PURPOSE: This rule describes the records that owners and operators must maintain for their financial responsibility instruments.
Form 9-Certification of Financial Responsibility
The following text should be used to comply with the requirements of 10 CSR 26-3.107(2)(K) as follows, except that the instructions in brackets are to be replaced by the relevant information and the brackets deleted:
Certification of Financial Responsibility
[Owner or operator] hereby certifies that it is in compliance with the requirements of 10 CSR 26-3.090-10 CSR 26-3.115. The financial assurance mechanism(s) used to demonstrate financial responsibility under 10 CSR 26-3.090-10 CSR 26-3.115 is (are) as follows:
[For each mechanism, list the type of mechanism, name of issuer, mechanism number (if applicable), amount of coverage, effective period of coverage, and whether the mechanism covers "taking corrective action" and/or "compensating third parties for bodily injury and property damage caused by" either "sudden accidental releases" or "non-sudden accidental releases" or "accidental releases."]
[Signature of owner or operator]
[Name of owner or operator]
[Title]
[Date]
[Signature of witness or notary]
[Name of witness or notary]
[Date]
10 CSR 26-3.107
*Original authority: 319.114, RSMo 1989 and 319.129, RSMo 1989, amended 1991, 1996, 1998, 2001, 2008.