Figure 30 TAC §37.880(b)(2)(A)
CERTIFICATION OF VALID CLAIM
The undersigned, as principals and as legal representatives of (insert owner or operator) and (insert name and address of third-party claimant), hereby certify that the claim of bodily injury (insert and/or) property damage caused by an accidental release arising from operating (insert owner's or operator's) underground storage tank should be paid in the amount of ${_____}.
(Insert signatures)
(Insert signature(s)}
(Insert owner or operator)
(Insert claimant(s))
(Insert attorney for owner or operator)
(Insert attorney(s) for claimant(s))
(Insert notary)
(Insert date)
(Insert notary)
(Insert date)
; or