Document: 

Form 62-761.900(3) Part E

Other Forms Needed, Examples, and Links

Bond Specific Guidance

  • Power-of-Attorney must be kept with bond and with any rider.
  • Power-of-Attorney date must be the same date as the execution date on the bond (page 1 of the bond) or rider.
  • Embossed surety seal must be on the original Power-of-Attorney and on the last page of the bond by the Authorized Representative of Surety’s signature.
  • Name of Authorized Representative of Surety on the bond must exactly match name on Power-of-Attorney. Example: John R. James is not the same as John James.
  • The Surety must be listed on the Treasury’s Circular 570 with licensure in Florida and the Annual Aggregate must be less than or equal to the Underwriting Limit.
  • Name of Surety should be exactly as on Circular 570.

What to Do with Completed Forms

  • An owner or operator must maintain financial responsibility records (copies of the completed form parts with required supporting documentation) at the facility or at their business office.
  • If not kept at the facility, they shall be made available at the facility or another agreed upon location upon five business days notice by a department or county inspector.

Return to the Storage Tank Financial Assurance Forms (Mechanisms) webpage.

 

 

 

Form Number: 
62-761.900(3) Part E
Effective-Revision Date: 
Sunday, June 25, 2023
Last Modified: Friday, Dec 13, 2024 - 05:37pm