Oil and Gas Operatr and Electrnic Filing Administratr (EFA) Registratin and Security Agreement fr Oil and Gas Electrnic Filing Systems Oil and Gas Operatr (Primary Reprting Entity) Name f Oil and Gas Operatr: Operatr Number (OGO#): Mailing Address f Operatr: City, State, Zip Cde: Spnsring Crpratin Telephne Number: Electrnic Filing Administratr (EFA) Infrmatin fr Operatr EFA Full Name: Title: Prfessinal License Number (If applicable): Name f EFA s Cmpany/Divisin: Physical Address f EFA: City, State, Zip Cde: EFA Business Telephne Number: EFA Cellular Telephne Number: GreenPrt Username: GreenPrt Email Address: Operatr s Business website: Pending apprval by DEP, the individual identified n this frm will be allwed t administer user access and als make electrnic submissins n behalf f the listed Oil and Gas Operatr. This registratin frm applies t the fllwing DEP Oil and Gas Electrnic Filing Systems. OGRE - Oil and Gas Prductin Reprting OGRE - Oil and Gas Ntificatins OGRE - Act 9 Well Site Infrmatin OGRE - Air Quality Data Entry Oil and Gas Electrnic Permitting (Planned) Please check yur submitted frm f picture identificatin: Valid Federally Issued Driver s License Valid Military Identificatin Valid Passprt Valid State Issued Driver s License Any Valid Prfessinal License
Security Agreement fr Oil and Gas Operatr and EFA: Fr purpses f this Security Agreement, the use f the terms yu and yur includes bth the Oil and Gas Operatr and the EFA when apprpriate. Yur access t the Department f Envirnmental Prtectin s (DEP) Oil and Gas Electrnic Filing Systems is a privilege and nt a right. Access fr yur emplyees, agents r assigns t engage in electrnic reprting is at the sle discretin f DEP and may be terminated at any time and withut ntice even ver yur bjectins. Access t the DEP Oil and Gas Electrnic Filing Systems, fr purpses f this agreement alne, is limited t the time that an individual is either a) yur emplyee r b) an independent cntractr, agent r assign wrking n yur behalf pursuant t yur cntract with DEP. The EFA and Users must be required t submit data t DEP as an essential duty pursuant t their designatin under either 2(a) r 2(b) f this Security Agreement. Yu are ultimately respnsible fr the security repercussins f the Users apprved by yu, the decisins and actins f yur EFA and the use by Users f their user name and passwrd. User names and passwrd are nt t be shared with any ther individual at any time during the curse f this Security Agreement. Failure t adhere t this prvisin may result in the immediate terminatin f access as t a specific individual r t all f yur apprved Users with pssible legal actin by DEP fr any direct, indirect r cnsequential damages that the breach f security caused. In the event that yu believe the security f yur user name and/r passwrd, r any user name and/r passwrd, has been breached, yu are required t immediately self-reprt the incident t DEP at 717-705-3768. Yu will then be instructed by DEP as t any further actin required. Failure t reprt a knwn security breach may result in the immediate terminatin f access t a specific individual r t all f yur apprved Users with pssible legal actin by DEP fr any direct, indirect r cnsequential damages that the breach f security caused. Yu agree that all electrnic filings made by yu and yur Users pursuant t this designatin will be in the manner prescribed by DEP. Yu agree that the apprval f all Users will be in the manner prescribed by DEP as utlined in Attachment A f this Security Agreement which is incrprated herein by reference. DEP reserves the right, at its expense, t audit yur recrds pertaining t the evaluatin, granting and mnitring f all security credentials granted t Users 2
under this Security Agreement and yu agree t cperate with any such audit including access t all related recrds and individuals. Yu understand and agree that everything that is filed electrnically must be submitted nly by the EFA r User apprved t the assigned GreenPrt accunt. Yu, the EFA r the Users have n authrity t delegate access t any third party that results in mre than ne persn utilizing the same GreenPrt user name and passwrd. Failure t adhere t this prvisin may result in the immediate terminatin f a specific User r yur access with pssible legal actin by DEP fr any direct, indirect r cnsequential damages that this breach f security caused. Access t and use f DEP s Oil and Gas Electrnic Filing Systems will be accrding t the designated and apprved use: read nly, submit nly r edit nly. Yu agree t engage in n activities during this Security Agreement that wuld be knwingly incmpatible with the sftware, equipment, r electrnic filing system f DEP. Yu will nt knwingly permit r instruct the filing f false r errneus data r dcuments by any individual with access t the DEP Oil and Gas Electrnic Filing Systems during the term f this Security Agreement. Yu agree that all electrnic access and filings shall be in accrdance with all Federal laws and the laws f the Cmmnwealth f Pennsylvania. Yu agree t immediately prvide t DEP changes t any infrmatin requested as part f the security verificatin prcess fr yur EFA, and all f yur apprved Users, nce knwn r shuld have reasnably been knwn. Failure t d s within thirty days f receipt as t any update may result in the terminatin f yur access. Yu will submit t DEP all riginal Security Agreement and Applicatin frms that yu prcess and apprve fr access t the DEP Oil and Gas Electrnic Filiing Systems cnsistent with Attachment A f this Security Agreement. Dcumentatin as t newly apprved users is t be submitted and received by DEP by the first f every mnth. Submissin must be by first class mail as directed in Attachment A. In perfrming the services required by this Security Agreement, User is an independent Cntractr and nt an emplyee r agent f DEP r the Cmmnwealth f Pennsylvania and this Security Agreement shall be gverned by and interpreted and enfrced in accrdance with the laws f the Cmmnwealth f Pennsylvania. 3
Fr the security purpse f verifying yur EFA s identity, yu will submit with this agreement t DEP a frm f picture identificatin. T be valid, the issued identificatin cannt be expired. If fr any reasn yu terminate the access f the EFA, r any f yur apprved Users whether it be vluntarily r invluntarily, yu are t ntify DEP within 24 hurs and prvide an explanatin as t yur decisin t terminate access. Yu will submit t DEP with this fully executed Security Agreement, the credentials f yur selected EFA. Apprval f yur designated Users as utlined in Attachment A will nt cmmence until yur EFA is apprved by DEP. DEP reserves the right t request additinal infrmatin frm the Oil and Gas Operatr and/r EFA prir t apprval f access t the DEP Oil and Gas Electrnic Filing Systems. In the event that the EFA is als a User, the EFA by signing this agreement incrprates as if set frth in full, and agrees t, the additinal bligatins cited within the User Security Agreement. Yu agree that all electrnic access and filings shall be in accrdance with any applicable Federal laws and the laws f the Cmmnwealth f Pennsylvania. The Oil and Gas Operatr and EFA shall hld DEP and the Cmmnwealth harmless frm and indemnify DEP and the Cmmnwealth against any and all claims, demands and actins, including attrney s fees and csts, based upn r arising ut f any activities perfrmed by the Oil and Gas Operatr, EFA and its emplyees and agents under this Security Agreement including all apprved Users. Yu agree t immediately prvide t DEP any changes as t any infrmatin that has been requested f the EFA and/r the Oil and Gas Operatr as part f the security verificatin prcess within thirty (30) days f any change. Failure t d s may result in the immediate terminatin f yur access. I agree that the use f my GreenPrt passwrd t submit data and recrds t DEP cnstitutes an electrnic signature. I understand that an electrnic signature is taking place every time I use my passwrd t submit data and recrds t DEP. I intend t be bund by my electrnic signature. I authenticate the electrnic data and recrd and attest t the statements cntained within. I understand that my electrnic signature is fully binding and has the same legal effect as an riginal, handwritten signature under the Electrnic Transactins Act, 73 P.S. 2260.101. I understand that submitting anther individual s electrnic signature r attesting t false statements in an electrnic recrd may be subject t substantial civil and criminal penalties, including, but 4
nt limited t, 18 P.S. 4904 relating t Unswrn Falsificatin t Authrities. If I discver that infrmatin I have submitted is incrrect, I will ntify the DEP immediately. I/We understand and agreed t the terms utlined within this Security Agreement. I d hereby say, verify and attest t that the infrmatin prvided belw fr this Oil and Gas Operatr and EFA Registratin and Security Agreement as being true and accurate t the best f my knwledge, infrmatin and belief, under penalty f perjury, and subject t the penalties f 18 Pa. C.S. 4904 relating t unswrn falsificatin t authrities. On behalf f the Oil and Gas Operatr: and President r Vice President Secretary r Treasurer Date: Date: Alternatively: I d hereby say, verify and attest t that I have delegated authrity t execute dcuments n behalf f the Oil and Gas Operatr fr which I represent. Written prf f my delegatin is prvided with this Security Agreement fr yur files. I represent my delegated authrity t execute dcuments n behalf f the Oil and Gas Operatr as being true and accurate t the best f my knwledge, infrmatin and belief, under penalty f perjury, and subject t the penalties f 18 Pa. C.S. 4904 relating t unswrn falsificatin t authrities. Signature: Delegate: Date: Title: Electrnic File Administratr fr Oil and Gas Operatr: I d hereby say, verify and attest t that: I am fully aware and accept my bligatins as an EFA as utlined within this Agreement and Attachment A ; and 5
The infrmatin prvided as t my Applicatin is true and accurate t the best f my knwledge, infrmatin and belief, under penalty f perjury, and subject t the penalties f 18 Pa. C.S. 4904 relating t unswrn falsificatin t authrities. Date EFA Signature 6
Access Determinatin: Operatr: This EFA applicatin fr electrnic filing has been apprved: DEP Official Date: OR This applicatin t serve as an EFA has been disapprved fr the fllwing reasn/s: DEP Official Date: Sent t Oil and Gas Operatr/EFA: (Date) 7
Attachment A Prcessing f User Requests 1. Prir t prcessing any User requests, the EFA will be prvided instructins (OGRE GreenPrt User Administratin User s Guide) fr administering users in the DEP electrnic filing system. All EFAs must be able t navigate the system, retrieve user accunts and prvide access t the electrnic filing system f all apprved Users as t the level f use apprved. 2. The EFA will prvide the fllwing t any prspective User. a. A cpy f the User s Applicatin and Security Agreement fr Electrnic Filing (Registratin Frm). The EFA may prvide this dcument in hard r electrnic cpy fr cmpletin by the User. b. The Oil and Gas Operatr s DEP assigned OGO Number. 3. The EFA will direct a prspective User t DEP s GreenPrt web site: http://www.depgreenprt.state.pa.us, t begin the registratin prcess. The individual will be required t cmplete the fllwing steps. a. Establish a unique DEP GreenPrt accunt (Username/Passwrd) b. Enrll in the Oil and Gas electrnic filing system (accessed via DEP s GreenPrt) and submit an electrnic request t the EFA in rder t access the electrnic filing system n behalf f the Oil and Gas Operatr administered by the EFA. c. Cmplete and submit a signed cpy f the User s Registratin and Security Agreement fr Oil and Gas Electrnic Filing System (Registratin Frm) t the EFA The OGRE GreenPrt Registratin User s Guide prvides instructins fr creating a GreenPrt accunt and requesting access t the Oil and Gas electrnic filing system. 4. The EFA will direct any prspective User t cmplete all parts f the Registratin Frm, including the submissin f pht identificatin. The EFA will require that all registratin frms be submitted in hard cpy. 8
5. The EFA will evaluate all cmpleted Registratin Frms. The evaluatin prcess t cnfirm each User s identity can include, but nt be limited t, verifying the User infrmatin telephnically with the spnsring crpratin, reviewing and cnfirming User infrmatin thrugh an available crprate website, r thrugh a licensing entity. The EFA must be cnfident that the User s identity is verified as the individual represented in the Registratin Frm. 6. Once a prspective User is verified, the EFA must evaluate and apprve the level f access requested. 7. The EFA will evidence apprval f a User by signing the submitted Registratin Frm. 8. In the event that the EFA disapprves a prspective User, the EFA will indicate n the Registratin Frm the reasn fr disapprval and sign the submitted Registratin Frm. 9. A cpy f the prcessed Registratin Frm is t be returned t the prspective User either via U.S. Mail r electrnically. 10. Once apprved, the EFA will take the necessary steps t activate the accunt fr the level f apprved User access. 11. DEP will prvide t the EFA fr each User written instructins as t hw data shuld be prvided. 12. The EFA will prvide in hard cpy by the first f each calendar mnth, hard cpies f each User Registratin Frm prcessed. Registratin Frms are t be mailed t: Department f Envirnmental Prtectin, Oil and Gas Management, Divisin f Cmpliance and Data Administratin, 400 Market Street, Harrisburg, PA 17105. 13. The EFA shall maintain hard cpies f all dcumentatin generated in the apprval prcess, including but nt limited t the Registratin Frms and pht identificatin fr a perid f 5 years after cmpletin f the User s wrk. 9