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FOUNDATION ENERGY
C/O PETROLEUM FINANCIAL, INC.
309 W. 7TH STREET, SUITE 200
FORT WORTH TEXAS 76102
NADOA ModeTForm Divi lion O
DIVISION ORDER
Property Number: 2022
Property Name: BARNEY 7
Operator: FOUNDATION ENERGY
County and State: WELD CTY, COLORADO
Production:
Date: December 3, 2008
dapted 9/ 5
Li Li
Effective Date: First Settlement
Oil X Gas X Other
Owner Name WELD COUNTY a political
And Address: subdivision of the State of Colorado
915 10`" ST., 3`" Floor
GREELEY, CO 80631
OWNER NUMBER: 3071
Type of Interest: R
Decimal Interest: 0.000593 8
The undersigned certifies the ownership of their decimal interest in production or proceeds as described above payable by Foundation
Energy (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 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 amounts equal $100.00 or until December 31" of each year, whichever occurs first, as
required by applicable state statue.
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 cdet the undersigned and Payor may have certain statutory ri:hts der the laws of
the state in which the property is located.
Owner(s) Signature (s) :
AT.TEST :
illiau( F. Garcia, Chair Cl
JAN 1 2 2009 BY `
Owner(s)Tax I. D. Number(s): 84-6000-813 Deputy Cle
Owner Daytime Telephone #: 970-356-4000 X4200
Owner FAX Telephone #: 970-352-0242
Federal Law requires you to furnish your Social Security or Taxpayer Identification Number.
Failure to comply will result in 28% withholding tax and will not be refundable by Payor.
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2009-0126
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December 3, 2008
Weld County Clerk to the Board
915 10th St, 3`d Floor
Greeley, CO 80631
Re: Division Order
Barney 7 Well
Township 6 North, Range 66 West, 6th PM
Section 23: SESW
Weld County, Colorado
Dear Owner:
FOUNDATION
Foundation Energy Management, LLC
1900 Grant Street Denver, CO 80203
Foundation Energy Management, LLC recently drilled and completed the referenced well. Our
title work indicates that you are entitled to the Royalty Interest as indicated on the enclosed
division order.
Please take a moment to read through the enclosed instruction page and division order. If
everything appears correct please return a completed original to the Ft. Worth, Texas address
listed on top of the division order form. The form marked COPY is for your records.
If you have any questions please do not hesitate to call me at (303) 861-0504 ext 202.
Sincerely,
Fou
David . is
Landman d
Enclosures
an
ent, LLC
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Tulsa Office
601 S. Boulder Ave., Suite 600
Tulsa, Oklahoma 74119
P: 918-585-1650 F: 918-585-1660
Corporate Office
14800 Landmark Blvd Suite 220
Dallas, Texas 75254
F: 072-934-8385 F: 972-934-8610
Denver Office
1900 Grant Street, Suite 1120
Denver, Cnlotado 80203
P:303-861-0504 F: 303-861-0604
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FOUNDATION
EF:L•F.G%
1900 Grant Street, Suite 1120
Denver,'Colorado 80203
Division Order Department
December 3, 2008
Barney 7 Well
Weld County, Colorado
Dear Interest Owner:
Please read the following instructions before signing the enclosed Division Orders.
These instruments should not be altered in any way unless accompanied by documentary evidence to support the
change. Do not eliminate any of the covenants and/or clauses shown thereon.
If you name and interest are correctly shown:
SIGNATURE:
Sign name as shown on instrument, and have your signature witnessed, (Two witnesses are required in Louisiana and in
Mississippi but only one elsewhere). If signing for a corporation, signature must be attested, corporate seal affixed, and title
of the signatory party shown. Any firm or partnership must have signatures of all partners.
SIGNATURE BY SECOND PARTY:
If the Division Orders are signed by any party other than the named interest owner, we must have evidence of the rights
vested in the signatory party.
SOCIAL SECURITY NUMBER OR TAX NUMBER:
Insert your number in the space provided on the Division Orders.
By Law, we are required to withhold 28% of proceeds for those payees that fail to furnish us Social Security or Taxpayer
identification Numbers, effective January I, 1984.
CURRENT MAILING ADDRESS:
Print or type the address to which checks are to be mailed.
NOTIFICATION OF ADDRESS CHANGE:
This notification in writing of any change in your mailing address must be over your own signature or that of your
appointed agent. It must include your owner number, your old address, and your new address with zip code.
SETTLEMENT FOR YOUR INTEREST:
Upon receipt of the properly executed instrument and evidence of clear title, the interest credited to you will be authorized
for payment. Checks will be mailed monthly when accruals to your interest equal $100.00 or more.
LEASE NUMBER:
This is in the upper left corner of the Division Orders and also appears on your check statements. Please use this number
when corresponding.
Please return one fully executed counterpart of the Division Orders to this office, keeping one copy for your records.
If you have any questions please call David Richardson at (303) 861-0504 ext. 202
Respectfully
FOUNDATION ENERGY MANAGEMENT, LLC
enclosures
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' TG�C
44— -.-Coun Attomey
DATE' l ®lo''
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