sale, free fran any equity of 

reda!ption and without appraisement or valuation, notice and right 

to redeem being waiVOO, ani to awly the pn;ceeds of sudJ sale or 

=llection, in Mmle or in part, to the satisfaction of any cta:rrages, 

demands, or deficiency arisin;J by reason of sudJ default, as its 
said attomey may deem best; and the undersigned further agrees that 

the authority herein granted is irrevocable. 

Permit No. ___ _ Illustration 7 

(Page 2 of 2) 

Partnership 

Arxi we hereby for ourselves, our heirs, execut=s, 

administrators, and assigns, ratify and calfirm lohatever our said 

attorney shall do by virtue of these PJ:: ut. 

rn WITNESS WHEREOF, the Cbligor has hereunto set hisjher 

signature this day of , 19 __ • 

(Partnership - Permittee) 

~·--------~~~----­ (Portnor) 

On this day of , 19 , before ne, a 

Notaiy Public in and f= the Co.mty of , in the 

state of , a~ to ne 

personally kno;m, ~ J::eiig by me duly ~. did say that he/she is 

a partner of , the partnership 

named in the foregoi.n] instrument, and that he/she, beln] authorized 

so to do, executed the foregoln] instrument on behalf of said 

partnership. 

IN Wl'rnESS WHEREOF 1 I have here.mto set my hand and official 

seal on the day, :month, and year aforesaid. 

My Commission Expires: 

Notacy Public in and for said 

Co.mty and state 

Securities nust be described by issui.n:.J institution, 

title, date of mab.lrity, rate of interest, 

denc:rnination, serial fl..ll1'ber, and whether coop:m or 

registered. 
Record of Recla:naticn 

Performance Bon:i(s) f= 

PeJ:mit No. 

Illustraticn SA 

(Page 1 of 2) 

In accordance with 30 CFR Part 800, the Offioe of surface Minin:J 

Reclamation an:i Enforcement (CISMRE) has received the reclamation 

performance bom[s) described below. !Ihe Principal has filed, and 

OOMRE has accepted, this perfomance bcn:l(s) as a guarantee that the 

reclanation of the lanl disturbed durirg this surface minirq 

operation will be =rpleted as ~ by the surface Mining 

Ccntrol and Recl.ana.tion Act of 1977 (30 usc 1201 et §!l9) ani 30 CFR 

Part J, arrl as specified in the aw=veci Permit, includin:J the 

Minirg ani Reclamation Plan. 

Principal: =;;;=========== Permittee: 

Permit No.: 

Description of Bo!rl: 

A) -.ty 

-

B) Negotiable Securities 

Naire of Issue & l3o!rl No. 

C) Certificates of Deposit, 

Letters of CrEdit 

-

Face Value Market Value 

sav~ Certificates, Bank Irrevo::ab1e 
Illustratiat 8A 

(Page 2 of 2) 

D) Cash, Certified, Check, cashier's Oleck, Treasurer's Check Bank 

Oleck NO. J\iiD.lnt 

Total J\iiD.lnt of Bond 

Received for OSMRE: 

(Nane an:l. Title 

(SignabJre) 
Illustratial BB 

Mgpher 

REl\SCN FOR RElEASE: 

'Ihe perfonrance borrl documents described aboVe are hereby releasEd 

by hard, mail to------------

RElEASE APPRJVED BY: 

(Name & Title) 

mTE: 

(Signature) 

'Ihe signature below acknc:wledges receipt of the borrl docwtent(s) 

described above. If received by mail, please sign, date an:l return 

this form in the envelcpe provided. 

L'OCOMENI' (S) RECEIVED BY: 

(C'arlp;my Representative Nane & Title) 

lli\TE: 

(Signature) 
Illustration BC 

(City) (~) (Date) 

'lhe W"Dersigne::l hereby ackrl:Mledges receipt of the securities hereinafter 

described, defx:>E;itOO with --==-====-:.--- (Name and Official 

- -"H;;:;;-;;e;;;o;;:;;;;;;;:;;;;,;;;-;;;;ec"':;--' as security to suwort the title of bond-approvin:J officer) 

attadled IOOernnity Agreement, filed with OOMRE thrcugh 

"";oc;c-~-;;o'"-';;;--' for mi.nin:J permit No. ----------- (Bureau or office) 

and Said are assigned securitic<es"_ll"''""'oe_':"'~lirt><ed:;~~in~;the~>nomo;;.~o;f~~=============== (state fonn of assignment) 

Title of 

securities 

'Ihls receipt is executed in duplicate. 

(Signature of ctlligor) 

11 'lhis infonnation to be furnished cnly in case of registered securities. 
Permit No. --- lllust=tion 9 

{Page 1 of 3) 

Sole Prcpriet:orship 

UNITED STA'lE'3 llE:PARIMENI' OF 'IHE !NillRIOR 

OFFICE OF SURFACE J>aNIN:; REC:lM9.TIC!'f AND ~ {OSMRE} 

l<NC'M ALL MEN BY THESE mE51'NI'S, '!HAT TilE UNDEilSIGNED 

~~~~--~=---~~~--~--' (street Address) (City) (state) (Zip) 

a sole proprietorship, as Obligor, is hereby held an:l firmly bound 

unto the UnitEd states, OSMRE, lll the sum of ---------- ($ ) • 

'IHE CONDITION OF 'IHE AOClVE OBLIG.IIT.ION is such, that; 

Whereas the above named Cbligor has sul:mittErl Permit 

Application No. , inclulirg a minin;r arrl 

reclamation plan, to corxiuct. arrl reclailn a surface coal 

minirq operation, as defined p.lrsuant. to the Surface 

Minirq Control and Reclilllli'Jtion Act of 1977, 30 u.s.c. 

§1201 et m . , (the Act) an:l its atterdant regulations; 

""' 

Whereas, the Cbligor has chosen to {XlSt as =llateral 

one of the instruments of inle!mificatic~'l specifi.e:l lll 30 

C.P.R. §800.5(b), rwnely in the 

"""""" of 

arrl dep::lsitErl with the Offiae of 

Surfac.e Minirg Reclamation an:l Enforcement as a guarantee 

that the reclamation of the larrl disturbed durirq this 

surface coal minirq operation will be carpleted as 

required by the Act an:l 30 C.P.R. Cllapter VII, an:l as 

spooifi€d in the Permit as issued; 

Whereas, the Cbligor, arrl their successors and 

assigns agree. to guarantee the OOligation arrl to 

irdemnify, deferd, am hold harmless the Unitoo states, 

Office of Surface Minin; Reclamation and EnforceJuent 

(OSMRE) f'l:."ctn any and all losses an:l ~ Mlich OSMRE 

nay sustain as a result of the Cbligor's failure to 

cmrply with the c:orrlition of the obligation; 
Permit No. -- Illustration 9 

(Page 2 of 3) 

Sole Proprietorship 

Whereas cbligations guaranteed l:1j this pertonr.moe bond shall 

be in effect for the fall~ described lards awroved as the 

pennit area or incremerrt: up:m which initial or succeedirq 

cperations will be con::lucted: • • • • • 

-----------' 

Now therefore, if the Obligor faithfully cmpletes all 

:reclamation an::l abatement requiLeneut::s set forth in the Act, in 30 

C.F.R. Chapter VII, an::l in its pennit, inclufulg the mining an::l 

:teclamation plan, then this obligation shall be void; otherwise, it 

shall rerre.in in full force an::l effect: 

(a) beginning on the date of the ~ and issuance of 

Permit No. an::l erterrlirg until all 

mcJ.amation, restoration, an::l abatement work pursuant to 

the Act, 30 C.F.R. Chapter VII, and the permit has been 

corrpleted to the satisfaction of Office of SUrface M1nin;J' 

Reclamation and Enforcement; and, 

(b) until the bond is released~ to 30 C.F.R. §800.40, 

replaced in accordance with 30 C.F.R. §800.30, or until 

the permit has been sold, reassigned or ot:hezwise 

transferred in acc:>::!!Uance with 30 C.F.R. §774.17; and, 

(c) for a minim.ml period of __ years, notwit:hstan::lin:J the 

requirenents of sub-paragrafbs (a} and (b) above, it being 

further urderstocd that if the Obligor perfOJ:JJB any 

augrrented sociing, fertilillation = ather supplenental 

reclamation work on the site prior to bond release, the 

perio::l of liability urrler this bond shall begin again 

subject to the exception foon:I in 30 C.F.R. 

§816.116(c)(4) or §817.116(c)(4). 
Permit No. --- Illusb:at.icrl 9 

(Page 3 of 3) 

Sole Proprietorship 

The failure of the Obligor to fulfill the cbligations specified 

by the Act, 30 C.F.R. Chapter VII, and its pennit, shall result in 

forfeiture of the collateral posta::t with this ~fonra!XlE! bon:l 

according to the proce;1ures described in 30 C.F.R. §800.50. 

IN WI'INESS WHER00F 1 the Obligor has hereunto set hisjher signature this __ day of , 19_. 

(Q:npany - Pennittee) 

(Irrlividual - Sole Proprietor) 

On this __ day of , 19 , before me, a Notary 

Public in and for the County of , in the state of 

.;c;:=-=c-==' aweared personally :kr"a.m to me to be the person whose name is subscribed to the foregoin;J 

instrument and l<ho, bein;J by ne duly swam, did say that he/she 

exearte::l. the same for the p.ll.pJSeS therein contained. 

IN WI'mFSS WHEREOF 1 I have hereunto set my hand and official 

seal en the day, m:x:tth and year aforesaid. 

My Comnissicn El!pires: 

Notaty Public in and for said 

Cl:lunty and State 

Where negotiable securities are used as collateral, a 

carplete:l FeWER OF A'I'TClRNEY AND liGREEMENl' RUSt be 

attached. 
Permit No. ___ _ Illustration 10 

(Page 1 of 3) 

PaJ;bgship 

UNITED STATEE DEP1IRIMENI' OF 'IHE INifRIOR 

OFFICE OF SURFACE: MINING RE:CJ:MIIATICN liND ~ (OSMRE) 

:rncM AIL MEN' BY 'IHESE PRESINrS, '!HAT 'IHE UNDERSIGNED 

---------=====-====---------· (Partnership - Pennitt:ee) 

'"'""'""O.t'>'""''~o=.~,,-----,,Ci'"''ty'"> ----'"'"""~c,c--"r'"'~P'>-, 

a partnership, as Obligor, is hereby held and firmly b:o.md unto the 

united states of Anerica, OSMRE, in the sum of 

($ ) . 

THE o::tiDITION OF 'IHE ABJVE OBLIGATICN is such, that: 

Whereas the alxJve rwred Obligor has sul:mitted Permit 

A(:plication No. , includin::J a minin::J and reclam3.tion plan, 

to conduct and reclaim a surface coal mining operation, as defined 

pursuant to the SUrface Mining Control and Reclamation Act of 1977, 

30 U.S.C.§1201 et gg., (the Act) and its atterrlant regulations; and 

Whereas, the Obligor has chosen to post as collateral one of 

the instnlmerrts of irdernnificatim specifie::l. in 30 C.F.R. §800.5(b), 

""""'¥ 

in the cmo.mt of 

($ ) , an::i deposited with the Office of SUrface 

Mining Reclamation and Enforcement as a guarantee that the 

reclamation of the land disturbed duri.n;J this surface coal mining 

operation will be canpleted as required by the Act an:l. 30 C.F.R. 

Olapter VII, and as specifie::l. in the Pennit as issued; 

'iihereas, the Obligor, and their sncoessors and assigns agree to 

guarantee the OOligation and to irdernnity, defend, an:l. hold 

harmless the United States Office of Surface Mining Reclamation and 

Enformmel!t (OSMRE) fran any and all losses and experses l.hich OSMRE 

may sustain as a result of the Cbligor's failure to COIIply with the 

condition of the d:lligation; 
Petmit No. ___ _ illustration 10 

(Page 2 of 3) 

Partnership 

Whereas chligations guaranteed by this perforlllance tx:ni shall be in 

effect for the follc:Ming des=ibed larx1s aWJ:OVed as the pennit area 

or incremerrt upon lolhidi initial or sua:eecti.rq q:erations will be 

con:hlct:e::l. : • • • • • 

------------' 

NCM therefore, if the Obligor faithfully carpl.etes all reclamation and 

abatement requirements set forth in the Act, in 30 C.F.R. Chapter VII, and 

in its permit, incluiirq the minirq and reclamation plan, then this 

obligation shall be void; otherwise, it shall remain in full force and 

effect: 

{a) beginning on the date of the awrova.J. an:l. issuanoe of Pennit 

No. and exten::lim until all reclamation, restoration, 

an:l. abatemmt work pursuant to the Act, 30 C.F.R. Chapter VII, and 

the permit has been carplet:ed to the satisfaction of Office of 

SUrface Minirq Reclamation and Enforcement; and, 

(b) until the bond is released pursuant to 30 C.F.R. §800.40, 

:replaced in ao::ordan:::e with 30 C.F.R. §800.30, or until the 

permit has been sold, reassigned or otherwise transferral in 

accordance with 30 C.F.R. §774.17; and, 

(c) for a minimum pericd of __ years, notwithstaniin;J the 

requirements of sub-paragrari'lS (a) and (b) above, it beirq 

further un:lerstoai that if the Obligor performs any augroontai 

seedirq, fertilization or other supplerrent.al reclamation work on 

the site prior to bond release, the period of liability urrler this 

bond shall begin a.gain subject to the exception fourrl in 30 C.F.R. 

§816.116(c)(4) or §817.116(c)(4). 
~tNo. -- Illustration 10 

(Page 3 of J) 

Partnership 

'lhe failure of the Cbligor to fulfill the cbligations specifie::'l. 

by the Act, 30 C.F.R. cmpteZ" VII, an::l. its pennit, shall result in 

forfei'b.lre of the =llateral posted with this performanae bon:i 

ac:cardin;J to the procedures described in 30 C.F.R. §800.50. 

m WI'INESS WHEREOF, the Obligor has hereurrl:o set hisjher signa'b.lre this __ day of , 19_ 

(Partnership - Permittee) 

"'" < """""'I 

011 this __ day of , 19 , , before me, a Notary 

Public in arxi for the OJunt:y of , in the state of 

-;;,;;---;:;;;;-.;;;<, appeared to me personally kilc:Mn, who beirrJ by me duly m.ttn, did say that he/she is a partner 

of , the partnership rnmed in the foregoin3" instrument, arrl that he/she, beirg authorized so to do, executed the 

foregoing instrument, and that he/she, beirxJ authoriZEd so to do, 

executed the foregoinl instrument on behalf of said partnership. 

m WI'INESS l<l11ERIDF, I have hereunto set my hard arxi official 

seal on the day, nonth and year aforesaid. 

My Cl::mnission Expires: 

Notary Public in arrl for said 

OJunt:y an::l. State 

Where negotiable securities are used as =llateral, a 

catpleted PCMER OF ATmllNE'i AND AGREEmNr rrPJSt be 

attadled. 
Permit No. ___ _ Illustration 11 

(Page 2 of 3) 

g" • •" ation 

Whereas d:lligations guarantooct 1::1f this bord shall be in effect 

for the follCMin;r described larrls aWJX!IfE!d as the permit area = 

increment up:>n which initial = suooeeding c:perations will be 

corrlucted • • • 

~ therefore, if the cbligor faithfUlly cctrpletes all reclamation 

am aba.terrent requirements set forth in the Act, in 3o CFR Olapter 

VII, am in its permit, inclu:iirg the lllinin;J ard reclamation plan, 

then this cbligation shall be void~ otheiWise, it shall remain in 

ftlll force am effect: 

(a) beginnirg s on the date of the arprovaJ. am issuance of 

Permit No. am exterdirg until all 

reclamation. restoration. am abatemerrt: l!.Urk p.rrsuant to 

the Act, 30 C.F.R. Clulpter VII, am the permit has been 

=rrpleted to the satisfaction of OOMRE; am 

(b) until the bon:i is released pursuant to 30 C.F.R. 800.40, 

replaced in accordance with 30 C.F.R. 800.30, or until the 

permit has been sold, reassigned = otherwise transferred 

in accordance with 30 C.F.R. 774.17~ am, 

(c) exterdirg for a :minim.lm pericd of __ """"' 

notwithstanding the requirements of sub-ParagraiiJs (a) am 

(b) alxNe, it being further urxierst:co:i that if the Cbligor 

perfonns any augmented see:l.irg, fertilization = ather 

suwJ_ei'IEiltal reclamation worK on the site prior to bond 

released the pericd of liability urder this bc:nd shall 

bEgin again subject to the exception f<:>..mi in 30 C.F.R. 

816.116(c) (4) or 817,116(c) (4). 

'Ihe failure of the Cbligor to ftllfill the cbligaticns specified 

by the Act, 30 C.F.R. 01apter VII, am its pennit, shall result in 

f=feiture of the collateral posted with this in:iennity agreement 

according to the procedures described in 30 c.F.R. 800.50. 
Permit No. --- Illustration 11 

(Page 3 of 3) 

rpnxm:rt=1 m 

IN WI'INESS WHEREOF 1 the Obligor has hereunto set its signature ard 

seal this day of , 19_. 

(Oorporati.ocl - Permittee) 

by'--===o;=:=;-- (Cbrporate Offioer) 

<n this day of , 19 , before me, a 

Notary Pillllic in ard for the o::o.mt:y of , in the 

State of , appeared to me 

personally kncMn who, being by me duly sworn, did say that hejshe is 

~-----~· of the corporation nanal in ard l'llhich executed 

the within instrument, ard that the seal affixed to said instrument 

is the corporation seal of said corporation, ard that said 

instnnnerrt who signed, seal, ard delivered in behalf of said 

corporation for the uses ard purp:lSeS of said instrument as therein 

set forth. 

IN WI'IN&'lS WliERtXJF , I have hereunto set !t'IJ haJD. ard official 

seal on the day, month ard year aforesaid. 

My Co!mtission Expires: 

Notary Pillllic in ar:rl for said 

o::o.mt:y am state 

Note: Where negotiable securities are used as collateral, a 

c:mpleted ro'lER OF ATTOONEY AND AGREEHENI' DUSt be attached. 
Pennit No. -- Illustration 12 

{Page 1 of 3) 

Un:bQLation 

UNITED STA'IES DEPliRIMENl' OF 'lHE INI'ElUOR 

OFFICE OF Sl.lRFACE MINING ~ AND :ENFORCEMENr 

WHERFAS, on the ____ day of _____ , "--

of 

(Name of Corporation - Permittee) 

~=>==~------~----~~-==-· (Street Address) (City) state) (Zip) 

executed certain certificate(s) of dep:lsit described as follCM.S: 

to secure pertonnance of certain :reclamation un:ler SUrface Coal 

Minirg and Reclamation Permit No. • 

WHEREAS, urx:ler 30 CFR 800.21(a) (3) the permittee is required to 

post an acceptable new certificate or provide an executed assignment 

of the existing certificate made payable to the regulatory 

authority. 

lt::M 'IHEREFORE, to satisfy the requirements of 30 CFR 

800.21{a) (3), the undersigned, _O'imootC<<POii>tionCC-,;;;m;itt;;e-) (Name of COJ:potation - Permittee) 

as Obligor, hereby assigns its :interest in the certificate(s) of 

deposit as described aboVe, made payable to "the united States, 

Office of SUrface Minirg Reclamation and Enforc:emeut." 

'IHE CXlNDmOO OF 'IHE AF£NE MSIGNHENI' is such that the 

certificate shall: 

(a) be assigned to the united states, Office of SUrface Mining 

Reclamation and Enforcement, both in writing ard upon the 

books of the institution issuing such certificates; 

(b) irrlividually not exceed $100,000, or the :maxiJmmt insurable 

am::o.mt as determinEd by F.D.I.C. and F.S.L.I.C; 
Permit No. Illustrati.crl 12 

(Pa;e 2 of 3) 

CU!oPQLation 

(c) be con::liticned upon the Issuing Institution waivin;J all 

rights of set-off or liens lllhiah it has or IIBY have 

against those aartificates; 

(d) be deposited in sufficient ano.mt:s, so that liqcrldation of 

those aartificates prior to ne.turity \<IOlld provide the 

ra:JUired OOn::i 1lll'Dllllt.; 

(e) the assigntrent shall remain in full force arrl effect 

until released in writin;J by the Offioe of SUrface M:iniJ"g 

Reclamation arrl Enforo::uent. 

'Itlis assignment shall be valid t:hrco;Jha.lt. art:! maturity 

redenption pericd as designated by the Issuin;J Institution, arrl 

shall also automatically renew itself ..men the oertificate(s) of 

deposit is renewed. 

rn WI'INFSS WHEREOF, the Cbligor has hereunto set its signature 

arrl seal this day of , 19_~ 

(Cbrporaticn Permittee) 

Title: -------------

rn WI'INESS WHERIDF 1 the Issuing Institution has hereunto set 

its signature arrl seal this day of , 19_~ 

(I~ Insti'l:l.ltion) 

~'---------------

Title: ------------
Permit No. Illustration 12 

(Page 3 of 3) 

Cbrporation 

~ OF OJRFORATICN - PERMl'lTEE 

On this day of , 19 , before me, a Notary 

P<lblic in an::l for the County of , in the state of 

;;-;;;c;oc"';,~,;;;:o;;;-, aweared to 

me personally Jma./n who, beirJo:J by me duly sworn, did say that hejshe 

is "' ' the cutfXJLation naJ'I'lE!d in an::l Wid!. executed the within instrument, 

an::l that the seal affixed to said inst.ruuJ?nt is the cutfXJLation seal 

of said =zporation, an::l 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, acknr~ledged said 

instrument to be the free act and deed. of said cutfXJLation for the 

uses an::l pu!:pOSeS of said i.nstrument as therein set forth. 

IN W!WESS WHEREDF, I have hereunto set my hand and official 

seal on the day, month, and year aforesaid. 

!ott Ccrnmission Expires: 

Notary Public in and for said 

County an::l state 

~ OF Issrml? INS'1TlUI'ICN 

On this __ day of 

I\Jblic in arrl for the county of 

of , aweared 

,19 , before me, a Notary 

' in the state 

me personally k:rlaom who, beirJo:J by me duly sworn, did say that he/she "' 

the is IssuiD1 Institution named in and 1\hidl of·-===~=~==-- executed the within 

instrument, and that the seal affixed to said instrument is the 

COip:Jration seal of said Issui.n::J Institution, an::l that said 

instrument was signed, sealed an::l delivered in behalf of said 

o:rrporation by authority of its Board of Directors, and hejshe, as 

sudl officer, aclmc:Mledged said i.nstrument to be the free act and 

deEd of said corporation for the uses an::l purposes of said 

instrument as therein set forth. 

IN WI'INESS WHEREOF, I have hereunto set my hand an::l official 

seal on the day, month, an::l year aforesaid. 

My Colmrission Expires: 

Notary Public in an::l for said 

County an::l state 
Permit No. Illustration 13 

(Page 1 of 3) 

J?artnership 

UNITED S'l'ATES rEPARIMENI' OF 'IHE INI'ERIOR 

OFFICE OF SURFACE MINING REx::U\Hl\TICN AND ENFORCEMENT 

ASSIGNMEffi' OF CERI'IFICATE OF QI'Kl'?IT 

WHERFJIS, on the ____ day of _____ , "--

----------~~70==c=~c-~=o==c------' of (Name of Partnership - Permittee) 

(Street 1\d:lress) (city) (state) (Zip) 

exeazted certain certificate(s) of deposit descri.ba::l as follows: 

WHEREAS, under 30 CFR aoo.n(a) (3) the permittee is required to 

post an acceptable new certificate or provide an executed assi.grnent 

of the existiJB certificate made payable to the l"a3Ulatocy 

authority. 

Na<J 'IHEREFORE, to satisfY the requiianents of 30 CFR 

800.2l(a) (3), the urrlersigna:l., ~~~=~==~~===-

(Name of Partnership - Permittee) 

as Cbligor, hereby assigns its interest in the certificate(s) of 

deposit, as descri.ba::l above, nade payable to the ''United states, 

Office of SUrface Mini.IB Reclamation ard Enforcement." 

'lHE WIDITION OF 'lHE ABJVE 1\SSICNm'II' is such that the 

certificate shall: 

(a) be assigned to the United States, Office of surtaoe Mining 

Reclamation ard Enforcement, both in lllriting an:i upon the 

books of the institutioo issuin:J such certificates; 

(b) :individually not exceed $100,000, or the maxim.Im insurable 

amount as determined by F.D.I.C. and F.S.L.I.C; 
Permit No. Illustration 13 

{Page 2 of 3) 

Partnership 

{c) be =n:litioned upm the Issuin;J Institut.i.oo. wa.ivim all rights of 

set-offs or liens which it has or may have against those 

certificates; 

{d) be deposited in sufficient am:urrts, so that 1icr-rldation of those 

certificates prior to maturity wruld provide the required borrl 

anv:o.mt; 

(e) that the assignment shall retain in full force arrl effect until 

released in writim by 'lhe Office of SUrface Mini.Ig Reclamation arrl 

Em=-n<o. 

ntis assignment shall be valid tllroughwt any maturity redemption period 

as designated by this Issuing Institution, arrl shall also autanatically 

reJ'leW" itself When the oertificate(s) of deposit is renewed. 

m WI'mESS ~F, the Cbligor has herwnto set hisjher signature this ___ day of , 19_ 

(Partnership - Permittee) 

( """""'") 

m WI'mESS WHrniDF, the Issui.Ig Institution has herwnto set its 

signature arrl seal this day of 19 __ 

{Issuing Institution) 

Title: --------------
Permit No. Illustration 13 

{Page 3 of 3) 

Partnership 

~ OF PARINERSHIP - PElMITl'EE 

Notary on PUblic this in arrl day for of the >.-<>iint;y;;r~:::_·~':'==·~"":':m:•~-, County of , in • the 

state of 

to .:c=c~====~e>o=~' ne personally ~. who """"""'ccc=~ccccc==c-,.,c=cc~cc--­ bein; by me duly sworn, did say that 

hejshe is a partner of , the 

partnership named in the foregoin; instrument, arrl that he/she, 

being authorized so to do, executed the foregoing instrument on 

behalf of said partnership. 

IN WI'lNESS WHEREDF, I have hereunto set llfJ hand arrl official 

seal on the day, I!Dlth arrl year aforesaid. 

My c:amnission Expires: 

Notary PUblic in arrl for said 

county arrl state 

On this .--ccc=oc day of 

Notary Public in arrl for the county of 

the state of 

, "--' before me, a ,ln 

to me personally ~ 

·-

who, bein; by ne duly 

sworn, did say that hejshe is of .T:::-:=:::;-c~ , the Issuing Institution named in 

arrl which executoo the within instrumerrt:, arrl that the seal affixed 

to said instrument is the =rporation seal of said Issuing 

Institution, arrl that said instrument was signed, sealed arrl 

delivered in behalf of said o:n:p:aation by authority of its Board of 

Directors, arrl hejshe, as sudl officer, acknowledged said instrument 

to be the free act arrl ~ of said =rporation for the uses arrl 

p.uposes of said instrument as the.rein set forth. 

IN wrrnESS WHERFDF, I haVe hereunto set 11fJ hand arrl official 

seal on the day, l11011th, arrl year aforesaid. 

My Ccmnission Expires: 

Notary PUblic in arrl for said 

County arrl state 
Permit No. -- lllust:ration 14 

(Page 1 of 3) 

Sole P.twrietorl3hip 

tJNlTED SI'ATES DEPARIMEm' OF 'IHE INI'ERIOR 

OFFICE: OF SURFACE M!NING RECLNIA'l'IOO liND E:NFCEC»>ENT 

WHE:REAS, on the ___ day of ____ _ "-- -------c~=c~~~~~~ ... 00 ______ , oc (Name of o::upmy - Permittee) 

(street Address) (City) (state) (Zip) 

executed certain oertificate(s) of deposit described as follOOIS: 

to SECUre perform:mce of certain reclamation urrler surface coal 

Mining ard Feclamation Permit No. --------

WHrnEAS, urrler 30 CFR 800.21(a) (3) the penuittee is required to 

post an acceptable new =rt.ificate or provide an executed assi.grment 

of the existin] certificate made payable to the :regulatmy 

authority. 

NCM THERE!!URE, to satisfy the requirements of 30 CFR 

800.2l(a) (3), the urdersigned, ----;;;:::;:-:o<c;;;;;o;;;;;-::.>;;e:o>+.;;:;-- (Name of Cooipany - Permittee) 

as Cbligor, hereby assigns its interest in the oertificate(s) of 

deposit as described above, made payable to "the United States, 

Office of Surface Mining Reclamation an:i Entmcemeut." 

'IHE mNDITIOO OF 'IHE ABJVE ASSIGNMENl' is sud! that the 

certificate shall: 

(a) J::e assigned to the United states, Office of Surface Mining 

Reclamation an:i Enfcrroetuent ooth in writing an:i upon the 

books of the institution issuing such certificates; 

(b) in:tiv:idually not excee:i $100,000, or the :rrwdJmJrn insurable 

arrount as determined by F.D.I.C. ard F.S.L.I.C; 
Permit No. Illustration 14 

(Page 2 of 3) 

Sole Proprietorship 

{c) 00 corditioned upon the Issuirg Institution waivi.IB all 

rights of set-off or liens '<lhidl it has or may have 

against those certificates; 

(d) 00 deposited in sufficient aJToOI.Ults, so that liquidation of 

those certificates prior to maturity would provide the 

required b:ni amoorrt. 

(e) that the assignn:ent shall rexrain in fUll force arrl effect 

until released in writin] by the Offioe of surtaae Mining 

Reclamation and EnforcelUellt. 

"!his assignment shall be valid throughcut any maturity rederrption pericd as designated by the Issuing Institution, and 

shall also autcmatically renew itself whoo the certificate(s) of 

deposit is renewed. 

rn Wl'INESS WHERIDF, the ct>ligor has hereunto set its signature arrl seal this day of 19 __ 

(Ccltpmy- Pennittee) 

ey,_~~~~~~~-­ (Itxlividual - Sole Proprietor) 

IN Wl'INESS WHEREX:lF, the Issui.IB Institution has hereunto set 

its signature arrl seal this day of 19 __ 

(Issuing Institution) 

Title: ---------------
~tNo. ·--

<» this __ day of 

Illustration 14 

(Page 3 of 3) 

Sole Proprigtop;hip 

, 19_ , 1:efore me, a Notary 

Public in and for the cnmty of , in the state of 

personally -===,.,cc~=~=' krla.m to 100 ""'"""" to be the perscn 1olhose naJre is suJ:a::ribed to 

the foregoin:J :instrurnerrt: and tmo, l::le1nJ by me duly sworn, did say 

that he/she executed the same for the IJ.UlXlElOO therein a:mtaina:l. 

IN WI'mESS WHEREOF, I have heramto set my harD and official 

seal on the day, =th, and year aforesaid. 

My Crnoni.<;sion Expires: 

Notary Rlblic in and for said 

County and state 

On this __ day of , 19 , before ne, a Notary 

P.Jblic in and for the County of , in the State 

of , appeared to 

me personally knc:Mn who, bein:J by me duly sworn, did say that he/she 

is of-~~~=~~=~~-- the Issuing Institution named in and ...trich exea.rta::l the within 

instrumerrt, and that the seal aff:ixe::i to said instrument is the 

mrp:n:ation seal of said Issuing Institution, and that said 

instrumerrt was signed, sealed and delivered in behalf of said 

=rporation by authority of its Board of Directors, and he/she, as 

such officer, ac!tr=i"led3"ed said instrument to be the free act and 

deed of said coq::oration for the uses and IJ.UlXlElOO of said 

instrument as therein set forth. 

IN WI'mESS WHEREOF, I have hera.mto set my harxi and official 

seal on the day, =nth, and year aforesaid. 

My Cclmnission ExpirEs: 

Notary PUblic in and for said 

County and State 
Self-Band No. --- Illustration 15 

(~e 1 of 4) 

KrlcM all ll'ell by tha3e presents, that the un:Jersigned, 

(State nane am form of b.Jsiness organization of the Permit 

AW1ication) du1y aut.horiZ€<1 to do b.Jsiness in the state of 

,.ocnuN;;;;"'cr"PAL;;;:;c,--,io•-;hel:::;od-f<inol<:· ::;-y brund unto the united states, Office of 

SUrface Minin} ReclaiMtion am Enforcement, in the stnn of 

($ ) , lawfUl money of the United States of 

America, to be p:~.id to the United states - Office of SUrface Mini.n;J 

Reclamation aOO EnforcemeJtt upon order of forfeiture by an 

authorize:l representative of the Office of SUrface Minin;r 

ReclaiMtion ani Enforcement, p.rrsuant. to 30 CFR 800.50. For the 

payment of said mnn, well ani truly to be made, we hereby jointly 

aOO severally bind ourselves, our heirs, executors, administra:tors, 

successors, ani assigns. 

Whereas, the Office of SUrface Mini.n;J Reclamation ani Enforcement 

issued Permit to Mine Number(s) am dated 

;~;::;;;~=.;;;;;;~·;""~;revisions(s) "" n.mi:ete:l 

datsd~----- pursuant to the awlication of the Prin:lipal. 

Whereas, (check one of the foll~): 

(a) === 'lllis is an =igi.nal agre:eueJ:tt. (b) 'Ibis is an agreement in additicm to 

pre<Jious bord agreement(s) f= the above 

referenced permit(s) to mine ani ~id!. 

agrearent(s) rerrain(s) in full foroo am 

effect 

(c) 'Ihls is a replaoement. agreement for: 

1. Bond Ntmt>erc_ _______ Principal, ____ _ 

&rrety ________ """"L_ ___ _ 

2. Bond Ntmberc_ _______ Principal, ____ _ 

&rrety---------""""'-----

3. Bond Numberc_ _______ Principal, ____ _ 

,_y ________ """"''-----
Self-Bord No. IllustratiCI'I 15 

(~ 2 of 4) 

Whereas, the Principal has o::rrpleted an initial application for a 

self-bon:li.n:J and Irrle:rrnity AgreEinent lohich are incorporated herein 

and made a part of this Self-Bord 11gl:eement:, 

'i'bereas, said l:loJ'D.irg agreernent.(s) shall CCNer any and all land 

affected or to be affected by the 111inin;J cperatiCI'I un::Jer the above 

nmt.ioned permit, revision(s) and :reJJEMa.l(s) since the date of 

issuance of the permit, upon the follQJ:irg described land, as given 

within said permit and revision(s), and :renewals: 

Now, therefore, the COOOitiCI'IS of the obligation are such that this 

agreement shall renain in full f~ and effect. until either 

releasa:l., or the sum specifie:i above forfeited p.rrsuarrt to the 

provision(s) of the Surface Mining control and Reclamation Act and 

the rules and :regulatiCI'IS adcpted ~ to that Act, or p.u=t 

to applicable federal laws and J:EqUJ.ations. 

said principal herein agrees that its obligatiaJ shall be 

mn-cancellable and that the liability hereurrler is for the duration 

of the above specified surface coal mining and :reclarration 

q:erations and continues thereafter for a period coincident with the 

principal's responsibility for the establistment of revegetation on 

the affected areas pursuant to the :requil:euert:s of the SUrface 

Mining Control and Reclamation Act (~), EXCEPr 'IllAT the 

obligation herein may be reduced befornhan::l \\hen such reduction is 

awroved by an authorized representative of the Secretacy of the 

Interior (hereinafter referred to as Secretacy) for d1.an:]es in the 

permittee's :method of operation or other ciJ:a..Jmstances l<lhich :reduce 

the estimated cost of reclamation in a=dance with the SUrface 

Minin;r Control and Reclamation Act (SH::FA) OR where l:loJ'D. acceptable 
Self-Bond No. Illustration 15 

{Page 3 of 4) 

to the Office of SUrface Minirq Reclamation and Enforc.eu::ut has been 

sul::mitted to replace this OOligati.m. 

'!he principal herein further urderstan'ls and agrees that the 

proc:.edu=s for the adjustment of the aDDlrlt wDer this borxi are 

specifie:i in 30 em 800,15; that proc:.edu=s gcvernirg the release of 

all or part of this borrl are spedfied in 30 CFR 800.40; and that 

the procedures for the forfeiture of this borxi are specified in 30 

CFR 800.50. 

J:Uol', lliEREFORE, the =rrlitions of this OOligation are sud!. that if 

the said principal herein shall o:rrply with the terns and <Xnlitions 

of said permit, revisions, and renewals thereto, the provisions of 

and obligations iJrposed by the SUrface Miniig Control and 

Reclamation Act and any a:rren:Iments thereto, then the release of this 

obligation shall pro::eed as specifie:i in 30 CFR 800.40. 

'!he principal herein further agrees that this bond is poste:i to 

insure the permittee's performance upon all acres specifie:i in the 

above permit. Upon borrl forfeiture p.JrSUant to 30 CFR 800.50, all 

bond or bon:'ls which =ntinue to be held by the Office of SUrface 

Miniig Reclanation and Enforcemerrt for all bc:in:lln1 within the above 

permit m:~y be forfeite:i ani the forfeited bon:1 or borrl incr:ertents 

may be use:I by the Office of SUrface Minirg Recl.am3.tion and 

Enforcement to ccrrplete the reclamation plan or a !OCrlifiE!d plan for 

any or all acres in the al::ove permit and to COFer associated 

administrative expenses. 

The principal herein further agrees and urderstan'ls that this 

self-borxi may =ntinue to remain in fUll force and effect as long as 

all information required by 30 em 800.23{f) is sumri.tted within 

ninety (90) days after the close of each fiscal year followin:J the 

issuan::e of the self-b:md to the Office of SUrface Minirq 

Reclamation ani Enforcement, and deiuonstrates the principal andjor 

guarantor remains qualifie:i. 'Ihe failure by the principal to file 

this information in a tim;ly manner shall in no manner inpin:Je upon 

or prejudice the rights held by the Unite:i states urrler this 

Agreement. Further, this agreement remains in fUll force and effect 

until released or substituted in acco:cdance with the requiremerrt:s of 

the SUrface Mining Control and Reclamation Act. 

'Ihe principal herein further agrees and urrlerst:ards that the 

authori<:e:i representative of the Secretary may require a 

sul::stitution of this self-borrl by a gocd, =zpxate surety licensed 

to do b.Jsiness in the State of , or other form of 

bon::I all<Me:i by 30 ern 800.12 (a), (b), or {d). 
' 

5elf-Bon::l No, ___ _ Illustration 15 

(Page 4 of 4) 

In witness ~<.~hereof, we, the said parties, have set cur han:l. arx:l 

""""'· 

SignOO aoo executed this ___ d<f of ___ _ 19_ 

BY, ___________ BY, _____ _ 

=·'-----------=''-----

state of ____________ ) 

, .... eo.mty of ____________ ) 

ALL APPLICABLE o.:JRRlRATE ~ AilE ATl.'AaiED HERElO AS 

PARI' OF 'nUS AGREEMENT. 

'Ihis fore:JOing instrument was aclmowledqed cy me ------- this day of , 19 __ 

Witness my han:l. an:l official seal.-;;;;;;;:;;;c;;o;;-,;;-;:;-::;;:;:;""';;;;""= (Notary Public or other authorized 

officer) 

My camd.ssion Expires: ___ _ 

------· 

Resident Agent: __________ _ Date: ___ _ 

"""'""'-'-_-_:-__ 

JIW=ed as to form an:l exea.1tion: 

'" Date: ____ _ 

APPIPVED: ll!te: -----
Permit No. ·c;:-====== Self-Bcni No. 

Illustration 16 

{Page 1 of 8) 

'!HIS 1IGREEMENl' OF nmEMNI'l'Y, by and between the United States, 

Office of SUrface Minin;J Reclamaticn and Enforcanent, 

(hereinafter referred to as CGMRE), as inle!mitee, and 

duly authorized to do l:usiness in the State of 

as indemnitor, (hereinafter referred to as the "~tor''); 

WHE:RFAS, ~tor has filed with CSMRE an awlication to 

self-b:>nd in carpliance with 30 usc 1259 et. seq., and the 

rules and regulations prarW.gated thereurxler, in =nnection 

with Cperator's Miniiq Permit No. -------------

WHEREAS, Operator has satisfia:l the self-bonlin:} requiLe.me11ls 

and =iteria set by OSMRE; 

' 

WHERFIIS, Operator desires to imemnify CGMRE from all loss arrl 

costs assooiate::l. with its self-bon1 No. ; 

WHERFAS, Operator has the full authority un:ler the laws of the 

State of , un:ier which it is 

incorpxated, its articles of ina:>qloration and bylaws to enter 

into this Indemnity Agreement; 

WHEREAS, eperator has full awroval tran its Board of Directors 

to enter into this Indemnity Agtee:meut; 

WHEREAS, it is in the best interests of cperator, in the 

legitimate furtherance of it p.n:p:JSeS and business, to enter 

into this Indemnity Agree'roent; 

WHEREAS, OSMRE, has the legal authority to administer the 

bon:llng reqt.Iirarents for cx:ral mine q;:erati.oos in the state of 

---' 

NCW 'IHEREFORE, effective upon the execution of this agreement 

by both parties, for value :reooived, and in CCilSideration of 

the awroval arrl exeart:ion of self-bord, n.nrt>er , 

it is agreed by and ootween the cperation and CJSMRE as follt:MS: 

I. Operator, their successors and assigns, jointly and 

severally do hereby =venant and agree to :irxiemni.fy 

OSMRE fTc:m and against any and all de!twDs, 

liabilities, charges, costs, and expenses of lllhatsoever 

kirrl or nature, which CSMRE may sustain or in::ur in 
Self-Bond No. __ _ Illustration 16 

(Page 2 of 8) 

conooquence of the failure by the ~tor to 

faithfully perfonn all the requiiements of the SUrface 

Miniiq Control ani ReClamation Act (SM:FA) ani any 

amerdments thereto, OOMRE regulations an aJll!!l'dmerrt: 

thereto, an:i awlicable fEderal laws ani regulations as 

they awly to min:in;J cperations urrler the aforesaid 

mining pennit No. ani the minin:;r ani 

reclamaticn plans ~ 'tllE!re.l'ith. With the 

~ion of litigaticn costs as referen::OO. in 

paragraii't VI, Ope:tator's liability hereurrler shall not 

excee:1. the principal aJOOUnt set forth in Operator's 

self-bard No. 

II. Upon this agreement becoming effective, OSMRE shall 

deliver ani execute, as necessary, to the cperator, any 

am au documents ani forms needed to allow the 

Operator to release any existing bonds, letters of 

credit, =tifka.tes of deposit, cash or governmE.'!I1t 

securities that are ~ replaoad by this self-lxln::l 

and self-bordirq Wemnity agreement. 

III. 'Ihis indemnity agreement is <Xl11tinurus ani is to be in 

full force and effect until all of the terms of the 

cperator's self-bond have been satisfactorily performed 

or otherwise discharged to the satisfaction of OOMRE. 

IV. Ope:tator hereby fully CCJn9el'lts and agrees that any of 

the foll<:Ming shall not affect nor d'lan:Je or discharge 

the obligations of this indemnity agreenart:: 

1. Any renewals, revisions, mxUfications or riders to 

the t.e.nns of the self-ixlnd, rrumber.~~~=-­

inc:luding i.nc:reases or decreases in the dollar 

amount of the bond, or the larrls to which it 

applies, in ao::on:lance with the requirements of the 

SUrface Mining Control and Reclamation Act and the 

rules and regulaticns prr:tllllgated thereJnder. 

2. Any extension of time for performance of the lltlole 

or any part of the conditions of the self-bond, 

----
Self-Bord No. Illustraticn 16 

(Page 3 of 8) 

3. Any changes, revisions, nn::lificaticns = renewals to 

the terms of the permit, rwmber ;H;;;;c.,~;co~ inclu:Iirg the lllini.rg and recJ.anation plans D:Xlt.aine:i 

tl>e<ein. 

v. If in the OSMRE's q~inion the cpll'ator has refused= is 

unable to =n:1uct reclazrati.cl'l of an W'labated violation, = 

if the terms of permit No. , are not met, or 

if the cpe.rator defaults on the ccnlitions UOOer which 

this OOrd. is acx::epted, CISMRE rray institute bond forfeiture 

prooeedings against the Operator in accordance with the 

forfeiture prooeedirqs set forth in 30 CFR aoo.so. 

In the event an order of forfeiture is entered 'r:!j an 

authorized representative of CISMRE against cperator 

requirirq the forfeiture of all = any part of the 

self-bon::l, OSMRE will mail to cperator written dernan:l f= 

payuent of the anount of the self-bon::l Mlich was so 

ordered forfeited and Operator shall pay sud!. anount in 

full to the indemnitee maki.n;J the dernan:l in :ill!rnediately 

available federal furrls, within ten (10) b.lsiness days 

after receipt of such dernan:l. Payment shall be made to 

such bank aD:Xll.lTlt as OSMRE shall specify in the deman:i 

notice to Operator. If such order is vacated, reversed, 

or othetwise made unenf=ceable 'r:!j co.rrt or 

administrative i'M:jfmcy of <Xt1pet.ent jurisdiction, any 

anount previously paid to OSMRE 'r:!j Operator hereunder 

shall be ref\m::lerl to q:>erator in full within thirty (30) 

business days after receipt of a certified copy of the 

rulirg, order = other acticn by such co.rrt or 

administrative agency. Any refund to Operator by OSMRE 

shall be in ilmlediately available federal furrls and shall 

be made to such bank account as Operator rray specify in 

writirq to the Oepartrnent. 

VI. In the event OSMRE initiates, pursues or is brot.¥Jht into 

litigation, as a result of atterrpts to enforce bonding 

requirements un::ler this i.ndertt1icy agreement, the cperator 

agrees to pay all litigation coots incurred by OSMRE in 

any Sl 'OO'?ssful effort to enforce this agreement against 

the Operator with respect to the operations or activit¥ 

for which this agreement is made. 'Ihis agnene11t pertains 

to all costs reasonably connected to the operation or 

activity for Which this agreement is rrade. nris agreenEI'lt 

pertains to all costs reasonably connected to the 

litigation costs and all administrative costs reasonably 

incurred in the course of enfo=irq = in preparation to 

enforce the rules and regulations for self-bondirq against 

the Operator with respect to the cpll'aticn or activity for 
Self-Bon:i No. __ _ Illustration 16 

(Page 4 of 8) 

..tlich this agrOOllEllt is 1'!'11lde. Liabilicy for payment of 

litigation costs shall nat be limited cy the priooipal 

am::o.mt of the Operator's self-bon1. ~tor agrees that 

vouchel.'s or other proper evidence shc:Mirg payment shall be 

conclusive evidence. of the fact ani aJOOUnt of liability of 

-=· 

VII. This agreenent shall be d ue:i tenninat:al in \blle or in 

part; (a) When ani as OOMRE certifies in 111ritirq to the 

cperator that Operator has sncorestully carpleted as 

required cy the SUrface Mini.rg o:mtrol ani Reclamation Act 

ani any anaxlments thereto, ani awlicable federal laws 

arxi regulations, the minl.nj arxi reclamation activities 

pursuant to Minl.nj Permit No. , for which this 

agreement is posted; or (b) When ani as OOMRE certifies in 

111ritirq to the operator that the operator has provided an 

acceptable =rporate surety bon1, letter of credit or 

other securicy carplying with 30 CFR SOO.U in 

substitution for this agLE:euant; or (c) 1llhen OOHRE 

otherwise authorizes release of this agreanent in whole or 

in part to the Operator p.lrSUarJl. to the SUrface Mining 

Control ani Reclamation Act ani the rules ani regulations 

pranulgated t.hereuOOer. 

c:perator shall have the right at any tima to post a arrporate 

surety borxl, letter of credit or other securities CCUJllying 

with 30 CFR 800.12 in sul:stitutioo for ani re1ease of all or 

part of this agreement. Cperator shall notify OOMRE in 111ritirq 

of any such substitution, and. OSHRE shall notify the Operator 

in writing of the acoeptabilicy of any sudl. Sllbstitution. Said 

substitution shall not be valid ani effective until OOMRE 

certifies such in writinJ. 

VIII.lhere are no conditions or limitations to this i.Irlemnity 

agreement except th:lse =rrtained herein at the date 

hereof, an;i thereafter no alteration, change or 

m:dification hereof shall be bilrling or 

effective unless executed in 111riting, signed by 

the cperator, ani ar:proved cy OSMRE. 

IX. Operator agrees to pay all costs and. expenses incurre::l cy 

0SMRE Which are experrled in any S"CC ful action 

_,_ institute:I to enfon:e the terms of this Wemnity 

X. 'Ihis indemnity agreement shall be gocrl ani effective 

notwith.st.aJ"ding any charge or chan:jes in the business tli'IIr<l 
of the cperator. 
Self-Borx:l No. __ _ Illustration 16 

(Page 5 of 8) 

XI. No chan:jes, rev:unons, modifications = renewals to the 

self-bond of the cperator or the terms of pemit rnmtler 

-;;;,;;;;;= shall act as a release of the cperat= fran this 

in:'Jemnity agreenent. 

XII. All notices required to, = which rrey be given shall be 

effective when received by the addressees at the addresses 

specified below. 

l. For the Operat=: 

2. For OSMRE: 

u.s. Deparbnent of the Interior 

Office of SUrface Mining ~tion an:l Enfo:rcemerrt: 

~1 delivery shall have the same effect as notice 

given 'r1j m:~.il. Notices given by mail shall be sent 

certified. 

XIII. In case of the insolvency, bankruptcy =dissolution of 

the Operator, all fun:js represented 'r1j the self-bard 

shall brrroodiately become due am payable. 

XIV. 'Ihe failure of any person = persons to sign this 

i.rx:lemnity agreement shall not release = affect the 

liability of the cperat=. 

lW, lhis irdemnity agreement is a birx:lin;; contract an:l shall 

be construed urrler an:l sUbject to the la\o/S of the United 

states of America. 

XVI. 'Ihis agrearent, tcqether with the awlication f= 

self-b:m::ling awlicable to Mining Pennit No. , 

contain the entire agreement of the parties hereto with 

respect to i.n:ienmification. 

XVII. If pennitte:I under the la\o/S of the State \o4lel:e 

Operator's :mine operation is located, this in:lemnity 

agreement when under f=feiture shall q:>erate as a 

judgement against those parties liable under this 

i.n:iernnity agieemeut. 
Self-Br.ln:l No. Illustration 16 

(Page 6 of 8) 

XVIII. It at any ti.Joo durim the pericd the self-b:ni number 

o===c. is p:sted, the financial conditions of 

Operator or CoLp:aate Guarantor dlarqe so that the 

financial =iteria at 30 em 800.23 are not satisfied, 

Operator shall notify C5MRE :iJnnediately and shall 

within ninety (90) days post an alternate, all<:Mable 

form of bond in the salTe annmt as the self-b:nl. 

XIX. EXEan"ION BY 'lliE OPERA'IOO: 

0~~: -------------------

BY••---------='------

'"---------=·------

ATI'EST: 

'lliE SI'ATE OF: 

a::tlN"IY OF: 

) 

)SS. 

) 

'Ihe foregoim instrurrent was aclo"a,fledged, subscribed ani sworn 

to before me this day of ---------------- 19 __ _ 

NOl'ARY RJI!LIC 

My Corrmission Expires: 

XX. OJRFORATE ~: 

Attaclled and incorporated herein as El!hibit A. 

-· ------- ------ --
Self-Bond No. __ _ 

XXI. EXEOJTION BY GOARliNIURS: 

Illustrat.ial 16 

(Page 7 of 8) 

BY, ________ =•-------

BY'--------=•-------

'!HE: STATE OF: ________ ) 

) "'. o:xJNlY OF: ________ ) 

~ canrnission Expires: 

XX. OORftlRATE ~: 

AttadlEd. and i.ncorp:>rated herein as Exhibit B. 

----------
Self-Bon:i No. Illustration 16 

(Page 8 of 8) 

XXIII. EXECUI'ITN BY OOMRE 

In witness ~<.~hereof, this Agreement is dated. and effective as of 

--------· "--· 

U.S. OFFICE OF SURF7ICE MININ; RElCIAMM"IOO' AND mFClRCEMENl' 

""""----------

'Ihe foregoing instrument was ac:knartledqa::l, subscribed and swom 

to before me this day of ------• "-

Witness my han::l and official seal. 

My camnission Expires: 
Illustration 17 

(Page 1 of 6) 

OFFICE OF SURFACE mNlNG RECU\MATIOO AND ENFORCEMENl' 

Pennit No. 

Self-Boro Noio..-========= ~-----~~~~~~~~~~----- {hereinafter referred to as Guarantor), 

WHEREAS Guararrtor satisfies the finardal ~ am =iteria 

set by the Office of Surface Minin;J Reclanation am Enforcement 

(OOMRE) rules am regulations; 

WHE:REI\S Cperator has nquested and desires to place with C6MRE its 

self-bond to secure reclamation obligations; 

WHEltF.AS Guararrt:or desires to guarantee the f'Unls pledged W1der 

self-bond of , the cperator; 

WHERFAS GLJarantor has the full authority un1er the laws of the Sbte 

of , un1er l'llhich it is irrlorp:uatw, its articles 

of incorporation and bylaws to enter into this guarantee; 

WHERFAS Guarantor has full approval fran its Board of Directors to 

enter into this guarantee; 

WHERFAS it is in the best i.nterest:s of Guarantor, in the leqitilte.te 

furtherance of its p..up:>ses an:i J:usiness, to enter into this 

~' 

WHEREAS OSMRE, p..u:suarrt to the 5urface Min:ln;j' Control and 

Reclamation Act, has the legal authority to administer the barding requi.re'rromts for mine opetations in the state of ______ _ 

I. NOO, for value received, am in consideration of the approva1 

and execution of self-bond l'll1l1i:ler , Guarantor, a 

corporation created and existing un1er the laws of the State of 

;;;;;;;;o;;;-;:;--oc-' its rn•cressors arx:1 assigns, jointly am 

severally, do hereby covenant, guarantee, premise ard agree to 

rrake prunpt payment Upon deman:l. of the full amount, or portions 

thereof as requested by OSHRE, of the self-borrl of Ope=tor, 

self-bond no. , on the tenJs ani ccn::litions described 

herein, said payment of monies to be used for the reclamation of 

all lands affected un1er permit in aocordance with the 

provisions and requiremerrt:s of 30 CfR 800.23, arrl the Surface 

Mining Control and Reclamation Act arrl acy amentnents hereto, 

with awlicable Federal laws and regulations, ani the terms and 

corxlitions of 
Self-Bord No. __ _ Illustration 17 

(Page 2 of 6) 

the permit. 'lhis guarantee covers ;my an:i all <iemanjs, 

liabilities, charges, ani expenses of 1\hat.soever Jd.ni of nab.lre, 

mich OOMRE may at any tilne sustain or :incur by reason of or in 

consequence of having acoepted the self-bon1 of ~tor, 

including all litigation costs ani all adJnini£rtmtive costs 

reasonably in:mrred by OOMRE in any effort to enforce 

®ligations an:i requiremerrt:s of the ~tor with respect to the 

cperation or activity that is borrled. 

II. 'Ihis guarantee is a =rrtinuing guarantee an:i is to be in full 

force an:i effect until all of the terns of ~tor's self-bond 

have been satisfactorily pertonnoo or otherwise discharged to 

the satisfaction of OOMRE. 

m. Guarantor hereby fully consents to the following, any of which 

shall not affect nor dlarge or disdla!:ge the OO!igations of 

this guarantee: 

1. Any :renewals, revisions, modifications to the tenns of the 

self-bond, nurrt:er , inclt.:ding increases or 

decreases in the dollar am:o.mt of the bcnl, or the lan::!s to 

whid'l it ar.:plies, in a=rdance with the recpirernents of 

the Surface Mining Corrtml am Recl.am3.tion Act an:i the 

rules ani regulations prarulgat.ed tlleraln:ier. 

2. Any extension of tilne for perfonrance of the whole or any 

part of the =nditions of the self-bond, l11n'l'tler ___ _ 

3. Any chan:]es, revisions, modifications or renewals to the 

terns of the permit, number , including the 

mining an:i :reclamation plans ccotained therein. 

IV. Guarantor expressly waives the follcwing: 

1. Notice of the acceptanoo of this guarantee by CSMRE. 

2. Notice of renewals, revisions, IOCidifications to the 

self-b:md lllnli:>er ----

3. Notice of changes, revisions, modifications or renewals to 

the terns of the permit of the ~tor, pennit number 

• 

4. Notice of any extensions of tilne for perfonnan::e of the 

whole or any part of the con:iition of the self-bond, nurrt:er 

5. Notice of bond forfeib.lre proceedings, notice of any derrarrl 

for payment of self-b:md; or, any dishonor t:l'lereof. 
Self-BOrd No. __ _ Illustrat.i.on 17 

(Page 3 of 6) 

6. All other notices to lo'hich GUarantor might otherwise be 

entitled in =nnecticn with this guarantee or the 

obligation hereby guaranteed. 

7. '!he institution of any civil acticns or the exhaustion of 

legal :ranedies against the cperator as a oordition to 

enforoe:meut of this guarantee. 

8. It is 1..lOOerstocd that any notioe provided by the united 

states of 1o!rerica to the G.larantor shall not constitute a 

release or mc:dificaticn of the above waivers. 

V. lhis guarantee is subject to the follCMir.q oon:lltions, to wit: 

1. Any demarxl for funds shall be a=rpanied by a signed 

statement that the Office of SUrface Mining" Reclamation arrl 

EnfOrCelrent has forfeited, in whole or in part, the 

self-bond, number >;;;c---• an::i one copy of the order of 

forfeiture is attacha::l. 

2. This guarantee shall be limited in annmt as follows: 

a. Reclamation costs: the 1rrlebtedness reflected by the 

approved self-bon::l existir.q at the time of bond 

forfeiture by OSMRE. 

b. Litigation and administrative costs: the actual 

annmt of such oosts reascnably ina.lrred in any 

sucoossful effort to enforce requirsnents an::i 

cbligations of the cperator arxljor the c:bligations of 

the Guarantor I.U'Xier this agreE'f~El'It. Litigaticn an::i 

administrative costs shall not be limited by the 

indebtedness reflected by the awt'Cm!d self-oon:t. 

3. If the Operator fails to ccuplete the reclamation as 

required by the SUrface Minin:J Control arrl Reclamation Act 

an::i any amendments thereto, an::i the terms and oorditions of 

the pennit, the G.larantor shall be reg.ri.nrl to ccuplete the 

approved reclamaticn plan for the lands in default or to 

pay to OOMRE the amount in full :necessacy to corrplete the 

approved reclamation plan, not to exceed the bond amount, 

within ten {10) business days after receipt of OOMRE's 

demarxl for payment. GllaJ:antor hereby agrees that darands 

for payment may be based an:l are payable on projections of 

costs or their actual a=ual and that liability for 

payment shall not be corrtingent on the costs havirq been 

presently sustainEd. 
Self-Bond No •. __ _ illustration 17 

{Page 4 of 6) 

4. 'ItJis guarantee may be cancelled a'lly upon notice of said 

cancellation being SEtlt to the cperator and OSMRE at least 

ninety {90) days in advanoe of the proposed cancellation 

date and t:l'lEln a'lly upon acoeptanoe of the cancellation by 

OSMRE. '!he cancellation shall be aooepted by OSMRE if the 

Operator cbtains a suitable rep1acemerrt bon:l. before the 

prqxlS€d cancellation date and then only if the l.an1s for 

which the sel:f-bon:l., or portion thereof, was aooepted haVe 

not and will not be disturbed llll1er the terns of the 

penult, or the self-bond has been released in accordance 

with the provisions of the SUrface Ml.nin; control and 

Faclamation Act and the nll.es and regulations prorrulgated 

VI. 'ItJis -· 

guarantee shall be and continue effective notwithstanding 

any present or future legal disability of the Operator. 

VII. 'lhere are no conditions or limitations to this guarantee except 

those contained herein at the date hereof, and thereafter no 

alteration, dlange or ttOOificaticn hereof shall be bincti.n3" or 

effective unless executed in writing, signed by the guarantor, 

and awrove::I by OSMRE. 

VIII. Guarantor agrees to pay all CXJSts and expenses incurred by 

OOMRE which are expe.OOed in any successful acticn insti'blted 

to enforce the tenns of this guarantee. 

IX. 'ItJis guarantee shall be good and effective notwit:hst.an:llrq any 

charge or changes in the b.Jsiness name of the Operator. 

x. No changes, revisions, ttOOifications or renewals to the 

self-bon::l. of the cperator or the terms of permit runber.o::cc--

shall act as a release of the Guarantor fran this guarantee. 

xr. All notices rEqUired to, or which nay be given shall be 

effective 1\tlen received by the addressees at the addresses 

specified below: 

1. For the Guarantor: 

2. For OSMRE: 

u.s. Depart:ment of the Interior 

Office of SUrface Minin; Reclamaticn and Enfotcena Ll 

Personal delivery shall have the same effect as notice given by 

mail. Notices given by nail shall be sent certified. 
" 

Self-Borrl No. __ IllustratiOCI 17 

(Page 5 of 6) 

XII. In case of the insolvency, bankruptcy or dissolution of the 

(perator 1 all :t\lnis represented by the self-bond shaJ.l 

immediately becane due ani payable an:i this guarantee may 

thereupon be enfort:ed. 

XIII. '!his guarantee is one of payment an:i not of collection. 

XIV. 'Ihe failure of any person or persoos to sign this guarantee 

shall not release or affect. the liability of Guarantor. 

XV. '!his guarantee is b:irrlirq contract an:i shall be =nstrued 

urder arrl subject. to the laws of the Unite::i States of llme!:'ica. 

XVI. SIGNA'IURES OF GUARANIUR: 

BY' ------------='"" 

STATE OF--------! 

)SS. a:<JNIT OF• _______ ) 

'!he fora;JOin:J instrument was ackl'lowledge:i, subscribed ani swom to 

before me this day of , 19 __ . 

Witness 11tf hand and official seal. 

"""""' RJBLIC 

My o:ttrnissicn Expires: ----

XVH. 

Attach and incorporate herein as Exhibit A. 

-------
3elf-Borxi No. __ _ Illustratioo. 17 

(Page 6 of 6) 

XVIII. OSMRE-MJIHlRIZED :REffiESENrATIV SIGIMURE: 

m''-------------------- 0:\te:, ____ __ 

OOMRE-Authorized Rl:pL sentative arrl. Title 

"!he fora:JOin:J instrurnerrt: was aola'K:IWled;Jed arrl. sul::ecril:::Ed to before 

me this day of 19 

Witness Irrj hand arrl. official seal. 

My camd.ssi.ocl Expires: ------
Permit No. __ _ Illustration 18 

(Page l. of 3) 

United states Depart::merrt of the Interior 

Office of SUrface M:inin;J Reclamation and Enforo€!l'ell't 

'lb be attache::l. to and fonn a part of SUrety ~ Eorrl No. 

___ written by---------------~ 

AS SUREIY, on behalf of -------------------

AS PRINCIPAL, in the stnn of -----------------

OOllA><S ($, _____ ) , in favor of the united states, Office of 

SUrface Minl.ni Reclamation and Enfot'CElliE!llt (OSMRE) and executed on 

Whereas, the OSMRE iss"e:l. pemit to Mine number ___ _ 

dated = _____ , arrl renewals arrl :revisions mLbete:l. and dated 

p.tn;uant to the awlicatioo of the Principal, 

Whereas, said i:Jon:j arrl rider shall =er any and all land 

affected or to be affected by the lllinirg operation urrler the above 

mentioned pennit and revisions and renewals sin::e the date of the 

issuance of the pennit, 

Now, therefore, the amount of the bon::l is increased,/decreased 

by _____ _ Dollars ($ ) , to a total sum 

of------------ Dollars ($ ) , 

to cmrer the addi tionaljrectn,...,;) oost of :rec1airning all affected 

larDs. It is fUrther urderstood and agreed that all other terms and 

corditions of this bon:l. shall ratain l.lndJan:;a:l.. 
lllustraticn 18 

(Page 2 of 3) 

Signed an:i execut.OO. this __ day of ------' >0 

"" 

~'-----------

state of _________ ) 

O>mty "' -------' '"· 

(Corporate 

'""'' 

thi> _____ day of ------' >0_. 

Witness my harrl an:i official seal, ---c;;;;;;;;;;;-o;"',;;-;;o-;;;,;;;;-- (Notary rublic or other 

authorized offioer) 

"¥ camdssion Expires: __ _ 

------

signed an:i executed this __ day of ------ "-- ~'------------

~'-------------

state of ________ ,) 

County of--------'"· 
Pennit No. -- Illustration 18 

(~3of3) 

'!he foregol..n; instrument was ackrDw'ledged before me by __ _ 

-------~• this __ dayof ___ , "-· 

Witness lTI'{ hard an:i official seal. 

(Notary Public = ather 

authorized officer) 

My Ccumission Expires: _____ _ 

-----·~-----

RESIDENT AGEm' FOR SERVICE 

Resident Agent: ---""==;;;---- oru .. ____ _ (Signature) 

--===;---~' (Printed Name) ---
Pennit No. ____ _ Illustration 19 

(Page 1 of 3) 

united states Ceparboont of the Irrl:erior 

Office of SUrface Minirg J!Ecli'UIII!tion and Enforoemerrt: 

'Ib be attached to and form a part of SUrety Q::a;>any Bond No. 

___ written cy --------------

ll5 SURETY, on behalf of-----------------

ll5 HUNCIPAL, in the sum of -----------------

DOLUU<S ($; _____ ), in favor of the United states, Office of 

SUrface Mining Reclamation and Enforc:ement (OSMRE) and eXECUted on 

Whereas, the OSMRE issued Pennit to Mine number _____ """ 

da'"' oo _____ , and rel"'EMals and revisions Illll'!1bere:;l and dated 

pursuant to the ~ication of the Principal, 

Whereas, said l:xxrl and rider shall oover any and all land 

affected or to be affected cy the mining cper:ation urrler the ab:rve 

nentioned pannit and revisions and renewals since the date of the 

issuance of the pennit, 

Now, therefore, the purpose of this rider is: 

It is further agreed that all other tetms and o:niitions of 

this l:xxrl shall remain unchange:i. 
Pennit No. Illustration 19 

(Page 2 of 3) 

Signed arrl executed this ~-- day of ------' 10 __ 

N'---------------

~'--------------~ 

state of _________ ) 

"""""' of --------------' '"· 

(Cb!:p:rrate 

'""' 

'Ihe fongoin;J instrument was acknowledged before me by ____ _ 

tlrls _____ day of ---------• "--· 

Witness my hand arrl official seal. -~-,;;c;;;;-;;;;;ocr;:-;;;-;;e;;;o~~ (Notary Public = ather 

auth=ize::l officer) 

My camrlssion Expires:'~--

------------~--------------

""""' 

Signed arrl executed this ___ day of ~-------• "--

N'--------------~ 

~'-------------

state of ____________ ) 

""""'Y of -----------~' '"· 
Permit No. ___ _ Illustratial 19 

(Page 3 of' 3) 

Ule foregoirq instrumerrt: was acknow'ledged before me by ____ _ 

_______ , tl>U. __ day of _____ , 10_. 

Witness m; han:l and official seal. 

(Notary Rlblic or other 

authori:~~ed officer) 

My Ccmnissioo Expires: _____ _ 

RESIDENT AGENT FUR SERVICE 

--===--- (Signature) "'"" ----

--===.---- (Printed Name) """"""' 
Illustration 20 

(Page 1 of 3) 

UNITED STATES llEPARIMENI' OF INTERIOR - OFFICE OF SlJlU>ACE: MINING 

RECU!MATIOO liND ENfORCl!lolmr 

Beneficiary: 

Unitoo States 

Office of SUrface Minin:; 

Reclamation & Enforcarent 

""""""' ,, ___ _ IIC number: ___ _ 

Issuin:J Bank: ---~=c--~ ,_, 

(hld<ess) 

(City) (state) (Zip) 

(Teleti'xme) 

(rate of Issue) 

(rate of Elq:liry) 

(Permit No.) 

Ladies/Gentlemen: 

~~fm_,-=~~==~c=~~==~c=~=cc=co~c==­ (Name of pennitt.eejbusiness directing bank to issue 

Letter of credit) 

(Street Miress) (City) (State) (Zip) 

we hereby establish our I=evocahl.a Letter of Cl'Edit in your favor, 

arrl agree to pay to the United states, Office of SUrface Mining 

Reclamation an:l Enfor<::e!tent, available by your draft(s) in an 

am:unt not to exceed ($ ) ' 

upon receipt of a written demand by the Office of SUrface Minirq 

Reclamation an:l Enforcement (CGMRE) p.u:suarrt to 30 C.F.R. 800.50. 

ntis Letter of CrEdit is effective , 19 __ , 

an:l will expire at the close of blsiness en , 19 __ ' 

hcMever, this credit will autcmatically be exteroed for periods of 

=-===~oc= from any scheduled expiration date (as originally scheduled or autanatically exterrled) unless ninety (90) days prior 

to such date we notify ya.t in writing by certified IJBil, retl.lrn 

receipt requested, that we elect not to renew this Letter of CrEdit 

for such additional perio:i. 
~C~: -------------

Illustration 20 

(Page 2 of 3) 

Permit No.: 

upon receipt l:1j you of such notice, you may draw on us at sight for 

the am:urrt of this Letter of Credit baginnirg 30 days or less prior 

to the then awlicable expiration date, ~ l:1j a statement 

signed l:1j OOM!lE's Bond AW=in;J Officer certifying" that the aJOOUnt 

of the drawing represents fuOOs due the united states of Merica 

because the peonittee has failed to nplace this Iet:t:er of Credit 

with other suitable bond p.u:suant to 30 C.F.R. 800.21(b) (2) an:i 30 

C.F.R. 800.30. 

We certify that the ano.mt of the =edit herein established will not 

be re<b1C'Rd for any reason during" the period of this instrument 

without the written =nserrt: of OOMRE. 

We will give p:taupl notim to the permittee arrl to OOMRE's Bond 

AWJ:oving" Officer of any notiae received or action filed allegirg 

the insolvency or bankruptcy of the Bank, or alleging" any violations 

of regulatoty requirements ~id:l cco.lld resu1 t in suspension or 

revocation of the Bank's charter or license to do business. 

In the event the Bank OOcones unable to fulfill cur obligations 

urder this Letter of Credit for any reason, notiae shall be given 

immediately to the permittee an:i to CSMRE's Bond Approving" Officer. 

IN WirnESS WHEREOF, the Bank has hereunto set its signature ard seal 

this day of 19 __ 

(Issuing" Bank) 

(Aut:horize:;I Offi.ulr) 

en this day of , 19 , before me, a 

Notary Public in arrl for the Camty of , in 

the state of , appearEd to 

re personally ~who, being" l:1j me duly sworn, did say that he/she 

the w hank rwned in an:i ~idJ. executed- cl the ~~""~~'""~~""--' within instrument, an:i 

that the seal affixed to said instrument is the seal of said Bank, 

ard that said instruroont was signed, sealed and c1elivered in behalf 

of said Bank l:1j authority of its Board of Direct:ors, an:i hejshe, as 

such offer, aclmc:Mledged. said inst:runEnt to be the free act an:i deed 

of said Bank for the uses an:i p.lrp:lSeS of said instrument as therein 

set forth. 
Illustration 20 

(Page 3 of 3) 

m WI'lNESS WHEREDF, I have hereunto set my han:l. an;i official seal on 

the day, rocmth an;i year aforesaid. 

M:f Co!!mission Expires: ---,;;;>;"'o;;;;-,-;;--,;;-;;;;;--,;;;-;;;;<;;--- Notary Public in an;i for said 

county an;i state 
Illustration 21 

Page 1 of 3 

united states Offioe of SUrface M:inirq 

Reclamation and Ehforoement 

'IHIS INOENIURE, rrade and entered on this , 

_, between herein referred to as the 

Grantor, the Offioe of SUrface Minin:] Reclamation and Enforcement 

(CSolRE), United States Oepartmerrt of the Interior, herein referred 

to as the Trustee, and the united states of America, herein rete=ed 

to as the Beneficiary. 

WI'INESSEIH: A first rwrtgage deed of trust grarrt.i.rg the OSMRE a 

security interest in the Real Pl:q:e:rty described belCM, with a right 

to sell or othel:wise dispose of the ptuperty in the event of a 

forfeiture urrler 30 CFR 800.50, is hereby given to OOMRE as 

=llatera1 by the Grantor. 'Ihe OOMRE security interest in the 

ptoparty shall be in the aJooUnt of $ and shall be for the 

purpose of securin:] the cost of the Grantor's reclamation 

obligations under Pennit No. ___ _ 

(Description of Real Pl:oparty =vered by deed of trust.) 

'Ihe above described real propercy, consisting of ~§~O:<a~cr'_"&",_m~ the aggregate, more or less, was CQ'llleyed to the ~ranter, 

, by warranty d§ fran as evidenced by beirg recorded 

in Book , Page of , in the records 

of eoonty Clerk's Offioe. 

To have ani to hold said real estate to the Trustee in trust for the 

purposes hereinafter set forth. 

1he Grantor <XJC.tenants with the Trustee that it is lawfully seize::l. in 

fee sillple of the real estate above ocnveye::l., has full power, right 

and authority to =rrvey sane, that said :t'eal. estate is free fran all 

ena.llli=mces, ani that it will forever warrant ani defend it arrl the 

legal title thereto against the lawful clallns of all petsaiS 

~-

'Ihe Grantor shall not sell or eilClDlber any porti= or interest of 

the real estate =vered by the deed of trust. 
Illustratioo 21 

Page 2 o:f 3 

lhe Grantor agrees to pay all taxes assessed on the real estate as 

t.my become due an:l. OW"irq arrl to aMp> proof of the payment of same 

by prov:iding Trustee with a a:py of the paid :receipt with thirty 

(30) days o:f payirq of sane. 

The Grantor agrees not to <Xmnit waste o:f any sort. 

In the event the Grantor :fails to ccmply with any o:f the :fcregcirq 

con:titicns, then the Trustee shall be entitled to :f=eclcse upc:n the 

real estate. 

'!his cxmveyance is !!ade in trust to the trustee f= the follOW"in;l' 

uses an:l. pn.pcaes an:l. llOJle other. 

As a OOrd to secure :reclamatioo Ul"):jer the laws an:l. Regulations of 

the United States Department of the Interi=, Office of SUrface 

Mining R£clamation arrl ~ un:ier AWl.icatioo No , Permit No. , in the am:mrt of $ '----

In the eo.rent the l::on:l secured hereby is forfeited, = in the event 

any of the cmrenants, I.IIldertakin;! = prua.ise ccn:litiOJlS, set out 

herein be breadl.ed or not performed, then the Trustee shall, after 

giving notice of the time arrl place of sale by certifiei nail to 

Grantor, or by weekly p.lblicatioo in sare ~ p.lblished in_ 

C:::GC=c- County, , at least twenty (20) days previous to said sale, an:l. on the day an:l. at the time arrl plaoo designated in 

the notioo, sell the prq::erty aboVe caweyed at p.lblic auction to 

the highest bidder for cash in moo in bar of the right arrl equity 

of raderrpt.ion, \Yhidl. is hereby waived an:l. surren:Jered, an:l. all other 

rights \Yhid:l Grantor might have in said p:cq:>erty. 'Ihe Trustee shall 

awl y the prcceeds frcm the sale as fellows: 

1. to the payment of all costs ard expenses of the sale, includirq a 

tee of 10 percent to the trustee, llhidl fee shall becorne absolutely 

due an:l. payable whenever foreclosure is CQ't'D11E!I"'C; 

2. to the reclamation of Permit No. 

any taxes unpaid or that are a lien on 

the sale; an:l. 

3. the surplus, if any, to the Grantor. 

,;;;:ey 

-

at """""' the date 

-

of 

'Ihe Grantor fUrther agrees that in case of sale of the aboVe 

described property that it will at once becorne arx:l be a tenant at 

will of the purchaser, and will surrerder the possession thereof on 

demand. If such possessions be not given, then Grantor tray be 

re=ved by a forcible arrl unlawful detainer action arrl the Grantor 

agrees to pay the purchaser the reasonable rental value 
Illustration 21 

Page 3 of 3 

of the prcperty from the date of sale fer as lon;J as they shall be 

in pc:ss ion thereof. 

Arry of the parties hereto may bid an1 beo:lne the p.rrdlaser at any 

sale hereun::ler. 

'lhe failure of the Trustee to have this deed of trust 

t'OZ'Ii!Closed ilrmediately upon any default provided herein shall net 

be CCl1Stl:'l.lEd so as to preclude foreclosure as a later date fer such 

default if sama still exists at the tiJne an1 shall net be construed 

so as to prevent foreclosure fer similar subsequent 

default. 

m WI'lNESS WHrniDF, the Grant= has hereurrt:c set its hand at the 

place an1 en the date first above written. 

"""" of------

Ccmlty of ____ _ 

en this __ day of __ , A.D. 19 _. before me personally 

ar:peared , to me kn;:,m to be the r president, 

vice president, secretary, treasurer, er ather authorized office or 

agent, as the case may be] of the COLp::u:ation that exeo.tt.ed the 

within an1 foregoing instrumerrt:, an::l acknowledged the said 

instrument to be the free an:i voluntary act an:i deed of said 

corp:>ration, for the uses an:i ?JrPCSeS therein mentiClT!Erl, an:i on 

oath state:i that he was authorized to exea.Ite said ilm.runent an:i 

that the seal affixed is the COLp::u:ate seal of said ccrpxation. 

m WI'INESS IYHEREDF, I have hereunto set my hand an:i affixed my 

official seal the day an:i year first above written: 

Notary Public in an:i 

fer the state 

residing at ___ _ 
Illustration 22 

(Page 1 of 11) 

United states Office of SUrface Minin;J 

Reclamation an1 Enfutu:uent 

'IHIS AGREEMENI' made ard entel:ed. into this ____ day of 

_____ , 19_, by ard between the United states, Office of 

SUrface Minirq Reclamation ard Enfarcarent, ( herein called 

"OSMRE:") ' the -------------------------

a National Banki.n;J Association (herein called "Bank"), and 

----------------' (herein called 

"Cperator") ; 

Wl'INESSEI'H: 

WHERFAS, cperator has heretofore filed with OSMRE a-------

issued by in ca~pliaooe with 

the provisions of the SUrface Minin:J Cl:l1trol an::l. Reclamation Act of 

1977 (SM:RA) , arrl the rules an1 ra;ulations adopted p.trSUant to that 

Act, in =nnection with Operator's Minirq Pennit No. ---' 

WHERE'.i\S, prrsuant to provisions of 30 CFR 800.21(d), Operator 

desires to dep:lsit into escrow cash havirq a value of $~----" 

Cash aeaning lawfUl currency of the United states of Amarica, an::l 

WHEREAS, Operator desires to en;age Bank as a dep"'Gi tory an::l escrcM 

agent for the p.u:p:>Se of taking custoo.y of sud! cash; 
Illustration 22 

(Page 2 of ll} 

NOO, 'IHEREEORE, in <XlflSideratinn of the nutual covenants o::ntained 

herein and the mutual benefits derived hereun:ler, it is agreed by 

and between the parties as follCAo~S: 

1. Upon execution of this agreement by the parties, (\::erator 

shall deposit with the Bank, ~~~~~~~~~~~~~~­

havirq a face value of$~~~~~~~~~-· U};>oo the Bank's 

receipt of custcdy of such Cash frmt the 0petator, it shall canfi:nn 

such receipt in writing to OOMI<E. 

2. SUch Cash shall be held by the Bank for the ~ of 

assurirq to OSMRE that the ~tor shall faithfUlly perform all 

the reclamation requirerent.s specifie:i in the ~ and 

:rnclarnatinn plan or plans ar:prrNed un1er Minirg Pennit No. 

3. 'Ihe parties hereto reccqnize that OSMRE will perirrlirally 

review- the Operator's minim" r:peration and mey fran ti.roo to ti.roo 

require increases in the reel amation J:x:n:l. mmt.. 'lhe parties 

specifically agree that ~tor nay frau. ti.roo to tim::!, as ~red 

by OSMRE, :Lncrease the mmt. of Cash or l:x:n:l. to caJforrn with the 

requilenrents of OOMRE without the execution by all parties of a 

further agreement to reflect increases in OOrrl 
Illusb:ation 22 

(Page 3 of 11) 

am:urrt:. cperator may, ~ receipt of prq:er notice ftan OSMRE, 

increase the am:urrt: of escrowEd cash to catform with OSMRE 

requi.n!ments IJIXl!l written notice to C9!RE and Bank; all additicoal 

cash so escrCMed and any increase in bcxx:l. anomts shall be subject 

to all terms, oon::litions and previsions of this :F.scr<:M Agreement. 

4. The Bank shall receive all interest or irxxrne on such cash and 

shall ~ such interest or incane as and when received to Operator, 

in care of or as otherwise directed by ~ in writin;r. 'Ihe 

Bank shall not invest any portion of the :funds in its possession or 

=nt=l. 

5, Upon receipt by OSMRE of Bank's written oonfirrrBtion that 

said cash has been deposited by Cperator, the OSMRE shall exea.tt.e 

and deliver to cperator, if desi.re:l, any and all necessary 

doo.lments and fonns to allOW" Cperator in its sole discretion to 

cancel or termi.nate any bcxx:l. bein;r replaced by this :F.scr<:M 

Agreement, pursuant to 30 CFR 800.30. 

6. In the event cperator violates the SMCRA, or any rules and 

regulations prrll'IU].gated there.mier, as the same applies to the 

reclamation requiremerrt:s of Permit No. ------- and fails 

to xemedy or correct such violations, C9!RE shall institute 

fOrfeiture 
Illustration 22 

(Page 4 of 11) 

~ against ~tor in a=rdance with 30 Cl'R 800.50, an:1. 

any illplernerrtin;J prooodures. 

Written notice of the forlei'b.n:e Pl' o:;eedjngs shall be fUrnished 

to the Bank by OSMRE. 

Upon receipt of certifie:i an:1. authenticated notice :frc:m OSMRE 

~, 1) the amount of bon:i declared forfeited; 2) that all legal 

or administrative remedies available to eperator have been waived or 

E!Jdla.usted arrl no action, proc:eed.iJ'q or ar:peal is penlirg thereon; 

an:1. 3) that a final order of forfeiture has been entered, the Bank 

shall surren:ier to OSMRE the requested porticn of the cash in its 

p::ssessicn. 

In the event the Bank shall for any reason fail, refuse or 

neglect to surren:ier the requested amount of the cash to OSMRE 

within ten (10) calenlar days after receipt of notice of forfeiture 

and deman::l for payment as hereinabove provided, the cperator agrees 

in such an event or events to, 1) hold OSMRE free, hannless and 

in::lannified of an:1. :frc:m any cost, expense or loss, actually 

incurre::l by reason of such refusal, in:::lu:ling b.lt not limited to 

court costs arrl attmney•s fees, and 2) to pay unto OSMRE interest 

on the amoont of the Cash reg.Jired to be surrendered at the highest 

legal rate authorized by United states law o::up.n:eci fran the date on 

lllhidl said Cash was required to be SI.U"rel"dere to an:1. inclu:ling the 

date on whidl such Cash deposits are actually received by OSMRE. 
Illustration 22 

{Page 4 of 11.) 

pz•o:cedings against (llerat= in a=dan:::e with 30 CFR 800.50, an:i 

any iltplementllq proc:edures. 

Written notice of the forfeiture pzo:• ee1ings shall be furnished 

to the Bank by c:aiRE. 

Upcn receipt of certified an:i authenticatoo notice from OSMRE 

shewing, 1) the amount of OOn:\ declared forfeitoo; 2) that all legal 

or adlninistrative remedies available to ~tor have been waived or 

exhausted an:i no action, pn>OOedllq or arpoal is perx:lirq thereon; 

an:i 3) that a final order of forfeiture has been entered, the Bank 

shall surrerder to CSMRE the requested portion of the cash in its 

p session. 

In the event the Bank shall for any reason fail, refuse or 

neglect to surrender the requested anomt of the cash to OSMRE 

within ten (10) calenlar days after receipt of notice of forfeiture 

arx:l. demaOO for payment as hereinaOOve prot~i.dEd, the ~tor agrees 

in such an event or events to, 1) hold CSMRE frEe, harmless and 

indemnified of ard from any cost, ~ or loss, actually 

incurra:l ey reason of such :refUsal, includin] rut not limited to 

court costs ard attomey's fees, an:i 2} to pay unto OSMRE interest 

on the anomt of the cash required to be surrerdered at the highest 

legal rate authorized by united states law o:ttp.Ited fran the date oo 

l.hich said cash was required to be surrerrlered to an:i includllq the 

date on which such cash deposits are acb.lally received cy OSMRE. 
Illustration 22 

(Page 5 of 11) 

7. 'Ihls agreEttent shall be d ,l!!d terminated in whole or in 

part: 1) 'Nhen arx:l. as C6MRE certifies in writirg to the Bank that 

the Operator has successfUlly carpleted of the requiremerrt:s of the 

surface minin;r arrl reolalre.ti.ocl activities recpired \JI'rler Pennit 

No. --------, for \Ohlch the cash was posted; 2) when arx:l. 

as OOMRE certifies in writirg to the Bank that the Operator has 

provided a corporate surety borxl, collatera.l. or self-bani, in 

substitution for arrl release of the cash; or 3) otlen CISMRE otherwise 

authorizes release of the cash in Whole or part to the Operator. 

Until this ag~:eemeut is tenninated in whole or part, the Bank 

shall not release, assign, transfer or deliver any of the Cash to 

Operator; or to any other party, mov:IrED, HCMEVER, Operator shall 

have the right at any time to post a corporate surety bon:i, 

collateral b:md or, if qualified, a self-bani in substitution for 

arx:l. release of all or part of said Cash. 

D.lrirg each morrt:h of €Nerf calen:lar year this agreE'tl'le!'lt is in 

force arrl effect, the Bank shall report to OSMRE an:l Operator in 

writirg the am::o.mt. arrl value of the cash then on deposit. 

Up::m the carplete tenninati.ocl of this agreeueut, the Bank shall 

deliver all said Cash deposited hereurDer to Operator or its 

TIClt\inee. Upon the partial tennination of this ~. the Bank 

shall deliver to the Operator or its naninee the Cash held hereurrler 

in the arrount certified in writin;r to the Bank by OOMRE as bein;r the 
Illustration 22 

(Page 6 of 11) 

ait'IOUrit of reclamation work \Ohid:! has been sncoessf'Ully o::~tpleted, 

other bend substituted, or the ait'IOUrit certified by CS!RE. 

8. All notice required to be given by the Bank shall be 

effective ~ received by the respective parties at their 

addresses specified bel<:M, namely: 

Office of SUrface Mining Reclamation and Enforcement 

------

or ather address as such party may have furnished the Bank and to 

the other party in writing. Aey notice to the Bank shall be 
Illustration 22 

(Page 7 of l.l) 

effective ..men received by the Bank atXIressed as follows: 

nw ________________ __ 

Trust~t 

Attn: EScr>:M Division 

EScr>:M No. --------------

Personal delivery shall have the same effect as notice given by 

nail. 

9. cperatar ~ to pay the Bank its fees for its services, 

inc:luii.n:J, but not limited to, the actual cost of legal services 

should the Bank deem it necessary to retain mmseJ. with ~ to 

any matters pertainirg to this instrurrent. 'Ihe fees as escrcM agent 

shall be determined in accordance with, an:i shall be payable as 

specified in the Schedule of Fees for E'scri:M services dated 

--------------, a receipt of lohl.ch. is Mreby acknoWled;red by 

10. 'Ihis agreement mrrtains the entb:e agreeuent of the parties 

hereto with respect to said Cash, an:i the Bank agr rs to hold an:i 

dispose of said Cash delivered to it by the Operator in accordance 

with the "tenrs an:i =nditions hereof. Hao~ever, the Bank is not a 
Illustration 22 

(Page s of 11} 

party to, nor b::urrl cy, any instnunent or ~ ather than this 

agLE!Eill21JL, and the Bank, as oustcdian of the cash deposited within 

hereurrler shall not be required to take notice of any default or any 

other matter, nor be bourxl lYf or required to give any notice or 

demani, nor be required to take any action whatsoever, except as 

hereinbefore provided. 

11. '!he parties have satisfied themselves as to the authority of 

any persons signin} this agreement in a L¥ ntative capacity. 

Should it be necessary for the Bank to accept or aot upon any 

instructions, directions, documents or 1nstrurrients signed or issued 

cy or on behalf of any =rporation, partnership, governmental 

entity, trade-name, fiduciary or :in1ividual, it shall not be 

necessary for the Bank to inquire into the authority of the 

signer(s) unless and to the exterrL expressl.y provided in this 

agreement. 

12. 'Ibis agreement may be altered or amen:led cnly with the 

cc:nsent of the parties and with the =nsent. of the Bank. Shculd 

the parties attenpt to change this agreement in a manner which, in 

the Bank's sole diBcretioo., is deemecl urDesirable, the Bank may 

resign as €!SCLlM agent lYf notifYing the parties in writing; 

otherwise, the Bank may resign as ~ agent at any ti1're upon 

thirty (30) days prior notice to OSMRE. In the case the Bank 

resignation, the only duty of the Bank, until a snccessor escrow 
Illustration 22 

(Page 9 of 11) 

agent shall have been awointed and shall have aocept:ed such 

aitX>intltent, shall be to hold and dispose of the cash in 

aa::ordance with the original provisions contained in this agreement 

(but without regard to any notices, request, instructions or demands 

received by the Bank fran either or both of the parties after the 

notice of resignation shall have been given, W1less the same shall 

be a direction by both parties that the errtire t'Urds be paid or 

delivered out of escrow). 

13. Operator warrants to and agrees with the l3ank and OOMilE 

that, W1less other wise expressly set forth in this agr:eme:trt, there 

is no security interest in the cash fUnd or any part thereof; no 

financing sb.tte!tent un:l.er the lJniform camnercial Cb::ie is on file in 

any jurisdiction claiming a security interest in or describing 

(whet:her specifically or generally) the cash turd or any part 

thereof; and the Bank and OSMRE shall have = responsibility at any 

t1lne to ascertain Whether or nat any security interest exists in the 

cash fUnd or any part thereof or to file any financing statement 

llllder the Uniform Conouetcial o:de with respect to the cash fUnd or 

any part thereof. 

14. Bank warrants to and agrees with the cperator and CISMRE 

that the cash fUnd is fOOe.rally insured and made payable upon demarrl 

to OOMilE in acoordanoe with section 6 of this ag:ree'!lelrt. 
Illustration 22 

(Page 10 of 11) 

rn WI'INESS WHEIU'DF; the parties have hereunto set their hanis a00 

seals this ____ day of------- "'-· 

~·-----------------

~·-----------------

""--------------

OPERAlUR: 

~. -------------------- President 
(Page 11 of 11) 

'"""" 

~'------------------

Title 

'Ihe foregoizB instrurrent was ackncwledged, subscribed and S~oUrD. to 

l:efore !IE this day or , 19_, by _____ _ 

-----------------

Wl'mESS my han::l and official seal. 

"""""' rusuc 

~ ocmnission Expires: 

'!HE STATE OF ----

"""l' OF