HomeMy WebLinkAbout20132897.tiffNADOA Model Form Division Order (Adopted 9/95)
DIVISION ORDER
To: Bonanza Creek Energy, Inc.
410 17th Street, Suite 1400
Denver, CO 80202
Attn: Chelsea Brakenhoff
Property Number: CO001081
Property Name: PRONGHORN 31-34-15HZ
Operator: Bonanza Creek Energy Operating
County and State: Weld, Colorado
Property Township 5 North, Range 61 West
Description: Section 15: ALL N E N 4
Pr?! 3 Oc-123- 55)'i(,
Production: X Oil X Gas
SE4
X
Date: August 26, 2013
Effective Date: May 18, 2012
YOUR CSPY
Other: all products
Owner Name OWNER NUMBER: 1041
and Address:
WELD COUNTY BOARD OF COMMISSIONERS Type of Interest: RI
P 0 BOX 758 Decimal Interest: 0.06250000
GREELEY, CO 80632-0758
The undersigned certifies the ownership of their decimal interest in production or proceeds as described above payable by
(Payor).
(Company Name)
Payor shall be notified, in writing, of any change in ownership, decimal interest, or payment address. All such changes
shall be effective the first day of the month following receipt of such notice.
Payor is authorized to withhold payment pending resolution of a title dispute or adverse claim asserted regarding the interest in
production claimed herein by the undersigned. The undersigned agrees to indemnify and reimburse Payor any amount attributable to
an interest to which the undersigned is not entitled.
Payor may accrue proceeds until the total amount equals $100.00, or pay yearly whichever occurs first, or as required by applicable
state statute.
This Division Order does not amend any lease or operating agreement between the undersigned and the lessee or operator or any other
contracts for the purchase of oil or gas.
In addition to the terms and conditions of this Division Order, the undersigned and Payor may have certain statutory
rights under the laws of the state in which the property is located.
Special Clauses:
Owner(s) Signature(s):
(None or See Attached Exhibit)
William F. Garcia, Chair
WELD COUNTY BOARD OF COMMISSIONERS
Owner(s) Tax I.D. Number(s): 84-6000-813 Attest:
Owner Daytime Telephone
Owner FAX Telephone #:
970-336-7204 Clerk to the
970-336-7233
B
Deput
OCT 1 4 2013
Federal Law requires you to furnish your Social Security or Taxpayer Identification Number.
Failure to comply will result in 31% tax withholding and will not be refundable by Payor
CB
Retain this copy for your records
2013-2897
l,EO i11
INSTRUCTIONS TO ALL INTEREST OWNERS
Dear Interest Owner,
Bonanza Creek Energy, Inc. has enclosed a Division Order for your execution.
The attached document should not be altered in any way except to correct spelling errors, unless accompanied by
documentary evidence to support the change.
If your name and interest are correctly shown:
1. Sign your name as shown on the Division Order.
2. If your name has changed due to marriage or divorce, execute the Division Order using your present name and furnish a copy
of the marriage certificate or divorce decree.
4. If signing for a corporation, signature must be attested, corporate seal fixed and title of signatory party reflected.
5. If signed by agent, attorney -in -fact, guardian or any party other than the named interest owner, a certified copy of the power
of attorney or other evidence of such party's right to sign must be furnished.
6. Your correct mailing address should be noted in the space provided to insure prompt receipt of production proceeds.
7. The top copy or the "Original" of the Division Order should be returned to:
Bonanza Creek Energy, Inc.
410 17th Street, Suite 1400
Denver, CO 80202
Attn: Chelsea Brakenhoff
8. Should you have any further questions regarding the enclosed Division Order, please contact Chelsea Brakenhoff at (720)
225-6616.
9. Please DO NOT DETACH the exhibit from the Division Order or Transfer Order if one is included.
COUNTY ATTORNEY STAFF APPROVAL
This is to affirm the attached Division Order and authorization to receive payment for an
oil and gas well has been reviewed by the County Attorney's staff as to form and legal
description.
Well Name(s): PRONGHORN 31-34-15HZ
Assistant County Attorney
File Location(s): LE0081-5
LE0214
DATE: /62✓`.j
Tammy Waters
Subject: FW: Pronghorn 31-34-15HZ
Attachments: Weld County - Pronghorn 31-34-15HZ - Interest Calculation.PNG; Weld County - Pronghorn
31-34-15HZ - Plat.pdf
Royalty;
Weld County, Colorado
[100%x25%x 125%+ 100%x25%x 12.5%]
Tammy Waters
Deputy Clerk to the Board
1150 O Street/ P.O. Box 7581 Greeley, CO 80632
tel: (970) 336-7215 X5226
........ r.. rrw
Confidentiality Notice: This electronic transmission and any attached documents or other writings are in
and may contain information that is privileged, confidential or otherwise protected from disclosure. If yi
immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, di≤
of this communication or any attachments by anyone other than the named recipient is strictly prohibit(
From: Chelsea Brakenhoff[mailto:CBrakenhoffObonanzacrk.com]
Sent: Tuesday, September 10, 2013 2:36 PM
To: Tammy Waters
Subject: Pronghorn 31-34-15HZ
Tammy,
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Sorry for the delay in response. Attached, please find the additional information you asked for regarding the Division
Order for Pronghorn 31-34-15HZ.
L.Coa11-1 t,%00g1
There are two (2) leases tied to this well. They can be found at Rec #3096555 and #3096556.
SPUD Date: 3/29/2012 3003- (g3'i 3— ($38
Date of First Production: 5/18/2012
If you have any other questions or need additional information, please let me know.
Thanks,
Che. 4ea-' 3 rralc&nh fF
Land Assistant
Bonanza Creek Energy, Inc.
410 17th Street, Suite 1400
Denver, CO 80202
Office: (720) 225-6616
1
IMPROVEMENTS WITHIN 400 FEET OF THE WELL SITE INCLUDE: NONE
FND REBAR & 2 1/2' AC
"ODOR" LSO 13886 N89°010'04"E
a
a
500'5 400' PAO SITE!
180.30222' 259.57
•
TARGET 1
LAT.. 40.40713'
LON.=-104.19293'
460'FNL, 2150'FEL
NW 1/4
SAND ROAD
SW 1/4
FNO REBAR 6 2 1/2" AC
"ODOR" LSO 13086
5303.94'
SEC, 15
S88°37'12"W 5330,33'
r SHL PNONHORN 31-34-15HZ
LAT.= 40.40784'
LON.=-104.19291'
EL.= 4665.09'
200.5'FNL, 2150.0'FEL
POOP - 2.104
EXISTING WELL 6 TANKS
NE 1/4
CC
z
SE 1/4
Eft PRONGHORN 31-34-15H2
LAT.= 40.39508'
LON.•-104.19325'
460'FSL, 2150'FEL
1
FND REBAR 6 2 062` AC
'O
DOR' LSO ]3686
O,
I �
1 O
O
O
BASIS OF BEARINGS IS
THE NORTH LINE OF
SEC. 15, T5N, R61W OF
THE 6TH P.M. WELD
COUNTY, CO. BEARS
N89°10'04"E BETWEEN
SET MONUMENTS AS
DETERMINED BY GPS
(NAD 83)
BASIS OF ELEVATION IS
U.S.G.S. POINT CB 3 BY
DIFFERENTIAL GPS
BEARINGS AND DISTANCES
SHOWN ARE FIELD MEASURED
AND THE LOCATION DISTANCES
ARE AT RIGHT ANGLES FROM
THE NEAREST NORTH -SOUTH AND
EAST -WEST SECTION LINES OF
SAID SECTION
- - -- -_ FND REBAR & 2 1/2" AC
UEL5. LLC" LSO 37897
I HEREBY CERTIFY THAT THIS PLAT IS AN ACCURATE REPRESENTATION
OF A CORRECT SURVEY SHOWING THE LOCATION OF SAID WELLSITE:
Dan R. Griggs PLS# 38138
1000 500 0
1000
Scale 1' = 1000'
CONTRACT SURVEYORS, LTD.
COMPLETE SURVEYING AND GLOBAL POSITIONING
2133 SOUTH BELLAIRE STREET #14
DENVER COLORADO 60222
(303) 756-3695
DATE OF FIELD WORK.
31 JANUARY, 2012
DATE OF DRAWING
2 FEBRUARY, 2012
PRONGHORN 31-34-15HZ
NW 1/4, NE 1/4 SEC, 15, T5N, R61W
BONANAZA CREEK OPERATING COMPANY, LLC
CSL# 12104-03
WELD COUNTY, COLORADO
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