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RESOLUTION
RE : APPROVE OIL AND GAS DIVISION ORDER REGARDING AMOCO PRODUCTION
COMPANY , P . O . BOX 591 , TULSA , OKLAHOMA 74102 , AND AUTHORIZATION
FOR CHAIRMAN TO SIGN SAME
WHEREAS , the Board of County Commissioners of Weld County ,
Colorado , pursuant to Colorado statute and the Weld County Home
o o Rule Charter , is vested with the authority of administering the
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▪ - affairs of Weld County , Colorado , and
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A WHEREAS , Weld County , Colorado is the holder of a certain
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0 3 lease with Amoco Production Company . Said lease covers land more z `7
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a a particularly •described as follows , to-wit : z No
o N1 Section 17 , Township 2 North , Range .6.5_ T;5_ A
OD
Nit West of the 6th P . M . , Weld County , Colorado M
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In WHEREAS , Amoco Production Company has submitted an Oil and t-m%, o
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w Gas Division Order on the subject property , and
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m z WHEREAS , the Board deems it advisable to approve said Oil P w
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N F- and Gas Division Order . o
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w NOWNo = , THEREFORE , BE IT RESOLVED by the Board of County Com- w
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m ! missioners of Weld County , Colorado , that the Oil and Gas Divi- c
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o ¢ Sion Order as submitted by Amoco Production Company be , and hereby m
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CU a is , approved . -n 0
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N It BE IT FURTHER RESOLVED by the Board that the Chairman be , o
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-- o and hereby is , authorized to sign same . - N.
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The above and foregoing Resolution was , on motion duly made 0 a
and seconded , adopted by the following vote on the 11th day of
July , A . D . , 1983 .
/ .. • P % BOARD OF COUNTY COMMISSIONERS
ATTEST : i ,„c. ' . .. M1' 'lr.
C? U ��
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Weld County Clerk and Recorder may„
and Clerk to the Bo uck Carlso , Chairman
By - EXCUSED
eputy n C erk Jo T . {�Mar/gttiin , , Pr-o--Tem
r ', �'E S TO FORM : i� IV Q,�(JSd�t-t7✓•�
sr.,. - Gene R . Brantner
tc,;i: , (..... eCs)
County Attorney Norman Carlson
Jacqueline Johnson
LHR 527 DAY FILE : July 13 , 1983
I )•- ; '10;3 J 83OO1O
_ T Amoco Production Company
•
Oil and Gas Division Order CFO/ u, ,
Page
Ob-1 4-83
Effective At 7A.M. FIRST PkUUUCI ION
Property Name S " D COUNTY UN IT
Royalty/Prod CUNOt_NSATE
Operator �L cORPURAT ION
LPN 6.3684 7---
Field rlAj IENEIERG
State CU County/Parish W Li) FLAC yQO,its1 00 0 00
US 000
Description of Property Special Notes
N/2 SEC 1 l• 12N• ft6 *
D 1 001 REC 01933487 07/14/83 08 : 45 $0,00 00 2/003
F 2 342 MARY ANN I i:::UI::RS T E:I N CLERK & RECORDER WELD CO, CO
El 1 002 REC 01933906 07/18/03 15 : 22 140.00 2/005
F . MARY ANN FEUERSTEIN CLERK & RECORDER WELD CO, CO
Business Associate
Number Name Type u cimai
Int. Interest b17000 00 5 AMOCO PRODUCTION COMPANY ( U5AI
01 .4375UUQ
705"255 00 5 WELD COUNTY COLORADO
C/OUQAWU OF COUNTY COMMISSIONERS U4 .Ub25000
7154bb 00 9 UALANCIN(I FACTOR _
04 .5000000
1.0000000
Type Interest Legend:
01 - Working Interest 02 = Overridin Royalty 03 = Production Payment 04 = Royalty Interest
B 1001 RE•:G 01933487 0;'/14/03 00 : 4t $0,00 3/003
E 2343 MARY ANN Ili_iJ I:::I STl::::I:i1 CLERK .c RECORDER WELD CO, CO
�T a
W� Oil and Gas Division Order
To: Amoco Production Company
P.O. Box 591, Tulsa, Oklahoma 74102
T
Each of the undersigned OWNERS guarantees and warrants he is the owner of the interest set out opposite his name on the reverse side r
hereof in oil and gas or the proceeds from the sale of oil and gas from the property described on the reverse side hereof, and until further ,1,^j V
written notice either from you or from us,the undersigned owner and all other parties executing this instrument hereby authorize you, your 0- N3
successors or assigns to receive and measure such sales in accordance with applicable governmental rules and regulations and to give credit
as set forth on the reverse side hereof.
3r M
The following covenants are parts of this instrument and shall be binding on the undersigned, their successors, legal representatives, and ...E
assigns:
Oil: Oil sold hereunder shall be delivered f.o.b.to the carrier designated to gather and receive such oil,and shall become your property
upon receipt thereof by the carrier designated by you or by any other purchaser to whom you may resell such oil.The term"oil"as Z c...4used in this division order shall include all marketable liquid hydrocarbons.
Should the oil produced from the herein described land be commingled with oil produced from one or more other separately owned .x
tracts of land prior to delivery to the designated carrier,the commingled oil sold hereunder shall be deemed to be the interest of the r y.,
undersigned in that portion of the total commingled oil delivered which is allocated to the herein described land on the basis of lease
meter readings or any other method generally accepted in the industry as an equitable basis for determining the quantity and quality .'J
of oil sold from each separately owned tract.Such formula shall be uniformly applied to all owners of an interest in the tracts of land ri. °..
involved.
Should the interest of the undersigned in the oil produced from the herein described land be unitized with oil produced from one or tti —,
more other tracts of land, this instrument shall thereafter be deemed to be modified to the extent necessary to conform with the Z 03
applicable unitization agreement or plan of unitization,and all revisions or amendments thereto, but otherwise to remain in force and
effect as to all other provisions. In such event,the portion of the unitized oil sold hereunder shall be the interest of the undersigned i
in that portion of the total unitized oil delivered which is allocated to the herein described land and shall be deemed for all purposes p
to have been actually produced from said land.
You agree to pay for the oil sold hereunder at the price posted b T.-
field or area on the date said oil is received by
such time as you do so, you agree to pay the price established by you for oil of the same grade and gravity in the same producing z
designated carrier. If you do not currently post such a price,then until �,.
by you.You are authorized to reduce the price by those truck, barge, rci
tankcar, or pipe line transportation charges as determined by you.
Should the oil sold hereunder be resold by you to another purchaser accepting delivery thereof at the same point at which you take I 'J
title, you agree to pay for such oil based upon the volume computation made by such purchaser and at the price received by you r•-,
for such oil, reduced by any transportation charges deducted by such purchaser.
Quality and quantity shall be determined in accordance with the conditions specified in the price posting.You tf
any oil not considered merchantable by you. may refuse to receive ri
Gas: Settlements for gas shall be based on the net proceeds realized from the sale thereof, after deducting a fair and reasonable charge l ,0
for compressing and making it merchantable and for transporting if the gas is sold off the property.Where gas is sold subject to £ 0
regulation by the Federal Power Commission or other governmental authority,the price applicable to such sale approved by order of t ,r
such authority shall be used to determine the net proceeds realized from the sale.
Settlements: Settlements shall be made monthly by check mailed to the respective parties according to the division of interest herein
specified at the latest address known by you, less any taxes required by law to be deducted and paid by you applicable to owner's C3
interest.
Evidence of Title: The oil and gas lease or leases, and any amendents, ratifications, or corrections thereof, under which said gas and/or oil O .8
is C7
is produced are hereby adopted, ratified, and confirmed as herein and heretofore amended. In the event any dispute or question \
arises concerning the title to the interest of the undersigned in said land and/or the oil or gas produced therefrom or the proceeds C UII
thereof, you will be furnished satisfactory abstracts or other evidence of title upon demand. Until such evidence of title has been
furnished and/or such dispute,defect,or question of title is corrected or removed to your satisfaction, or until indemnity satisfactory --
to you has been furnished, you are authorized to withold the proceeds of such oil or gas received and run, without interest. In the
event any action or suit is filed in any court affecting the title to the interest of the undersigned in the herein described land or the
oil or gas produced therefrom or the proceeds thereof to which the undersigned is a party,written notice of the filing of such suit or
action shall be immediately furnished you by the undersigned,stating the court in which the same is filed and the title of such suit or
action. You will not be responsible for any change of ownership in the absence of actual notice and satisfactory proof thereof.
Contingent Interests: Whether or not any contingency is expressly stated in this instrument,you are hereby relieved of any responsibility for
determining when any of the interests herein shall increase, diminish,terminate, be extinguished or revert to other parties as a result
of the completion or discharge of money or other payments from said interest, or as a result of the expiration of any time or term
limitation(either definite or indefinite), and, unless you are also the operator of the property, as a result of an increase or decrease in
production,or as a result of a change in the depth,the methods or the means of production,or as a result of a change in the allocation \
of production affecting the herein described land or any portion thereof under any agreement or by order of Governmental authority,
and until you receive notice in writing to the contrary,you are hereby authorized to continue to remit without liability pursuant to the 1
division of interest shown herein.
Warranties: Working Interest Owners and/or Operators,and each of them, by signature to this instrument, certify,guarantee for your benefit and that of any pipe line or other carrier designated to run or transport said oil or gas,that all oil or gas tende ed here-
under has been and shall be produced from or lawfully allocated to the herein described land in accordance with all applicable Federal,
state and local laws,orders, rules and regulations.
This instrument may be executed by one or more, but all covenants herein shall be binding upon any V
his heirs,devisees,successors,and assigns irrespective of whether other parties have executed this instrument. \\
same and upon 1\
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loess of Signature
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��� Na e •
Street or Box No.
Social Security for Tax ID)Number City,State,Zip
Ni
Witness of Signature Name
Street or Box No. 7
Social Security or Tax ID)Number City,State,Zip
I
Witness of Signature Name �
Street or Box No. rryye�
Social Security for Tax ID)Number City,State.Zip
Amoco Production Company •
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Oil and Gas Division Order R� 0 1 1
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0o-14—t3.1
Effective At 7 A.M. FIRST PRODUCT ION
Property Name — =LU COUNTY UNIT
Royalty/Produc NATURAL. taA LPN 6.102347---
Operator 3A1rui..rnRPURAT ION
Field WATTENtiN(i
State CU County/Parish WtL 1
.0 FLAC 000 00 0 00
10 o0ta0
Description of Property Special Notes
N/2 stC 11. 12N. Roow
El 1002 REC 01933906 07/18./83 15 ; 22 $0. 00 4/005
F 0797 MARY ANN FEUEf:S'T.. IN CLERK & REC(7FLDER WELD CO, CO
Business Associate
Type Decimal
Number Name
Int. Interest
617000 00 5 AMOCO PRODUCTION COMPANY (USA) 01 .4375000
7pb2S5 00 5 WELL. COUNTY COLORADO 04 .062000
C/u BOARD OF COUNTY COMMISSIONERS
illb4bb OU BALANCINCa FACTOR 04 .5000000
1 .0000000
Type Interest Legend
Form 899 1-77 01 = Working Interest 02 = Overriding Royalty 03 = Production Payment 04 = Royalty Interest
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AMOCO Oil and Gas Division Order
To: Amoco Production Company V 1
P.O. Box 591 , Tulsa, Oklahoma 74102
Each of the undersigned OWNERS guarantees and warrants he is the owner of the interest set out opposite his name on the reverse side
hereof in oil and gas or the proceeds from the sale of oil and gas from the property described on the reverse side hereof,and until further
• written notice either from you or from us,the undersigned owner and all other parties executing this instrument hereby authorize you,your
successors or assigns to receive and measure such sales in accordance with applicable governmental rules and regulations and to give credit
as set forth on the reverse side hereof.
The following covenants are parts of this instrument and shall be binding on the undersigned, their successors, legal representatives,and '+ r"
assigns. J —
Oil: Oil sold hereunder shall be delivered f.o.b.to the carrier designated to gather and receive such oil, and shall become your property -d 0
upon receipt thereof by the carrier designated by you or by any other purchaser to whom you may resell such oil.The term"oil"as ;„ 0
used in this division order shall include all marketable liquid hydrocarbons.
Should the oil produced from the herein described land be commingled with oil produced from one or more other separately owned j' 7,
tracts of land prior to delivery to the designated carrier,the commingled oil sold hereunder shall be deemed to be the interest of the D n
undersigned in that portion of the total commingled oil delivered which is allocated to the herein described land on the basis of lease j ['3
meter readings or any other method generally accepted in the industry as an equitable basis for determining the quantity and quality
of oil sold from each separately owned tract.Such formula shall be uniformly applied to all owners of an interest in the tracts of land
involved. Z `0
Should the interest of the undersigned in the oil produced from the herein described land be unitized with oil produced from one or Z Ca
more other tracts of land, this instrument shall thereafter be deemed to be modified to the extent necessary to conform with the -,,
applicable unitization agreement or plan of unitization,and all revisions or amendments thereto,but otherwise to remain in force and ni a
effect as to all other provisions. In such event,the portion of the unitized oil sold hereunder shall be the interest of the undersigned 0 a
in that portion of the total unitized oil delivered which is allocated to the herein described land and shall be deemed for all purposes T�
to have been actually produced from said land. ✓; 0
You agree to pay for the oil sold hereunder at the price posted by you for oil of the same grade and gravity in the same producing —; -.4
field or area on the date said oil is received by you or the designated carrier. If you do not currently post such a price,then until _ N.
such time as you do so, you agree to pay the price established by you.You are authorized to reduce the price by those truck,barge, z w
tankcar, or pipe line transportation charges as determined by you. N.
Should the oil sold hereunder be resold by you to another purchaser accepting delivery thereof at the same point at which you take :7 cc
title, you agree to pay for such oil based upon the volume computation made by such purchaser and at the price received by you r f..:
for such oil, reduced by any transportation charges deducted by such purchaser. X
Quality and quantity shall be determined in accordance with the conditions specified in the price posting.You may refuse to receive x
any oil not considered merchantable by you. `"'g
Gas: Settlements for gas shall be based on the net proceeds realized from the sale thereof, after deducting a fair and reasonable charge 2' r.?
for compressing and making it merchantable and for transporting if the gas is sold off the property.Where gas is sold subject to 7 f.
regulation by the Federal Power Commission or other governmental authority,the price applicable to such sale approved by order of rn
such authority shall be used to determine the net proceeds realized from the sale.
Settlements: Settlements shall be made monthly by check mailed to the respective parties according to the division of interest herein 0
specified at the latest address known by you, less any taxes required by law to be deducted and paid by you applicable to owner's
interest. m to
Evidence of Title: The oil and gas lease or leases, and any amendents, ratifications, or corrections thereof, under which said gas and/or oil xi a
is produced are hereby adopted, ratified, and confirmed as herein and heretofore amended. In the event any dispute or question £
arises concerning the title to the interest of the undersigned in said land and/or the oil or gas produced therefrom or the proceeds �,.t 9
thereof, you will be furnished satisfactory abstracts or other evidence of title upon demand. Until such evidence of title has been
furnished and/or such dispute,defect,or question of title is corrected or removed to your satisfaction,or until indemnity satisfactory
to you has been furnished, you are authorized to withold the proceeds of such oil or gas received and run,without interest. In the
event any action or suit is filed in any court affecting the title to the interest of the undersigned in the herein described land or the 2 L':
oil or gas produced therefrom or the proceeds thereof to which the undersigned is a party,written notice of the filing of such suit or ..
action shall be immediately furnished you by the undersigned,stating the court in which the same is filed and the title of such suit or 0
action.You will not be responsible for any change of ownership in the absence of actual notice and satisfactory proof thereof. C; 0
Contingent Interests: Whether or not any contingency is expressly stated in this instrument,you are hereby relieved of any responsibility for '—"''
determining when any of the interests herein shall increase, diminish,terminate, be extinguished or revert to other parties as a result
of the completion or discharge of money or other payments from said interest, or as a result of the expiration of any time or term _.—-
limitation(either definite or indefinite), and, unless you are also the operator of the property, as a result of an increase or decrease in
production,or as a result of a change in the depth,the methods or the means of production,or asa result of a change in the allocation
of production affecting the herein described land or any portion thereof under any agreement or by order of Governmental authority,
and until you receive notice in writing to the contrary,you are hereby authorized to continue to remit without liability pursuant to the
division of interest shown herein.
Warranties: Working Interest Owners and/or Operators,and each of them, by signature to this instrument,certify,guarantee and warrant,
for your benefit and that of any pipe line or other carrier designated to run or transport said oil or gas,that all oil or gas tendered here-
under has been and shall be produced from or lawfully allocated to the herein described land in accordance with all applicable Federal,
state and local laws,orders, rules and regulations.
This instrument may be executed by one or more, but all covenants herein shall be binding upon any party executing same and upon
his heirs,devisees,successors,and assigns irrespective of whether other parties have executed this instrument.
A� /_1ess o ignature r NN Street or Box No.
cial Security Ior Tax ID)Number City,State,Zip
Witness of Signature Name Street or Box No.
Social Security)or Tax ID)Number City,State,Zip
Witness of Signature Name Street or Box No.
Social Security(or Tax ID)Number City,State,Zip
46
`TS
AMOCO Amoco Production Company
_'— Amoco Building
P.O. Box 591
Tulsa, Oklahoma 74102
QUALIFIED ROYALTY OWNER' S EXEMPTION
Owners who may qualify for exemption from Crude Oil Excise Tax
(commonly referred to as Windfall Profit Tax).
The Economic Recovery Tax Bill of 1981 provides that beginning in 1982 and
in subsequent years, specified amounts of a qualified royalty owner' s royalty
production are exempt from crude oil excise tax. The amount of exemption
is two barrels per day for 1982 through 1984 and three barrels per day for
1985 and thereafter.
For you to take advantage of this exemption, you must certify to the pur-
chaser (or other withholding agent) by using IRS Form 6783. This Certifi-
cation Form (6783) requires that you certify under the penalties of perjury,
on a property by property basis, each property that you want the exemption
applied to.
Enclosed is a copy of Form 6783 so that you may review the instructions and
determine if you can qualify for the exemption. If you determine that you
meet the three conditions to qualify, as provided in the instructions for
Form 6783, please complete and sign the form and date it or we cannot accept
it as a valid certification.
Please notice that Form 6783 includes a provision for revocation of a pre-
viously filed certification under Part B. If you should determine that you
are no longer able to certify your production from a property then you must
send Amoco a completed Part B revoking the specific property(ies) previously
certified.
Any new properties that may begin production at a later date will also require
a supplemental certification on Form 6783 in order for Amoco to exempt your
interest from the tax.
If you qualify, please return the completed certification form to the follow-
ing address as soon as possible.
Amoco Production Company
P. O. Box 591
Tulsa, Oklahoma 74102
Attention: Compliance Coordination Group
BUSINESS r+SS0CIATE NUMBER
6783 OMB No. 1545-OGIS
Form Qualified Royalty Owner's Exemption Expires 9-30-84
InteDeprne:
Re a the Seeasury rvice
Inhrnat Revenue Service Certificate
(December 1981)
Name I Taxpayer Identifying Number
Number and street
City or town,State and ZIP code
Part A—Royalty Owner's Exemption Certificate.
I certify that I am a qualified royalty owner(as defined in section 6429(d)(1)) and that all of my production from the property(ies)
listed below qualifies for exemption from the withholding of windfall profit tax.
The total qualified royalty production from these property(ies) (plus qualified royalty production from other properties that I have
certified) does not exceed my share of the maximum amount exempt for qualified royalty owners.(Attach additional sheets, if needed).
Property#1
Full lease name Identifying number,if applicable
Location
Property #2
Full lease name Identifying number,if applicable
Location
Property #3
Full lease name Identifying number, if applicable
Location
Property #4
Full lease name Identifying number,if applicable
Location
Part B—Revocation of a Previously Filed Certificate.
I am revoking my previously filed certificate with respect to the property(ies) listed below. (Attach additional sheets, if needed,)
Property #1
Full lease name Identifying number,if applicable
Location
Data original certificate was filed
Property #2
Full lease name Identifying number,If applicable
Location
Date original certificate was filed
Under penalties of perjury, I declare that I have examined this exemption certificate and to the best of my knowledge and belief, it is true.
Please correct, and complete.
Sign
Here Signature Date
For Paperwork Reduction Act Notice,see back of this form. Form 6783 (12-81)
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Instructions To All Interest Owners
Read Carefully Before Signing The Instrument
This instrument should not be altered in any way unless accompanied by documentary
evidence to support the change.
If your name and interest are correctly shown:
Signature: Sign name as shown on the instrument. Have your signature witnessed.
If signing for a corporation, signature must be attested, corporate seal affixed,
and title of signatory party shown.
Signature by Second If the instrument is signed by agent, attorney-in-fact, guardian or any party
Party: other than the named interest owner, we must have evidence of the rights
vested in the signatory party.
Taxpayers Identification Insert your number in the space provided below your name on the instrument
Number or Social in accordance with the instructions reproduced on the reverse side hereof.
Security Number:
Mailing Address: Insert the address to which checks are to be mailed. Print or type. Do not
abbreviate. If you are already receiving checks from this company, be sure to
use the same address to which we are now mailing checks.
Property Number: In the upper right corner of the instrument you will find the number assigned
to this property. This number will appear on the statement attached to your
check and should always be used when corresponding with this company.
Settlement for your Upon receipt of the properly executed instrument and evidence of clear title,
Interest: the interest credited to you will be authorized for payment. Instruments must
be received in our office by the 20th of the month for checks to be issued the
following month. Checks will be mailed monthly when accruals to your interest
equal $25.00 or more. In November of each year payment will be made for all
accumulated sums of more than $1.00.
Change of Address: You should notify us promptly of any change in your mailing address. This
notice must be over your own signature, or the signature of your appointed
agent. Always include your business associate number and your old address,
then state your new address with zip code.
Return the executed instrument without delay to the address below. Keep one copy for
your records.
Amoco Production Company
(Attention: Division Order Section)
P.O. Box 591
Tulsa, Oklahoma 74102
Any questions about your payments or other matters involving your interest should be directed to
the above address, Attention:
Royalty/Interest Owner Relations — Phone (918) 581-4800.
Form 1104 Nov 82 (See reverse side for additional information)
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