HomeMy WebLinkAbout20090686.tiffNADOA MODEL FORM DIVISION ORDER(Adopted 9/95)
To: Noble Energy Inc.
1625 Broadway, Suite 2200
Denver, CO 80202
Property Name:
Operator:
County and State:
Property Description:
DIVISION ORDER
Date:
Effective Date:
Property Number:
See Attached Exhibit "A"
Noble Energy, Inc.
Weld County, Colorado
See Attached Exhibit "A"
Production: Gas Oil All X Other
L/If �
February 17, 2009
Date of Last Distribution
See Attached Exhibit "A"
Owner Number:
Type of Interest:
Decimal Interest:
18032 Owner Name: WELD CO CLERK TO THE BOARD AT WELD
RI
See Attached
Exhibit "A"
COUNTY GOVERNMENT
Owner Address: P 0 BOX 758
GREELEY, CO 80632
The undersigned certifies that ownership of their decimal interest in production or proceeds as described above payable by
Noble Energy, Inc., hereinafter referred to as "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 Payor 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 annually, 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: None
WELD COUNTY CLERK TO THE BOARD
AT WELD COUNTY RNMENT
•
Owner(s) Signature(s):
Owner(s) SS or Tax I.D. #
BY: William F. Garcia, Chair
MAR 2 3 ?DU9
84-6000-813
Owner Daytime Telephone No.: 970-356-4000 X4200
WITNESS(S)
BY
D•puty Clerk o the Board
Fax No: 970-352-0242
Address: 915 10th Street, P.O. Box 758, Greeley, Colorado 80632
Federal Law requires you to furnish your Social Security or Taxpayer Identification Number.
Failure to comply will result in 28% withholding and will not be refundable by Noble. 2009-0686
OBLE-C1 d ��
LEO/3 /
EXHIBIT "A"
Attached to and made a part of that certain
Oil and Gas Division Order dated February 17, 2009
Weld County Clerk to the Board at Weld County Government
Property
Number
100104002
118310086
Property Name &
Description
LEHFELDT C 27-25 (CN)
T4N-R64W-Sec. 27: SW4 (NWSW)
Weld County, Colorado Lro V 1
LESSER J 21-7X (CN)
T5N-R66W-Sec. 21: W2NE4 (NWNE)
Weld County, Colorado
End of Exhibit "A"
Decimal
Interest/Type
0.06906250 RI
0.00025000 RI
Page 1 of 1
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. >y/''/liAar
" Courp{y Attorney
T
DATE .5 c(
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