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Home My WebLink About20100864.tiff DIVISION ORDER To: Noble Energy Inc. Date: April 1, 2010 1625 Broadway, Ste 2200 Effective Date: First Production Denver, CO 80202 RETAIN THIS COPY FOR Well Name: Kodak 34-22 Property Number: 12498 YOUR FILE Prospect: Jackrabbit Trail Prospect- P05103 (DO NOT DETACH EXHIBIT "A") Operator: Petro-Canada Resources (USA) Inc. County and State: Weld County, Colorado Property Description: T6N R67W, 6th P.M., Section 34: W/2NW/4 Production: Oil X Gas X Other Owner Name and Address: Owner Number: SEE ATTACHED EXHIBIT "A" SEE ATTACHED EXHIBIT"A" Type of Interest: SEE ATTACHED EXHIBIT"A" Decimal Interest: SEE ATTACHED EXHIBIT"A" The undersigned certifies the ownership of their decimal interest in production or proceeds as described on Exhibit"A" payable by Petro-Canada Resources (USA) Inc. (Payor). 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 regarding the interest in production claimed herein by the undersigned. The undersigned agrees to indemnify and hold Payor harmless from and against any and all liability, loss, costs, damage and expenses (including, but not limited to, attorneys' fees, court costs and interest at the statutory prejudgment rate on funds improperly paid to the undersigned), relating to or in any way arising from from payments made under this Division Order, including payments mistakenly made to the undersigned, or otherwise attributable to the interest in production claimed by the undersigned. In the event of any mistake in such payments made to the undersigned, the undersigned shall immediately refund such payments to Payor. Payor may accrue proceeds until the total amount equals $25.00, or pay once a year 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: None Owner(s) Signature: d — Douglas Rademacher_ chair 04/26/2010 Social Security/Tax ID Numbers) 84-6000-813 Daytime Telephone No. 970-356-4000 X4200 Witness• Clerk to the Board FAX Telephone No 970-352-0242 Witness: Deputy Clerk to the Board oVe D p/� Federal Law requires you to furnish your Social Security or Taxpayer Identification Number. L�'oa� Failure to comply will result in 31%tax withholding and will not he refundable by Payor. iWYPI-Lla 1%-& a6/C cc;Pe>lr_g) 404//o PETTRO-CANADA RESOURCES INC Attached to and made a part hereof that • Certain Division Order Effective on Date Shown Herein: Exhibit"A" Well/Unit No: 12498 Issue Date: 04/01/10 Well/Unit Name: KODAK 34-22 Effective Date: First Production County: WELD Last Change Date: 03/15/10 State: COLORADO 0/0 Master Ref: 17328 Operator: PETRO-CANADA RESOURCES (USA) I Product: ANY PRODUCT Original 0/0 Date: 04/01/10 From Well Master Tract4: 12750 Well/Unit Description: W/2NW/4 34-T6N-R67W Owner Owner Name and Address Type Decimal Pay Number Taxpayer ID Interest Interest Code 102098 WELD COUNTY BOARD OF COUNTY RI 0.00093196 M COMMISSIONERS WELD COUNTY CENTENNIAL CENTER 915 10TH ST GREELEY, COLORADO 80632 PAGE 1 DIVISION ORDER To: Noble Energy Inc. Date: April 1, 2010 1625 Broadway, Ste 2200 Effective Date: First Production Denver, CO 80202 RETAIN THIS COPY FOR Well Name: Kodak 34-23 Property Number 12499 YOUR FILE Prospect: Jackrabbit Trail Prospect- P05103 (DO NOT DETACH EXHIBIT "A") Operator: Petro-Canada Resources (USA) Inc. County and State: Weld County, Colorado Property Description: T6N R67W, 6th P.M., Section 34: W/2NW/4 Production: Oil X Gas X Other Owner Name and Address: Owner Number: SEE ATTACHED EXHIBIT"A" SEE ATTACHED EXHIBIT"A" Type of Interest: SEE ATTACHED EXHIBIT"A" Decimal Interest: SEE ATTACHED EXHIBIT "A" The undersigned certifies the ownership of their decimal interest in production or proceeds as described on Exhibit"A" payable by Petro-Canada Resources (USA) Inc. (Payor). 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 regarding the interest in production claimed herein by the undersigned. The undersigned agrees to indemnify and hold Payor harmless from and against any and all liability, loss, costs, damage and expenses (including, but not limited to, attorneys' fees, court costs and interest at the statutory prejudgment rate on funds improperly paid to the undersigned), relating to or in any way arising from from payments made under this Division Order, including payments mistakenly made to the undersigned, or otherwise attributable to the interest in production claimed by the undersigned. In the event of any mistake in such payments made to the undersigned, the undersigned shall immediately refund such payments to Payor. Payor may accrue proceeds until the total amount equals $25.00, or pay once a year 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: None Owner(s) Signature: L _zet Douglas Rademacher, Chair / /J 04/26/2010 Social Security/Tax ID Number(s) 84-6000-813 Daytime Telephone No. 970-356-4000 X4200 Witness: Clerk to the Board FAX Telephone No. 970-352-0242 Witness: Deputy Clerk to the Board 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. -• PETRO-CANADA RESOURCES INC Attached to and made a part hereof that Certain Division Order Effective on Date Shown Herein: Well/Unit No: 12499 Issue Date: 04/01/10 Well/Unit Name: KODAK 34-23 Effective Date: First Production County: WELD Last Change Date: 03/15/10 State: COLORADO D/0 Master Ref: 17329 Operator: PETRO-CANADA RESOURCES (USA) I Product: ANY PRODUCT Original D/0 Date: 04/01/10 From Well Master Tract*: 12819 Well/Unit Description: W/2NW/4 34-T6N-R67W Owner Owner Name and Address Type Decimal Pay Number Taxpayer ID Interest Interest Code 102098 WELD COUNTY BOARD OF COUNTY RI 0.00093196 M COMMISSIONERS WELD COUNTY CENTENNIAL CENTER 915 10TH ST GREELEY, COLORADO 80632 PAGE 1 INSTRUCTIONS TO INTEREST OWNERS Tins instrument should not be altered in any way unless accompanied by documentary evidence supporting the change. If name and interest are correctly shown: ?. Interest owner should sign as shown on the instrument as it reflects record title. If owner's name has changed, please alter the Division Order when executing it and attach a copy of the marriage certificate, divorce decree,change of name certificate or other supporting document. 2. All individual signatures should be witnessed by two disinterested and unrelated parties. 3. For joint interest or life estate interests, execution should include signatures of all joint owners or reinaindermen,as appropriate. 4. If signed by agent, attorney-in-fact, or any party other than the named interest owner, evidence of the rights vested in the signatory party must be furnished (if not already furnished). 5. All partners must sign for a partnership unless signature is that of an authorized partner, and a certified copy of his authority must be furnished (if not already furnished). 6. For a limited liability company or similar entity, the signature of the signing party must be duly authorized by the entity and a certified copy of his authority must be furnished(if not already furnished). 7. If the signature is that of an officer of a corporation,the signature must be attested, title of signatory party shown and corporate seal affixed. 8. Verify address to which checks are to be mailed and make corrections if necessary. (If a subsequent change of address is necessary, please notify us promptly in writing, including your Owner Number, which appears on your check). 9. Tax Identification Number or Social Security Number must be inserted in the space provided. The Internal Revenue Service requires that we withhold 28% of the proceeds payable to any owner who does not furnish such number. If qualified under Federal Regulation as TAX EXEMPT,copy of Certification of Tax Exemption should be furnished. RETURN ONE FULLY EXECUTED INSTRUMENT PROMPTLY TO THE ADDRESS BELOW. KEEP THE OTHER COPY FOR YOUR RECORDS. Noble Energy Inc. Attention: Division Order Department 1625 Broadway,Ste 2200 Denver,CO 80202 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, legal description, and percentage of royalties, if applicable. BYE JLi^4,� e4�4—e� Sz Cou Attorney DATE: 1/11—M 1-M Hello