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noble
energy
Noble Energy Inc.
1625 Broadway, Suite 2200
Denver, CO 80202
Property Name:
Operator:
County and State:
Property Description:
Product:
Cecil K 35-30 CN
Noble Energy Inc
Weld Co., CO
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NADOA Model Form Division Order (Adopted 9/951
DIVISION ORDER
Desk Code: LJ/ale
Date: August 12, 2009
Effective Date: March 28, 2009
OWNER NAME / ADDRESS
PROPERTY #
OWNER #
INTEREST
WELD COUNTY COLORADO
C/O BOARD OF COUNTY
COMMISSIONERS WELD COUNTY
CENTENNIAL CENTER
PO BOX 758
GREELEY CO 80632
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124102-I
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The undersigned certifies that ownership of their decimal interest in production or proceeds as described above payable by Noble
Energy Inc. (Noble).
Noble 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.
Noble 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 Noble any amount attributable to
an interest to which the undersigned is not entitled.
Noble may accrue proceeds until the total amount equals $25.00, or pay proceeds with a balance of $10.00 or more annually in
September of each 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 Noble may have certain statutory rights under the
laws of the state in which the property is located.
Special Clauses:
Owner(s) Signamre(s):
OWNER(S)
WELD COiRQTY COLORADO
William F. Garcia, Chair
10/26/2009
Owner(s) Social Security or Tax I.D. Number(s): 84-6000-813
TIN(s) or SSN(s)
Owner Daytime Telephone No./Fax
970-356-4000 X4200
Address: 915 10th Street, Greeley, Colorado 80631
WITNESS(S)
ATTEST:
Federal Law requires you to famish your Social Security or Taxpayer Identification Number.
Failure to comply will result in 28% tax withholding and will not be refundable by Noble Energy, Inc
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OWNER NAME: WELD COUNTY COLORADO (124102-1)
Property Description Attachment
Property Name
Property Number(s)
Operator
County / Parish and State
DOI(s)
Property Description
: Cecil K 35-30 CN
: 435663167
: Noble Energy Inc
: Weld Co., CO
: 83213
GWI
NRI Type
.00000000 .00071016 RI
Township 4 North, Range 66 West, Section 27: SESE,Section 34: )VENE, Section 35: NWNW, Section 26: SWSW (SWSW)
Dear Interest Owner:
Please read carefully before signing the enclosed oil and gas division orders:
Your interest as shown on this instrument should not be altered in any way unless accompanied by
documentary evidence to support the change. We may reject any division orders changed without our
approval. Do not detach Exhibit "A", if applicable.
2. Furnish in writing any change of address information and include your signature. For change in ownership,
furnish copies of properly filed and recorded legal documents affecting title of interest ownership under
which payment is made. Provide a letter describing effect of change.
3. Sign your name EXACTLY AS IT APPEARS ON THE INSTRUMENT. Please have your signature
witnessed by two separate parties.
4. If signing for a corporation, signature must be attested, corporate seal affixed and title of signatory party
shown.
5. If signing for a partnership, all partners must sign, unless signed by an authorized partner and we are
furnished a certified copy of his/her authority.
6. If the instrument is signed by an agent, attorney -in -fact, guardian, estate representative, trustee or any
party other than the named interest owner, we must have evidence of the rights vested in the signatory
party.
7. If an interest is shown jointly for more than one person, each party must sign the division order in the
manner that his or her name is shown thereon. In the event one party has been designated agent for the
joint interest shown or he/she has been granted a power of attorney for the other party(ies), we must have
evidence to this effect.
8. Insert your Tax Identification Number or Social Security Number, whichever is applicable, in the space
provided. We may withhold payment until such number is received.
9. Confirm the address to which checks are to be mailed. If different, please provide the correct address.
You should notify us promptly of any changes in your mailing address.
10. The number assigned to this property can be found on page two of your division order. The number will
be used to designate this property on your revenue check. Refer to the property number when
corresponding.
1 I. Return the executed instrument without delay to the address below. KEEP ONE COPY FOR YOUR
RECORDS.
RETURN SIGNED DIVISION ORDER TO:
NOBLE ENERGY PRODUCTION, INC.
ATTENTION: MARILYN PEOPLES
1625 BROADWAY, SUITE 2000
DENVER, CO 80202
WITH QUESTIONS OR CONCERNS REGARDING
YOUR DIVISION ORDER:
PLEAS C
DIRECT:
MUNSON
CCy1Sj i if {-Ic eyrie
IcI9 (R.tCi
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.
By.
�- County Attorney
DATE. /1
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